Antimicrobial resistance in bacteria isolated from the poultry production system in Nepal.

SETTING: Twenty poultry farms in five provinces of Nepal were selected for studying bacterial pathogens and their antimicrobial resistance (AMR) patterns. OBJECTIVE: To document the proportion of cloacal swabs collected from 3,230 broiler and 3,230 layer chickens from September to December 2021 that grew isolates of Escherichia coli, Enterococcus spp. and Salmonella spp. along with their AMR patterns. DESIGN: This was a cross-sectional descriptive study. RESULTS: In broiler birds, Enterococcus spp., Salmonella spp. and E. coli were identified in respectively 36%, 39% and 63% of swabs. In layer birds, Enterococcus spp., Salmonella spp. and E. coli were identified in respectively 31%, 48% and 60% of swabs. For both bird types, there was variation in bacterial prevalence between the regions. For all three bacterial isolates, the lowest antimicrobial resistance was found with amikacin. For the other nine antibiotics tested, >50% of bacterial isolates showed resistance; between 60% and 90% of isolates showed resistance to ciprofloxacin and trimethoprim-sulfamethoxazole. Multidrug resistance ranged from 45% to 46% for Salmonella spp., 37-44% for E. coli and 13-17% for Enterococcus spp. CONCLUSION: This study shows that a large proportion of poultry in Nepal are infected with potentially pathogenic bacteria, and these are frequently resistant to commonly used antibiotics. Nepal urgently needs to implement corrective measures.

CONTEXTE: Vingt fermes avicoles dans cinq provinces du Népal ont été sélectionnées pour étudier les pathogènes bactériens et leurs profils de résistance aux antimicrobiens (AMR). OBJECTIF: Documenter la proportion d'écouvillons cloacaux prélevés chez 3 230 poulets de chair et 3 230 poules pondeuses de septembre à décembre 2021 qui ont produit des isolats d'Escherichia coli, d'Enterococcus spp. et de Salmonella spp. ainsi que leurs profils d'AMR. MÉTHODE: Il s'agissait d'une étude descriptive transversale. RÉSULTATS: Chez les poulets de chair, Enterococcus spp., Salmonella spp. et E. coli ont été identifiés dans respectivement 36%, 39% et 63% des écouvillons. Chez les pondeuses, Enterococcus spp., Salmonella spp. et E. coli ont été identifiés dans respectivement 31%, 48% et 60% des écouvillons. Pour les deux types d'oiseaux, la prévalence bactérienne varie selon les régions. Pour les trois isolats bactériens, la résistance la plus faible a été observée avec l'amikacine. Pour les neuf autres antibiotiques testés, >50% des isolats bactériens présentaient une résistance ; entre 60% et 90% des isolats présentaient une résistance à la ciprofloxacine et au triméthoprime-sulfaméthoxazole. La multirésistance variait de 45 à 46% pour Salmonella spp, 37 à 44% pour E. coli et 13 à 17% pour Enterococcus spp. CONCLUSION: Cette étude montre qu'une grande proportion de volailles au Népal est infectée par des bactéries potentiellement pathogènes, et que celles-ci sont fréquemment résistantes aux antibiotiques couramment utilisés. Le Népal doit de toute urgence mettre en œuvre des mesures correctives.

A study on clinical outcomes of people living with HIV/AIDS on anti retroviral therapy from rural hospital in Nepal.

Anti Retroviral Therapy has been started in Nepal since 2004 and the treatment centers have been upgrading all over the country regularly. A prospective observational study was carried out from August 2008 to December 2009 with an objective to evaluate clinical outcome of People Living with HIV/AIDS undergoing the therapy as per National Guidelines. After taking written informed consent pre-structured questionnaire was filled and patients were followed for next six months. All information were entered into SPSS 11.5 system and analyzed. Out of 44 patients, 24 (54.6%) were males and 20 (45.4%) were females. Age group 31-35 years were predominant 16 (36.6%) followed by 36-40 years 12 (27.2%). Clinically WHO stage III was found among 97.7% of the patients and 45.4% of housewives got HIV transmitted from husbands. Anti Retroviral Therapy was started in 25 (59.2%) of patients within three months HIV test positive. From initiation of therapy till six months there was, 1.7 kg of mean increase weight gain and 354 cells/mm3 increase in mean Total Lymphocyte Count. Opportunistic infections occurrence decreased significantly from 34.1% to 2.3% and 41 (93.2%) patients had drug adherence scale of more than 95 percentile. Hence it can be concluded that there is an urgent need of expanding the accessibility of the therapy to eligible patients throughout the country.

Central nervous control of venous tone. III. Responses of capacitance and resistance vessels of skin to bulbar and hypothalamic stimulation.

Electrical stimulation of 350 points in the bulbar formation of 35 dogs under chloralose anaesthesia demonstrated the presence of sites producing increase or decrease of systemic arterial pressure (SAP) in the same general morphological limits of bulbar pressor and depressor regions as described by earlier authors. Simultaneous recording of pressure changes in the cutaneous vessels however demonstrated that pressure changes in these vessels did not correspond to the pressor or depressor effects of the SAP. Instead, responses were obtained in which pressures in cutaneous capacitance and resistance vessels followed a trend which was opposite in direction and magnitude to that of SAP. Thus there were 30 depressor sites which produce increase in cutaneous vessel pressure and 23 pressor sites which produced a fall in cutaneous vessel pressure. For a marked rise in the SAP, only 62 sites elicited equally marked increase in both capacitance and resistance vessel pressure, while another 52 elicited only a small increase of equivalent magnitude in the capacitance and resistance vessels. Stimulation of 84 points produced dissimilar effects on capacitance and resistance vessels out of which 38 elicited moderate increase in resistance vessel tone with minimal changes in the capacitance vessel tone, while 46 points elicited moderate increase in capacitance vessel tone with only a small increase in the resistance vessel tone. These points were diffusely admixed in the bulbar reticular formation. Effects which were exclusive to the capacitance and resistance vessels of skin, singly or in combination, without affecting the SAP were elicited from 12 points while another 28 points produced marked rise or fall of systemic arterial pressure without affecting the cutaneous vessels. These observations suggest that the neuronal organisation regulating cardiovascular activities at the bulbar level is quite complex having the capacity to generate varying activities in different components of the vascular circuits by differentially altering the discharge of the efferent sympathetic fibres on the one hand, and marked selectivity of action on any particular vascular bed or circulatory component on the other hand. Stimulation of 93 points in the hypothalamus produced similar patterns of response as obtained from medulla oblongata. In addition, stimulation of 6 points in the anterior hypothalamus produced a distinctive response accompanied by dilatation of cutaneous resistance and capacitance vessels with marked increase in respiratory rate and minimal changes in the SAP. This type of response which resembled the physiological response employed for heat loss was not obtained from any stimulation site in the medulla oblongata.