Skip to main content

Table 1 Number of different bacterial pathogens isolated and reported by the AMR surveillance by participating laboratories during 1999 to 2012

From: The challenges and successes of implementing a sustainable antimicrobial resistance surveillance programme in Nepal

Year Vibrio cholerae* Shigellaspp.** Streptococcus pneumoniae*** Haemophilus influenzae**** Neisseria gonorrhoeae***** Salmonellaspp.****** ESBL Escherichia coli******* Total
1999 61 8 55 2 18 NI NI 144
2000 244 33 155 25 36 NI NI 493
2001 4 40 141 57 21 NI NI 263
2002 25 48 54 115 9 44 NI 295
2003 78 36 56 56 22 745 NI 993
2004 290 43 83 25 2 510 NI 953
2005 62 51 132 60 14 692 NI 1010
2006 32 23 92 38 5 1611 NI 1801
2007 204 37 120 185 5 1512 NI 2063
2008 148 17 189 136 16 1697 NI 2203
2009 109 20 213 101 13 1307 14 1764
2010 45 9 165 35 7 1525 86 1872
2011 1 11 163 71 6 1018 76 1346
2012 35 14 257 27 7 1102 447 1889
Total 1338 390 1875 933 181 11763 623 17103
  1. Susceptibility of all consecutive isolates collected in the participating laboratories was determined by disk diffusion method [8].
  2. *Susceptibilities for tetracycline, erythromycin, ciprofloxacin, furazolidone, cotrimoxazole, nalidixic acid and ampicillin were determined; a shift in serovars with changing antimicrobial resistance trends was observed for V. cholerae, yet the El Tor biotype remained predominant.
  3. **Susceptibilities for ampicillin, ciprofloxacin, cotrimoxazole, nalidixic acid, mecillinam, and azithromycin were determined. S. dysenteriae was the predominant species during 1999 – 2004 and S. flexneri during 2005 – 2009. S. dysenteriae was predominant in eastern Nepal, while S. flexneri dominated in the western Nepal. Ciprofloxacin resistant S. dysenteriae was common before 2005, which then decreased up to 2007, and re-emerged in 2008. An overall multiresistance rate of 33-75% in shigella isolates was found with individual temporal and species variations from S. dysenteriae to S. flexneri.
  4. ***Susceptibilities for penicillin, ampicillin, erythromycin, ciprofloxacin, cotrimoxazole, chloramphenical, and ceftriaxone were determined; S. pneumoniae maintained a persistently high level of resistance (58-74%) to cotrimoxazole. Amoxicillin resistance increased to 13% in 2010. One-third of the pneumococcal strains were isolated from children below 15 years with 21% of all isolates from children less than five years of age.
  5. ****Susceptibilities for penicillin, ampicillin, amoxi-clav, ciprofloxacin, cotrimoxazole, erythromycin, chloramphenicol, azithromycin and ceftriaxone were determined. Cotrimoxazole resistance remained high (up to 60%) while more than a quarter of the isolates were resistant to at least ampicillin, penicillin and erythromycin. Penicillin resistance reached 100% in 2010.
  6. *****Susceptibilities for penicillin, tetracycline, ciprofloxacin, spectinomycin, azithromycin and ceftriaxone were determined. Prevalence of resistance was high for ciprofloxacin (14-30%) and tetracycline (more than 70%). Ceftriaxone remained 100% susceptible.
  7. ******Susceptibilities for ampicillin, tetracycline, ciprofloxacin, cotrimoxazole, nalidixic acid, chloramphenicol, and ceftriaxone were determined. Increasing resistance of S. Typhi and S. Paratyphi A to nalidixic acid was observed (the resistance rate was higher among S. Paratyphi A than among S. Typhi. The prevalence of S. Paratyphi A increased annually indicating changing epidemiology. Multi drug resistance (MDR-resistance to ampicillin, chloramphenicol and cotrimoxazole) at a time among salmonella isolates declined from 2002 onwards, and newly emerged MDR isolates (resistant to fluoroquinolone [ciprofloxacin, ofloxacin] and nalidixic acid with additional resistance to tetracycline and cotrimoxazole) were identified in 2005, 2006, 2008, 2009 and 2010. MDR phenomenon has increased again from 2009 (7%) and 2010 (8%). Chloromphenicol sensitivity re-emerged (96% in 2010).
  8. *******All isolates exhibited 100% resistance towards quinolones viz. norfloxacin and ofloxacin followed by 99% resistance to ciprofloxacin. ESBL E.coli were found to be susceptible to gentamicin (67%) followed by vhloramphenicol(66%) and amikacin(59%).
  9. NI, not included in the surveillance.