For addressing the issue of antimicrobial drug resistance in developing countries, it is important to investigate the characteristics of carbapenemase-producing organisms. We aimed to genetically characterize a carbapenemase-producing Klebsiella pneumoniae (CPKP) isolated in the intensive care unit of a tertiary hospital in Bangladesh. The number of CPKP isolates were 43/145 (30%), of which pandrug-resistant (PDR) strains were 14%. These carbapenemases were New Delhi metallo-beta-lactamase (NDM)-1 (53%), NDM-5 (14%), oxacillinase (OXA)-181 (12%), OXA-232 (10%), NDM-5 + OXA-181 (5%), and NDM-5 + OXA-232 (2%). Many CPKP isolates harbored a variety of resistance genes, and the prevalence of 16S rRNA methyltransferase was particularly high (91%). The 43 CPKP isolates were classified into 14 different sequence types (STs), and the common STs were ST34 (26%), ST147 (16%), ST11 (9%), ST14 (9%), ST25 (7%), and ST231 (7%). In this study, PDR strains were of three types, ST147, ST231, and ST14, and their PDR rates were 57, 33, and 25%, respectively. The spread of the antimicrobial drug resistance of CPKP in Bangladesh was identified. In particular, the emergence of PDR is problem, and there may be its spread as a superbug of antimicrobial treatment.
The aim of this study was to characterize the fluoroquinolone (FQ) resistance mechanism of Salmonella enterica serovar Typhi and Paratyphi A in Bangladesh. Salmonella Typhi isolates were classified into sequence type (ST) 1, ST2, and ST2209 and Salmonella Paratyphi A isolates were classified into ST85 and ST129. The most common STs of the FQ-nonsusceptible strain were ST1 (44.4%) and ST129 (66.6%). Thirty-nine percent of Salmonella Typhi isolates were multidrug resistant, and these were all ST1, which is the type prevalent in the Indian subcontinent. Although plasmid-mediated quinolone resistance genes were not detected in any of the tested strains, single and double mutations were identified in the quinolone resistance-determining region (QRDR). The most common QRDR mutation was GyrA_Ser83Phe (66.7% for Salmonella Typhi and 100% for Salmonella Paratyphi A). Treatment with an efflux pump inhibitor resulted in susceptibility of the strains to levofloxacin. All isolates demonstrated 100% susceptibility to ceftriaxone, azithromycin, and carbapenem. Our results suggest that mutations in gyrase A and enhancement of efflux pump activity are responsible for the resistance to FQs; in particular, the AcrAB-TolC efflux pump may be an important resistance factor for levofloxacin. To control the spread of FQ-nonsusceptible Salmonella Typhi, intensive surveillance in endemic areas, including Bangladesh, and effective infection control are necessary.
A retrospective study was done in ICU of BSMMU during January to June 2007 with a total number of 157 patients. Patients were included from this hospital and also from private hospitals. In accordance of the criteria for analysis a structured questionnaire was used whereas data obtain from hospital record sheets and file. We observed admission diagnosis, co-morbidities, length of stay, different procedures and overall outcome. Among 157 Patients age group of 61-70 yrs. constitutes the major proportion, which was 20.4% and male was 61.8%. 108 patients (75.2%) were admitted due medical illness and among which respiratory failure was 15.3%, intracranial hemorrhage was 13.4%. Among 112 deaths 77 died after 96 hours of admission. Death occurred in 90.5% for non-traumatic hemorrhage and 94.1% cases for pneumonia (P<0.5). We did not find any significant association between outcome and co-morbidities except for cerebrovascular in sufficiency (P<0.5). Therefore we can predict that admission diagnosis and other factors
Pathogens that carry antibacterial resistant genes represent a threat for failure of antibiotic therapy and are associated with high mortality, morbidity and expenses. In Bangladesh, although quinolone resistance in clinical infections has been reported, environmental influence to this resistance is poorly known. Thus, to examine the existence of quinolone resistant bacterial strains in surface water in Dhaka, the study was conducted during June 2012 to January 2014. Surface water samples from Dhaka city were screened and isolated quinolone resistant Pseudomonas putida, Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. Molecular and genetic analysis identified the resistant determinants in these isolates. The study suggests that potential role of water for the dissemination and transmission of resistant genes among microorganisms causing human and animal infections in Bangladesh.
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