Background: Respiratory tract infections (RTIs) are significant health concern for mortality and morbidity in many developing countries. Proper identification of causative pathogens and their antibiotic susceptibility testing is needed to select appropriate antibiotic therapy for management of the patient suffering from RTI. The study was aimed to determine the spectrum of bacterial pathogen causing respiratory tract infections with their antibiogram in Dhaka Medical College hospital (DMCH), Dhaka, Bangladesh. Methods: This observational study was conducted from October 2018 to March 2019 in DMCH. Respiratory tract specimens (sputum, tracheal aspirate and throat swab) sent to the Microbiology laboratory for culture and sensitivity test were included in this study. Data regarding information of the patients, isolated organisms and sensitivity reports were collected from the records of the Microbiology laboratory. Results: Out of 580 processed specimens, 64.66% yielded significant growth of organisms of which 88.80% were gram negative and 11.20% were gram positive bacteria. Pseudomonas spp was the most commonly (31.47%) isolated organism followed by Klebsiella spp (23.47%), Escherichia coli (15.20%) and Staphylococcus aureus (8.53%). Gram negative bacteria were mostly resistant to amoxicillin followed by fluoroquinolones, cotrimoxazole, cephalosporins whereas colistin, carbapenems and piperacillin/tazobactum were the most sensitive antibiotics against them. Among gram negative bacteria, 31.23% were extended spectrum beta lactamase (ESBL) producing organisms and Klebsiella spp were the most commonly isolated ESBL producers. Majority of gram positive bacteria were resistant to fluoroquinolones and co-trimoxazole but all Staphylococcus aureus were susceptible to vancomycin and linezolid followed by teicoplanin (84%) and 37.5% of them were Methicillin resistant (MRSA). Conclusion: Gram negative bacteria were predominant where Pseudomonas spp and Klebsiella spp were most commonly isolated organisms. Most of the bacteria showed high resistance to commonly used antibiotics and this antimicrobial resistance is a matter of concern for the treatment of respiratory tract infections. Bangladesh Medical Res Counc Bull 2023; 49(1): 15-21
Introduction: Rickettsial infections are re-emerging diseases and are major causes of febrile illnesses throughout the Asia-Pacific region. It is difficult to diagnose due to the non-specific clinical manifestations, absence of reliable and affordable diagnostic tests thereby contributes to increasing the acute febrile burden and preventive illness in many populations. Undiagnosed or late-diagnosed cases are associated with high morbidity and mortality. Objectives: The study aimed to determine rickettsial disease by Weil-Felix test and to know the frequency of rickettsial diseases in febrile patients presenting to tertiary care hospitals in Dhaka, Bangladesh. Methods: In this study, a total of 135 peripheral blood samples were taken and tested by Weil Felix test from clinically suspected patients of rickettsial fever. Results: Weil- Felix test was positive in 33((24.4%) cases. Of Weil- Felix test-positive cases, OX-2 was positive in 87.87% cases, followed by OX-K (6.06%), OX-19 (3.03%), and both OX-2 & OX-K (3.03%) cases. OX-2 positive cases are suggestive of spotted fever group, OX-K of scrub typhus group, OX-19 of typhus group, and OX-2 & OX-K are suggestive of both spotted fever group and scrub typhus group. This finding suggests that most cases were infected with spotted fever group rickettsiae (SFGR). Conclusion: Analyzing the present study's findings, it may be concluded that rickettsial infection is not uncommon in Bangladesh. Weil-Felix test can be used in laboratories to diagnose rickettsial diseases where specific reliable serological or molecular test is not available.
Background: Rickettsial infections are re-emerging arthropods born worldwide zoonotic disease caused by Rickettsia, which is responsible for spotted fever and typhus fever. The diagnosis of a rickettsial illness is important for appropriate antibiotic treatment. Aims: The study aimed to determine the diagnostic accuracy and clinical usefulness of using nested polymerase chain reaction (PCR) by comparing nested PCR, ELISA, and Weil-Felix (WF) tests. Methodology: This was a prospective type of cross-sectional study. A total of 135 clinically suspected rickettsial infection cases were enrolled. Peripheral blood was taken to detect gltA, 17 kDa lipoprotein antigen gene (17 kDa), ompA, and ompB gene of Rickettsia by nested PCR. ELISA and Weil-Felix tests were done to compare with nested PCR. Results: Out of 135 cases, we detected Rickettsia in 70(51.85%) cases by nested PCR assay (p<0.01), 33((24.4%) by Weil- Felix test, 34 (25.18%) by ELISA. Only 26.66% of cases were PCR positive, which were negative by both ELISA and Weil-Felix test. Fifteen (11.11%) cases were positive by all three tests. Among 70 PCR positive rickettsia cases most frequently detected gene was ompB 42(60%), followed by 17kDa 34(48.58%); gltA 21(30%), and ompA 3(4.28%). Multiple gene combinations (ompB, 17kDa and gltA) detected in 98.57 % cases. Conclusion: Nested PCR assays showed the highest rate of detection of rickettsia cases than ELISA and Weil-Felix test. Multiple gene combinations (ompB, 17kDa, and gltA) showed the highest positivity. Therefore, diagnosis of rickettsial infection can be confirmed by PCR assay, and clinicians can plan appropriate treatment for these patients.
Background & Objective: This cross sectional study was carried out to assess the diagnostic value of PCR in different forms of leprosy. For the detection of Mycobacterium leprae, DNA amplification by polymerase chain reaction of a 531-bp fragment of the Mycobacterium leprae specific gene encoding the 36 kDA antigen. Methodology: It was done on different clinical specimens (slit smear of skin, ear lobule smear and nasal smear) from 50 leprosy patients attending the Leprosy Hospital, Mohakhali, Dhaka. Patients were divided into two groups; paucibacillary (70%) group and multibacillary (30%) group. PCR showed 100% positivity in skin and ear lobule and 73.4% positivity in nasal smear of multibacillary group. PCR was positive in 40%, 25.7% and 11.4% in skin lesion, ear lobule and nasal swab in paucibacillry group respectively. Result: Compared with other diagnostic procedures, PCR showed clear advantages over both modified Z-N stain and auramine-phenol stain especially in paucibacillary patients. Bangladesh J Med Microbiol 2020; 14 (1): 11-14
Background: Pseudomonas aeruginosa are among the major nosocomial pathogens that demonstrate all known enzymatic and mutational mechanism of bacterial resistance. They are able to acquire drug resistant determinants by horizontal transfer of mobile genetic elements coding for class B carbapenemases, called metallo b lactamases which hydrolyze all b lactams except aztreonam. MBLs like bla VIM has been reported among isolates of Enterobacteriaceae family, P.aeruginosa and other gram negative nonfermenters. On the other hand NDM-1 was first identified in Klebsiella Pneumoniae. Its spread among Pseudomonaceae implies possibility of numerous New NDM-1 cases to be detected in near future. Objective: The study aimed to isolate VIM and NDM-1 producing P. aeruginosa from burn wound and to see their susceptibility pattern. Materials and methods: P. aeruginosa was isolated by culturing on Macconkey agar media both on 370 C and 420 C and biochemical test. For gene detection organisms were stored at -700C, bla VIM and bla NDM-1 was detected by PCR. Susceptibility pattern of organisms were done by Kirby Bauer Disc Diffusion Method. Result: Among the 98 isolated P. aeruginosa 21(47.7%) were VIM producers and 6 (13.6%) NDM-1 producers. VIM producers were 80.9% resistant to imipenem and NDM-1 producers were 100% resistant imipenem. Discussion: VIM producing P. aeruginosa was isolated from burn patient in accordance with other study, NDM-1 producing P. aeruginosa is emerging that are more resistant to conventional antibiotcs even to the last resort drug imipenem. Conclusion: Imipenem resistence is increasing among P. aeruginosa as a result of acquiring MBL genes. Risk factors for acquiring resistance is increased carbapenem use, longer hospital stay, ICU admission, being on total parenteral nutrition, using catheter and tubes. In this study patient in whom imipenem resistant isolates were identified had hospital stay more than 7 days Sir Salimullah Med Coll J 2022; 30: 35-39
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