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This article focuses on examining the structure of microorganisms and their antimicrobial drug resistance during the provision of in-hospital medical care for patients with COVID-19. Among monotypic fungal infections, Candida albicans predominated at 46.82% (n = 375), followed by Candida glabrata at 21.97% (n = 176). Streptococcus pneumoniae accounted for 25.24% (n = 617), while the combined antimicrobial presence of S. pneumoniae with Candida species represented 11.17% (n = 273), ranking highest in isolation frequency among all microorganisms. In deceased patients, the dominant pathogens identified were Klebsiella pneumoniae at 36.3% (n = 159) and Candida fungi at 21.92% (n = 96). Analysis of antimicrobial resistance revealed that S. pneumoniae (n=890) exhibited low resistance rates to benzylpenicillin (4.2%, n = 37), levofloxacin (11.5%, n = 102), and linezolid (0%), but showed elevated resistance to erythromycin (27.4%, n = 244), lincomycin (25.2%, n = 224), and doxycycline (15.5%, n = 141). The vast majority of K. pneumoniae isolates (n = 326) demonstrated resistance to ampicillin (97.9%), cefuroxime (94.2%), cefotaxime (87.7%), ceftazidime (85%), and cefepime (73%), with comparatively lower resistance to amoxicillin-clavulanic acid (52.1%, n = 170) and meropenem (33.4%, n = 109). Microorganisms exhibiting pan-drug resistance accounted for 7.6% (n = 125) of isolates, with the highest proportion of PDR strains attributed to K. pneumoniae, comprising 33.4% (n = 109) of all Klebsiella isolates. C. albicans and S. pneumoniae are the most frequently isolated pathogens among COVID-19 patients receiving inpatient care. The rising detection of extensively drug-resistant (XDR) and pan-drug-resistant (PDR) Klebsiella spp. underscores the critical need for careful selection of empirical antibacterial therapies.

This investigation examined the bacterial profile and patterns of antibiotic resistance among cancer patients receiving care at B.P. Koirala Memorial Cancer Hospital in Bharatpur, Chitwan. Employing a hospital-based cross-sectional design, the study processed 384 clinical specimens obtained from cancer patients. Once bacterial growth was observed on selective and differential culture media, Gram staining was used as a preliminary identification method. Organisms were subsequently characterized based on their biochemical features, and antibiotic susceptibility testing was performed using the Kirby-Bauer disk diffusion technique. The results, measured by determining the diameter of the inhibition zones, adhered to the Clinical and Laboratory Standards Institute (CLSI) guidelines established in 2020. Data analysis was conducted using SPSS version 20.0.Among the 384 individuals included, 55.4% were male and 44.6% female. Bacterial growth was detected in 43.5% of the total specimens analyzed. A comparison between cancer types showed that hematogenous malignancies accounted for 40.7% of the positive cultures, while 45.5% were associated with non-hematogenous cancers. The most frequently isolated organism was Escherichia coli, making up 38.9% of isolates, followed by Klebsiella species (20.4%), Pseudomonas species (19.2%), Citrobacter species (9.0%), and Acinetobacter species (4.8%). Additionally, Staphylococcus aureus and Enterobacter aerogenes were detected in 3.6% and 3.0% of cases, respectively, while Proteus species and coagulase-negative Staphylococci (CoNS) accounted for 0.6% each. Regarding antibiotic resistance, E. coli demonstrated substantial resistance to amoxicillin (98.5%), followed by ciprofloxacin (73.9%) and cotrimoxazole (67.7%), whereas resistance to amikacin remained low. In contrast, S. aureus, the predominant gram-positive isolate, exhibited complete resistance (100%) to amoxycillin, ciprofloxacin, cloxacillin, and cephalexin (each at 66.7%), but remained fully sensitive to both Amikacin and Tigecycline. Overall, gram-negative bacteria were more frequently identified than gram-positive bacteria. The findings highlight the vulnerability of cancer patients to infections by opportunistic organisms, including multidrug-resistant (MDR) strains, underscoring the urgent need for robust antimicrobial stewardship and ongoing surveillance of antibiotic resistance trends.