Purpose: The purpose of this study was to detect biofilm formation in clinical isolates of Acinetobacter species and to observe correlation between biofilm formation and antimicrobial resistance among Acinetobacter isolates. Methods: Two hundred fifty six clinical samples collected from patients who were admitted in Intensive Care Unit (ICU) and on device, patients from Surgery, Medicine, Gynae & Obs and Urology department of Bangabandhu Sheikh Mujib Medical University (BSMMU) and from Burn unit of Dhaka Medical College Hospital were included in this study. Biofilm formation and antibiotyping were performed for the isolates of Acinetobacter species recovered from clinical samples including tracheal aspirates, blood, urine, wound swab, pus, throat swab, endotracheal tubes, burn samples, ascitic fluid, sputum, aural swab, oral swab, cerebrospinal fluid, and catheter tip. Correlation of biofilm formation with antimicrobial resistance pattern among Acinetobacter isolates were also observed in this study. Result: A total of 256 various specimens were studied of which 95 Intensive Care Unit (ICU) and 161 Non ICU samples. Out of 95 ICU and 161 Non ICU samples, Acinetobacter species were isolated from 32 (33.7%) and 20(12.4%) respectively. From 32 ICU and 20 Non ICU Acinetobacter isolates, 28 (87.5%) and 11 (55%) were biofilm producers. Biofilm forming capacity of Acinetobacter species was significantly (p<0.008) greater in ICU than in Non ICU isolates. In both ICU and Non ICU isolates, biofilm forming Acinetobacter species were 100% resistant to amoxicillin, ceftriaxone, ceftazidime, cefotaxime, cefuroxime, and aztreonam. Resistance to antibiotics such as gentamicin, amikacin, netilmicin, ciprofloxacin and imipenem was higher among biofilm forming Acinetobacter isolates in ICU than Non ICU isolates. Susceptibility to colistin was 100% in Non ICU isolates but in ICU it showed 7.1% resistance. Conclusions: This investigation showed that most of the clinical isolates of Acinetobacter species were biofilm producers especially from ICU samples and they were multidrug resistant. Even polymixin resistant Acinetobacter isolates are slowly emerging. This is very alerming for us that biofilm forming multidrug resistant Acinetobacter species represents a severe threat in the treatment of hospitalized patients. So, antibiotic policy and guidelines are essential to eliminate major outbreak in future.DOI: http://dx.doi.org/10.3329/jom.v14i1.14533 J MEDICINE 2013; 14 : 28-32

Dermatophytes are by far the most significant fungi because of their widespread involvement of population at large and their prevalence all over the world. This is an attempt to observe the spectrum of dermatophytes among the clinically suspected cases of dermatophytosis attending the outpatient department of Dermatology and Venereology, Bangabandhu Sheik Mujib Medical University, Dhaka. Three hundred and twenty clinically suspected cases of dermatophytosis were subjected to mycological studies. One hundred and five cases (32.8%) were positive for fungus in direct microscopy while 97(30.3%) were culture positive. Tinea unguium was the most common clinical type encountered followed by tinea corporis. Dermatophytosis was more common in the age group of 21-30 years. The male to female ratio was 1.54:1. Trichophyton rubrum 84(86.6%) was found common etiological dermatophyte species followed by Trichophyton mentagrophytes 8(8.2%) and Epidermophyton floccosum 5(5.2%).DOI: http://dx.doi.org/10.3329/bjmm.v6i2.19370 Bangladesh J Med Microbiol 2012; 06(02): 11-14

Tonsils are one of the important secondary lymphoid organ in immune system. It remains controversial whether tonsillectomy results in decreased serum immunoglobulin level. The purpose of this study was to observe the effect of tonsillectomy on humoral immunity parameters among the patients with tonsillar disease. Total group A 70 patients up to the age of 18 years, who were enrolled for tonsillectomy and 30 age matched children group B were included for comparative study. Serum IgG, IgM and IgA levels were measured in all 70 patients before tonsillectomy and in 56 patients who came for 1 st follow-up after one month and 30 patients who came for 2nd follow up after three months of tonsillectomy. Serum IgG, IgM and IgA levels were also measured in group B children. Serum IgG, IgM and IgA levels in patients of group A did not show any significant difference in comparison to group B. One month after tonsillectomy the level of IgG was slightly decreased and IgM and IgA were increased compared to preoperative value but not statistically significant. All IgG, IgM and IgA were also not significantly altered in comparison to group B. Three months after tonsillectomy serum IgG, IgM and IgA level were found decreased in comparison to pre operative value and group B, among which difference of only IgG was significant. After tonsillectomy humoral parameters were found reduced but overall impact on humoral immune status was not significantly altered.

Critically ill patients acquire an infection during their stay in an intensive care unit (ICU) and the frequency of these infections varies considerably in different populations and clinical settings. The purpose of this study was to know the antimicrobial sensitivity pattern of Acinetobacter isolates from tracheal aspirate, blood from central venous catheter, peripheral blood, urine and endotracheal tube of patients admitted in ICU at BSMMU(Bangabandhu Sheikh Mujib Medical University) hospital, Dhaka, Bangladesh over a one year period from January 2010 to December 2010. A total 95 ICU samples were studied of which 32(33.7%) were Acinetobacter species. Acinetobacter species isolated from endotracheal tube (100%), tracheal aspirate (54.3%), blood from central venous catheter (36.4%), peripheral blood (13.6%), and urine (12.5%). Acinetobacter isolates were 100% resistant to amoxicillin, ceftriaxone cefuroxime and gentamicin. Higher level of resistance was recorded for amikacin (68.4%) and imipenem (66.7%). Lower resistance only showed in colistin (10.5%). The findings of this study will help our clinician to apply antibiotics for treatment of the patients admitted in ICU. Producing a local antibiogram database will improve the knowledge of antimicrobial resistance patterns in Bangladesh and will also help to improve treatment strategies.DOI: http://dx.doi.org/10.3329/bjmm.v6i1.19352 Bangladesh J Med Microbiol 2012; 06(01): 3-6

Abstract:Background: Antinuclear antibody (ANA) is useful in the diagnosis of systemic lupus erythematosus (SLE). Association