Background: Carbapenem resistance is a major and ongoing public health problem globally and locally. It occurs mainly among Gram-negative pathogens such as Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii. Most of the carbapenemase-producing bacteria are multidrug resistant, including 3rd generation of cephalosporin and carbapenems. It may be intrinsic or mediated by transferable carbapenemase-encoding genes. This type of resistance gene is already widespread in certain parts of the world, mainly Europe, Asia, and South America. Objective: To isolate and identify WHO-declared carbapenemase-producing deadliest drug resistance bacteria with their antibiogram in the Rajshahi region. Materials Method: Cross sectional descriptive study was done from July 2017 to June 2018. Wound swab was collected in different surgical and burn units of Rajshahi Medical College Hospital. The specimens were inoculated in blood agar, nutrient agar, and MacConkey's agar media and incubated aerobically at 370 C for 24 hours. Susceptibility tests of the bacterial isolates were done by using the modified Kirby Bauer disk diffusion method on Mueller Hinton agar media. Carbapenemase-producing bacteria were identified by using the modified Hodge test. Results: Out of the total 250 samples, culture yielded growth in 213(85.2%) cases, and 37(14.8%) yielded no increase. Females were predominant 146(58.4%) in comparison to males 104(41.6%), with a male-female ratio of 1: 1.4. A maximum of 47.2% of cases were between 19-30 years old. Among the culture-positive isolates, gram-negative organisms were higher (58.8%) than gram-positive (41.2%). S. aureus was the predominant organism 71(30.8%), followed by P. aeruginosa 47(20.3%), E.coli 43(18.7%), and Acinetobacter baumannii 07 (3%). Among seven isolated Acinetobacter baumannii, 47 isolated P. aeruginosa, and 82 isolated Enterobacteriaceae: 6(85.7%), 33(70.2%), and 53(64.6%) were MDR; and 4(57.1%), 12(25.5%) and 14(17%) were carbapenemase-producers respectively. Conclusion: Most of the isolated carbapenemase-producing bacteria are multidrug resistant, and they tend to cause complicated infections. In addition, the expression of specific virulent factors, difficulty in diagnosis, and the non-availability of newer generation antibiotics make them one of the deadliest bacteria. TAJ 2022; 35: No-1: 91-98
Background: Dermatophytosis is considered one of the most common public health problems in the world and is the most commonly diagnosed skin disease in Bangladesh. The prevalence and types of dermatophyte infections vary with climate conditions, age, lifestyle, and population migration patterns. Depending upon the anatomical site of the lesion, dermatophytes are classified into different varieties. Objective: To isolate dermatophytes and their antifungal susceptibility pattern by agar-based disc diffusion method in the Rajshahi region. Materials and Methods: Clinical samples (e.g., skin scrapings, nail clipping, and hair plucking) were collected under aseptic precautions. The identification of dermatophytes was performed through a microscopic examination using 10% KOH mount, mycological culture, and species identification by lactophenol cotton blue mount from culture. In addition, all dermatophytes isolates were subjected to antifungal susceptibility testing using the agar-based disc diffusion method. Results: Out of 171 samples, Trichophyton rubrum was the predominant dermatophyte species with 76(71.7%), followed by T.mentagrophyte were 15(14.2%), E. floccosum were 12(11.3%), and M. canis were 03(2.8%). Voriconazole and Itraconazole were more effective drugs. Griseofulvin was the least effective drug, followed by Fluconazole. Conclusion: Despite several treatment options being available for cutaneous fungal infections, Due to the increasing trend of antifungal drug resistance among dermatophytes, treatment should be based on antifungal sensitivity testing. The disc diffusion method is a simple and valuable method for the evaluation of antifungal susceptibility of dermatophytes. TAJ 2022; 35: No-1: 99-106
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