The present study has been carried out in an attempt to evaluate antimicrobial susceptibility patterns with special reference to susceptibility of Salmonella Typhi to ciprofloxacin isolated from blood culture. The study is also designed to find out the MIC of Ciprofloxacin by E-test. Blood samples were taken for culture sensitivity, Widal test and ICT from 100 clinically suspected cases of typhoid fever in 1 st week of illness who attended at out patient department of Rajshahi Medical College Hospital (RMCH).The study was done in Microbiology Department of Rajshahi Medical College and Shishu Hospital, Dhaka. Diagnosis of patients was based on history of fever, blood culture, Widal test and ICT. The antimicrobial susceptibility pattern of isolates from blood culture was recorded. Further more, the minimum inhibitory concentration of Ciprofloxacin was determined by E-test for the isolates resistance to Ciprofloxacin. Out of 100 suspected cases of typhoid fever, blood culture positive for S. Typhi were 16 (16%). Antimicrobial susceptibility pattern of 16 isolates of S. Typhi showed that no isolate was resistant to Ceftriaxone and Ceftazidime, only 03(18.75%) were resistant to Ciprofloxacin and Azithromycin whereas 10(62.5%) were MDR showing resistance to Ampicillin, Co-trimoxazole and Chloramphenicol which are first-line antityphoidal drugs. On the other hand, all (100%) the isolates were resistant to Nalidixic acid.The study revealed that Ceftriaxone and Ceftazidime are the most effective drugs in the treatment of typhoid fever. Moreover, E-test has been found to be helpful to determine appropriate therapeutic dose of Ciprofloxacin specially in case of drug resistance and pediatric population.
Original Research ArticleIntroduction: Urinary tract infections (UTI) account for significant health burden among all age groups. Isolation and identification of the uropathogens by bacterial culture and selection of appropriate antimicrobial drugs through susceptibility testing is the mainstay in management of UTI cases. Material & Methods: This was a cross-sectional study which was carried out in the Department of Microbiology, Rajshahi Medical College (RMC) to evaluate the performance of a Chromogenic agar medium (commercially named as HiCrome UTI agar) and conventional culture system like Blood agar (BA) and MacConkey (MAC) agar for isolation and presumptive identification of the uropathogens. Results: Slightly higher bacterial growth was noted among female (29.33%) than male (17.00%) patients as a whole and 15-45 years was the leading age group with higher number of culture positive cases. Out of 300 urine samples cultured, a total of 139 (46.33%) yielded bacterial growth and 161 (53.67%) were negative for bacterial growth. Bacterial isolates included E. coli 91(62.75%), Klebsiella spp. 18(12.41%), Enterococcus spp. 16(11.03%), Pseudomonas spp. 09(06.28%), Staph. saprophyticus 05(3.44%), Enterobactor spp. 04(2.75%) and Proteus spp. 02(1.37%). It is evident from the present study that both HiCrome UTI agar and BA media supported growth of all 145 bacteria, while MAC agar yielded 133(91.72%) bacterial growths. The rate of presumptive identification of the isolates was found significantly higher (97.24%) on HiCrome UTI agar when compared with the MacConkey agar (80.68%) and Blood agar (27.58%) media. In antimicrobial susceptibility testing, majority of the isolates showed very high (78% -100%) sensitivity to Imipenem. Ceftazidime and Cefuroxime were also found efficacious against E. coli and Staph. saprophyticus, while Klebsella spp., Enterococcus spp., Pseudomonas spp., Enterobacter spp. and Proteus spp. showed variable sensitivity to these drugs. Further, most of the isolates showed moderate to poor sensitivity to Ciprofloxacin, Nalidixic acid, Cephalexin, Amoxicillin and Cotrimoxazole. (Minimize that red mark) Conclusion: HiCrome UTI agar can be recommended as primary urine culture medium to be used by the clinical microbiology laboratories.
Objectives : To determine the prevalence, aetiology and susceptibility profile of bacterial agents of wound infection among in- and- out patients.Methods : Wound swabs collected from 150 patients were, cultured and microbial isolates identified using standard methods. Antibiotic susceptibility testing was done on bacterial isolates.Results : Of the 150 swabs 131 (87.4%) were culture positive for bacterial pathogens, while 19 (12.6%) were bacteriologically sterile showing an isolation rate of 87.4%. The predominant bacteria isolated from the infected wounds were Staphylococcus aureus 47 (32.4%) followed by Escherichia coli 29 (20%), Proteus species 23 (16%), Coagulase negative Staphylococci 21 (14.5%), Klebsiella pneumoniae 14 (10%) and Pseudomonas aeruginosa 11 (8%). All isolates showed high frequency of resistance to ampicillin, penicillin, cephalothin and tetracycline. The flouroquinolones were the most potent antimicrobial agents against bacterial isolates from both in - and out -patients.Conclusion : Staphylococcus aureus was the most predominant etiologic agent of wound infection among in and out patients. A generally higher resistance pattern was observed among nosocomial bacterial pathogens. Prudent use of antibiotics is recommended.TAJ 2011; 24(2): 136-141
Objective: The present study was done to see the antimicrobial susceptibility pattern of bacterial isolates from wound infection.Methods: Wound swabs collected from 150 patients of wound infection were cultured and microbial isolates identified using standard methods. Antimicrobial susceptibility testing was done on bacterial isolates by Modified Kirby Bauer method.Results: Of the 150 swabs 131 (87.4%) were culture positive for bacterial pathogens, while 19 (12.6%) were bacteriologically sterile showing an isolation rate of 87.4%. The predominant bacteria isolated from the infected wounds were Staphylococcus aureus 47 (32.4%) followed by Escherichia coli 29 (20%), Proteus species 23 (16%), Coagulase negative Staphylococci 21 (14.5%), Klebsiella pneumoniae 14 (10%) and Pseudomonas aeruginosa 11 (8%).In case of gram positive bacteria- rate of isolates resistant to ampicillin was 94%, followed by penicillin G, 86.8%, Tetracycline, 51.5%. In case of gram negative bacteria- rate of isolates resistant to ampicillin was 96%, followed by cephalothin, 92.4%, Tetracycline, 74%.Conclusion: In antimicrobial susceptibility testing ampicillin, penicillin, cephalothin and tetracycline were the least effective. Gentamicin, norfloxacin, ciprofloxacin, vancomycin and amikacin were the most effective antibiotics.TAJ 2013; 26: 61-66
Objective: The present study was done to compare the performance of chromogenic agar medium and conventional culture media for the isolation and presumptive identification of uropathogen.Methodology: A total 300 sample were collected from Rajshahi Medical College Hospital, Bangladesh during January to June, 2008. Urine samples of the suspected UTI cases, showing pus cells >5/HPF on microscopic examination were included for urine culture simultaneously onto 2 conventional media (Blood agar and MacConkey agar) and chromogenic agar medium (HiCrome UTI agar medium). Results: Culture yielded 139 (46.33%) bacterial growth among them, 133 (44.33%) showed single organism and remaining 06 (2.00%) showed mixed growth of two organisms in different combinations. It is evident from the present study that both HiCrome UTI agar and Blood agar (BA) media supported growth of all 145 bacteria, while MacConkey (MAC) agar yielded 133(91.72%) bacterial growths. The rate of presumptive identification of the isolates was found significantly higher (97.24%) on HiCrome UTI agar when compared with the MacConkey agar (80.68%) and Blood agar (27.58%) media. Out of 91 E. coli isolated, 88(96.70%) could be identified differentially on HiCrome UTI agar medium in contrast to 85(93.40%) on MacConkey agar and only 06(06.59%) on Blood agar. Again, all 06 (100%) of the isolate-pairs of mixed growth were identified distinctly on HiCrome UTI agar, whereas both Blood agar and MacConkey agar media could revealed only 01(16.66%) of the polymicrobial growth.Conclusion: HiCrome UTI agar medium has been documented for its very high yielding rate, rapid presumptive identification of both single and polymicrobial growths with greater precision and avoidance of biochemical tests for further identification of uropathogens. Thus it can be recommended as primary urine culture medium to be used by the clinical microbiology laboratories.TAJ 2011; 24(2): 128-135
Then Present study was done to assess the distribution of bacterial pathogens with their pattern of antibiotic susceptibility in an urban referral hospital in RMCH. A total of 393 bacteria strains were isolated from various specimens over a 10-months period. The majority of the organisms were Escherichia coli (33.33%) followed by Klebsiella species (27.48%), staphylococcus aureus (17.05%), Acinetobcter species (8.14%), Pseudomonas species (7.12%), and others. The third-generation Cephalosporins like Ceftriaxone, Ceftazidime and Cefotaxime were sensitive to Ciprofloxacin of various Enterobacteriaceae was only between 33-40% compared to 52.8-37.9% against Gentamicin. Majority of the Enterobacteriaceae were resistant to Ampicillin, whereas almost all of the Enterobacteriaceae (94-100%) were sensitive to Imipenem. About 97.0% Acinetobacter species were susceptible to Imipenem. Sensitivity of the organism (Acinetobacter) to third-generation Cephalosporins ranged between 50-56%, whereas 40.6% were found sensitive to Ciprofloxacin. The sensitivity to Chloramphenicol, Co-trimixazole, Cephalexin and Ampicillin ranged between 9.3% to 34.3%. About 93.0% of Pseudomonas species were sensitive to Imipenem. The rate of susceptibility to Gentamicin and Netilmicin was higher than those of the Ciprofloxacin and Ceftriaxone (37.8% and 53.5% vc. 39.2%). About 70% of isolated S. aureus were resistane of Oxacillin but all were sensitive to Vancomycin. The result of this study would help the physicians to make a judicious choice of antibiotics for therapeutic purposes.TAJ 2012; 25: 72-76
Background: Placenta previa is a localization of placenta in the lower uterine segment, near or over the internal os. Multigravida is one of the risk factors of placenta previa. The aim of study is to look for current frequency of placenta previa in multigravida, so that further improvement in diagnosis and treatment modalities can be made in order to decrease the morbidity & mortality related to it in this group.Objective: To determine the frequency of various grades of placenta previa in multigravida at a tertiary care center.Methodology: This is a cross sectional study conducted from December 2014 to June 2015 at the department of Gynecology and Obstetrics, Rajshahi Medical College Hospital. A total of 208 patients enrolled in the study with non -probability purposive sampling technique. All pregnant women with singleton pregnancy of 25-35 years of age in their second or more pregnancy with gestational age ≥ 34 weeks were included. Exclusion criteria observed for patients with multifetal pregnancy, previous history of cesarean section, dilatation and curettage, cervical cone biopsy, myomectomy or any pelvic surgery. All pregnant women had trans-abdominal ultrasound. The presence or absence of placenta previa was reported by an experienced sonologist. The data was analyzed using SPSS version 12.Results: Among the total recruited patients, mean age of these multigravidas was 30.1±5.6 years. The mean parity of our population was 4.02±1.2. The gestational age noted was 38±1.4 weeks as mean.. The frequency of placenta previa was 13 (6.3%) and type IV was the most common type.Conclusion: It is concluded from this study that the frequency of placenta previa in patients of multigravida was 6.3% and apart from other risk factors, multigravidity is an independent risk factor for placenta previa.TAJ 2012; 25: 59-63
Objective: The present study was done on Chromogenic agar media to identify uropathogens more efficiently by its characteristic colony colour for each of the organism.Methodology: A total 300 sample were collected from Rajshahi Medical College Hospital, Bangladesh. Urine samples of the suspected UTI cases, showing pus cells >5/HPF on microscopic examination were included for urine culture simultaneously onto Chromogenic agar media, Blood agar and MacConkey agar media.Results: Culture yielded 139 (46.33%) bacterial growth among them, 133 (44.33%) showed single organism and remaining 06 (2.00%) showed mixed growth of two organisms in different combinations. It is evident from the present study that both Chromogenic agar media and Blood agar (BA) media supported growth of all 145 bacteria, while MacConkey (MAC) agar yielded 133(91.72%) bacterial growths. The rate of presumptive identification of the isolates was found significantly higher (97.24%) on Chromogenic agar media when compared with the MacConkey agar (80.68%) and Blood agar (27.58%) media. Out of 91 E. coli isolated, 88(96.70%) could be identified differentially on Chromogenic agar media in contrast to 85(93.40%) on MacConkey agar and only 06(06.59%) on Blood agar. Again, all 06 (100%) of the isolate-pairs of mixed growth were identified distinctly on Chromogenic agar media, whereas both Blood agar and MacConkey agar media could revealed only 01(16.66%) of the polymicrobial growth.Conclusion: Chromogenic agar media has been documented for its very high yielding rate, rapid presumptive identification of both single and polymicrobial growths with greater precision and avoidance of biochemical tests for further identification of uropathogens. Thus it can be recommended as primary urine culture medium to be used by the clinical microbiology laboratories.TAJ 2012; 25: 64-71
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