Background & Objectives: Emergence of drug resistant Tuberculosis (TB) is a major obstacle in the TB control programme of Bangladesh. This study was carried out to detect pre-extensively drug resistant TB (pre-XDR-TB) cases among the multidrug resistant TB (MDR-TB) patients in Bangladesh, as the early detection of pre-XDR-TB can guide clinicians in the appropriate modification of MDR-TB treatment regimen with effective drugs to prevent treatment failure. Methodology: A total of 68 MDR-TB cases were enrolled in this study. Multiplex Real-time PCR was done to detect pre-XDR-TB cases directly from sputum samples of MDR-TB patients. Results: Out of 68 MDR-TB cases 11 (16.18%) cases were detected as pre-XDR-TB. The resistant profile of the 11 pre-XDR-TB revealed 9 (81.82%) cases of fluoroquinolone (FLQ) resistant pre-XDR-TB and 2 (18.18%) cases of injectable second line (ISL) agent resistant pre-XDR-TB. Out of 11 pre-XDR-TB cases 7 (63.64%) cases had history of taking treatment for MDR-TB regularly, 1 (9.09%) case had history of taking treatment for MDR-TB irregularly and 3 (27.27%) cases had no history of taking treatment for MDR-TB. Conclusion: This study encountered a high rate of pre-XDR-TB cases along with a significant number of primarily resistant bacilli which is of concern in the management of MDR-TB. It is evident that Bangladesh is in urgent need to device strategies for rapid and early detection of pre-XDR-TB in order to prevent treatment failure of MDR-TB cases and also to halt the progression of MDR-TB cases to extensively drug resistant TB (XDR-TB), which is not only difficult but also very expensive to treat.
Background and objectives: Fluoroquinolones (FLQs) are an essential component of multidrug resistant-tuberculosis (MDR-TB) treatment regimen but unfortunately the emergence of FLQ resistant MDR-TB cases is challenging the current MDR-TB treatment regimen. FLQ resistance is mainly caused by gyrA gene mutation and phenotypic cross-resistance may occur among the different FLQs. A limited number of data exists regarding the cross-resistance phenomenon among FLQs and it appears that resistance to the present class representative FLQ, ofloxacin (OFX), may or may not correlate with complete cross-resistance to other FLQs. So the study was designed to observe if gyrA gene mutations confer to the phenotypic cross-resistance among FLQs [OFX, Levofloxacin (LFX) and Gatifloxacin (GFX)] tested. Methodology: Sputum samples from 68 diagnosed pulmonary MDR-TB cases were collected. All samples were subjected to Multiplex Real-time PCR for the detection of gyrA gene mutations and conventional culture on Lowenstein-Jensen (L-J) media followed by drug sensitivity testing (DST) of culture isolates (MDR-TB strains) by indirect proportion method for the detection of phenotypic resistance pattern to OFX, LFX and GFX. Results: Out of the 68 MDR-TB sputum samples 13 (19.11%) had MDR-TB bacilli with mutations in the gyrA gene and 11(16.18%
Background: This study aimed to investigate the epidemiology and antibiogram of clinical Staphylococcus aureus isolates from three tertiary care hospitals in Dhaka , Bangladesh. Methods: A total of 185 clinical S. aureus isolates were studied from March 2016 to February 2017 and identified by standard microbiological methods and an antibiogram was determined by disc diffusion method. A duplex polymerase chain reaction (PCR) assay was performed on all isolates to detect femA and mecA genes of S. aureus. Results: Among the 185 isolates, all (100%) were positive for the femA gene, 76 (41.1%) were methicillinresistant S. aureus (MRSA), and 109 (58.9%) were methicillin-susceptible S. aureus (MSSA). The highest and the lowest frequency of both MRSA were isolated from pus and urine specimens, respectively. All 185 S. aureus were 100% sensitive to both vancomycin and linezolid and were highly sensitive towards rifampicin (94%), meropenem (87%), gentamicin (85.4%), and cotrimoxazole (82.2%), whereas the highest resistance was against penicillin G (94.6%) followed by amoxicillin/clavulanic acid (82.7%), azithromycin (72.4%), amoxicillin (66.5%), and ciprofloxacin (63.2%). After vancomycin and linezolid, MRSA showed good susceptibility to rifampicin, cotrimoxazole, and gentamicin, while MSSA exhibited high sensitivity toward rifampicin, gentamicin, cefoxitin, meropenem, cloxacillin, ceftriaxone, and cotrimoxazole. Furthermore, MRSA was significantly more resistant to antibiotics than MSSA (P value<0.05), and the majority of S. aureus (81.1%), MRSA (97.4%), and MSSA (69.7%) were multidrug-resistant (MDR). Conclusion: Our findings can guide physicians to provide effective antibiotic therapy, implement monitoring and control strategies to reduce antimicrobial resistance, and prevent the dissemination of MRSA and MDR in the environment.
Background: This study was carried out to evaluate the utility of multiplex real-time polymerase chain reaction (PCR) to identify the common bacterial agents of community acquired pneumonia (CAP). Methods: Sputum and blood samples were collected from 80 clinically suspected CAP patients in three tertiary-level hospitals in Dhaka city. Multiplex real-time PCR assay was carried out to simultaneously detect five common bacterial agents of CAP; Streptococcus pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Legionella pneumophila. Routine microbiological methods and serology were carried out. The results of PCR were compared with culture, Gram stain and serology. Results: Among the 80 patients, sputum samples of 35 (43.7%) patients were positive by PCR, of which the most commonly detected bacteria were S. pneumoniae (25/35, 71.4%), followed by H. influenzae (9/35, 25.7%) and L. pneumophila (1/35, 2.9%). All 80 sputum samples were negative for both M. pneumoniae and C. pneumoniae by PCR. Out of the 26 culture positive sputum samples, 8 (30.7%) were positive for S. pneumoniae and 1 (3.8%) was positive for H. influenzae. Among the 52 Gram stain valid sputum samples, 24 (46.1%) were S. pneumoniae and 7 (13.5%) were H. influenzae. By serology, out of the 80 cases, M. pneumoniae was detected in 32 (40%) and C. pneumoniae in 24 (30%) of cases. Mixed infections comprised of 38.8% (31/80) cases. Conclusion: Multiplex real-time PCR is useful for the rapid and simultaneous detection of bacterial pathogens of CAP in sputum and can help support traditional laboratory methods for the accurate diagnosis of CAP patients. Bangabandhu Sheikh Mujib Medical University Journal 2023;16(1): 17-25
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.