{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T05:12:17Z","timestamp":1736226737423,"version":"3.32.0"},"reference-count":45,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T00:00:00Z","timestamp":1732665600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microbiology and Immunology"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Multidrug\u2010resistant (MDR) bacteria cause infections with higher risks of morbidity, mortality, and financial burden. Understanding the antimicrobial resistance patterns of these pathogens is crucial for effective treatment and managing resistance. Therefore, this retrospective study examined the prevalence, causes, and trends in antimicrobial resistance in bacterial infections at a neurosurgical hospital in Nepal. We analyzed the demographics, bacteriological profiles, and antimicrobial susceptibility results in patients who visited Dirghayu Guru Hospital and Research Center, Kathmandu, Nepal, between January 2014 and January 2024, using SPSS, version 17.00. Among 4758 patients, 465 (9.77%) had infections caused by 571 bacteria. Of them, 435 (93.55%) patients had urinary tract infections, 89 (19.14%) had bloodstream infections, and 31 (6.67%) had respiratory tract infections. <jats:italic>Klebsiella pneumoniae<\/jats:italic> (n\u2009=\u2009172, 30.12%) was the predominant bacteria. Proportions of drug\u2010resistant Enterobacterales and gram\u2010positive cocci among drug\u2010resistant bacteria against tetracyclines were 83.33% and 45.83%, cephalosporins were 78.02% and 40.45%, quinolones were 72.25% and 50.00%, aminoglycosides were 65.14% and 43.53%, carbapenems were 62.96% and 30.00%, penicillins were 54.55% and 57.89%, and penicillin with beta\u2010lactamase inhibitors (PwBLIs) were 40.54% and 42.31%, respectively. Proportions of drug\u2010resistant nonfermenters among drug\u2010resistant bacteria showed 100.00% resistance to these antimicrobials. MDR isolates (<jats:italic>n<\/jats:italic>\u2009=\u2009118, 20.67%) were 100.00% susceptible to piperacillin\u2013tazobactam and 83.33% to polymyxin B. Over the years, resistance increased for cephalosporins (48.15%\u201360.53%) but decreased for carbapenems (50.00%\u201333.33%), penicillins (64.29%\u201342.31%), PwBLIs (50.00%\u201312.50%), aminoglycosides (60.00%\u201349.12%), tetracyclines (100.00%\u201316.67%), and polymyxins (76.22%\u201316.67%). One\u2010tenth of hospital\u2010visiting patients had bacterial infections, with three\u2010fourths involving Enterobacterales and one\u2010fifth involving MDR bacteria. In recent years, resistance to cephalosporins has increased, whereas resistance to other beta\u2010lactams, aminoglycosides, and polymyxins has decreased.<\/jats:p>","DOI":"10.1111\/1348-0421.13185","type":"journal-article","created":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T10:00:27Z","timestamp":1732701627000},"page":"10-24","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Decade\u2010Long Analysis of Trends in Antimicrobial Resistance in a Neurosurgical Hospital in Kathmandu, Nepal"],"prefix":"10.1111","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8951-6490","authenticated-orcid":false,"given":"Ajaya","family":"Basnet","sequence":"first","affiliation":[{"name":"Department of Microbiology Nepal Armed Police Force Hospital Kathmandu Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Apurba","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Nepal Armed Police Force Hospital Kathmandu Nepal"},{"name":"Department of Internal Medicine Dirghayu Guru Hospital and Research Center Pvt. Ltd. Kathmandu Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gopal Raman","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Neurosciences Nepal Mediciti Hospital Lalitpur Nepal"},{"name":"Department of Neurosciences Dirghayu Guru Hospital and Research Center Pvt. Ltd. Kathmandu Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shila","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Blood Bank Unit, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University Teaching Hospital Kathmandu Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laxmi Kant","family":"Khanal","sequence":"additional","affiliation":[{"name":"Department of Microbiology Nepal Medical College and Teaching Hospital, Attarkhel Kathmandu Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junu Richhinbung","family":"Rai","sequence":"additional","affiliation":[{"name":"Department of Microbiology Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Institute of Medicine, Maharajgunj Kathmandu Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajendra","family":"Maharjan","sequence":"additional","affiliation":[{"name":"Department of Pathology Nepal Armed Police Force Hospital Kathmandu Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bijaya","family":"Basnet","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Houston Methodist Hospital Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shiba Kumar","family":"Rai","sequence":"additional","affiliation":[{"name":"Department of Microbiology Nepal Medical College and Teaching Hospital, Attarkhel Kathmandu Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,11,27]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13756-017-0222-z"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciab773"},{"key":"e_1_2_11_4_1","doi-asserted-by":"crossref","unstructured":"A Tool for the Potential Fall 2009 Wave of Pandemic H1N1 to Guide Public Health Decision\u2010Making: An Overview of the Public Health Agency of Canada's Planning Considerations September 2009.The Canada Communicable Disease Report36 no.Suppl 3(2010):1\u201320.","DOI":"10.14745\/ccdr.v36i00as3"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2017.01041"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/iub.2356"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003139"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/5474388"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)02724-0"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.10.010360"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41182-021-00313-3"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/2314808X.2021.1905464"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2019.00105"},{"volume-title":"Koneman's Color Atlas and Textbook of Diagnostic Microbiology","year":"2020","author":"Procop G. 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