There is an increasing focus on researching children admitted to hospital with new variants of COVID-19, combined with concerns with hyperinflammatory syndromes and the overuse of antimicrobials. Paediatric guidelines have been produced in Bangladesh to improve their care. Consequently, the objective is to document the management of children with COVID-19 among 24 hospitals in Bangladesh. Key outcome measures included the percentage prescribed different antimicrobials, adherence to paediatric guidelines and mortality rates using purposely developed report forms. The majority of 146 admitted children were aged 5 years or under (62.3%) and were boys (58.9%). Reasons for admission included fever, respiratory distress and coughing; 86.3% were prescribed antibiotics, typically parenterally, on the WHO ‘Watch’ list, and empirically (98.4%). There were no differences in antibiotic use whether hospitals followed paediatric guidance or not. There was no prescribing of antimalarials and limited prescribing of antivirals (5.5% of children) and antiparasitic medicines (0.7%). The majority of children (92.5%) made a full recovery. It was encouraging to see the low hospitalisation rates and limited use of antimalarials, antivirals and antiparasitic medicines. However, the high empiric use of antibiotics, alongside limited switching to oral formulations, is a concern that can be addressed by instigating the appropriate programmes.

Objective: The focus on COVID-19 in children in low- and middle-income countries including Bangladesh has been on addressing key issues including poor vaccination rates as well as mental health issues, domestic violence and child labour. However, the focus on optimally managing children in hospitals is changing with new variants and concerns with the development of hyperinflammatory syndromes. There are also concerns with the overuse of antimicrobials to treat patients with COVID-19 in hospitals enhancing resistance rates. The Bangladesh Paediatric Association have developed guidelines to improve patient care building on national guidance. Consequently, there is a need to document the current management of children with COVID-19 in Bangladesh and use the findings for future guidance. Methods: Rapid analysis of the management of children with COVID-19 among eight private and public hospitals in Bangladesh with varying numbers of in-patient beds using purposely developed case report forms (CRFs). The CRFs were piloted before full roll-out. Results: Overall low numbers of children in hospital with COVID-19 (4.3% of in-patient beds). The majority were male (59.6%) and aged 5 years or under (63.5%). Reasons for admission included respiratory distress/ breathing difficulties with 94.2% of COVID-19 cases confirmed. All children were prescribed antibiotics empirically, typically those on the Watch list of antibiotics and administered parenterally, with only a small minority switched to oral therapy before discharge. There was appreciable prescribing of Vitamins (C and D) and zinc and encouragingly limited prescribing of other antimicrobials (antivirals, antimalarials and antiparasitic medicines). Length of stay was typically 5 to 10 days. Conclusion: Encouraging to see low hospitalisation rates and limited use of antimicrobials apart from antibiotics. Concerns with high empiric use of antibiotics and limited switching to oral formulations can be addressed by instigating antimicrobial stewardship programmes. We will be monitoring this. Bangladesh Journal of Medical Science Vol.20(5) 2021 p.188-198

Poultry chickens are potential source of transmission of zoonotic Salmonella, into human food chain, causing food-borne illness and also hindering development of poultry industry in Bangladesh. The non-judicious uses of antibiotics in poultry farm have increased the multidrug resistant bacteria. So, this study reports the occurrence of Salmonella in poultry samples (meat, egg, liver and cloacal swab) and the antimicrobial resistance pattern of the isolates. This study was carried out throughout the period of May 2019-March 2020, at the bacteriological laboratory in the Department of Microbiology, University of Chittagong. Isolates were identified on the basis of cultural and biochemical tests from a total of 25 broiler samples (meat, liver, eggshell and cloacal swab). Antibiotic susceptibility pattern was observed using Kirby-Bauer disk diffusion method. The overall detection rate of Salmonella was 48% (12/25) and the highest occurrence was noticed in raw meat 62.5% and the lowest in liver (37.5%). The antimicrobial resistance tests revealed that all the isolates (n = 12) exhibited 100% resistance to vancomycin and cephalexin, followed by ampicillin (75%), nalidixic acid (58.33%), chloramphenicol (41.66%), doxycycline (50%), and neomycin (50%). On the other hand, ciprofloxacin showed 83.33%, ceftazidime and amoxicillin showed 91.6% sensitivity respectively. A considerably high proportion of isolates (11/12, 91.67%) was resistant to three or more antibiotics and 6 multidrug profiles were observed. The ampicillin-chloramphenicol-nalidixic acid-neomycin-cephalexindoxycycline-vancomycin (4/12) was more frequently observed phenotype in multidrug profiles. Finally, two multidrug-resistant strains of Salmonella

As a matter of fact, infectious diseases hamper everyone's life and produce a lifelong threat to everyone neutral of age, sex, lifestyle and socio-economic status. Nowadays, come into the sight of Chikungunya viral (CHIKV) infection injured many Asian and African countries, also deliberated threat in rising countries and also low socio-economic countries. CHIKV is a positive-sense, enveloped single-stranded, RNA virus belonging to the genus Alphavirus, family Togaviridae.

Background Sterilization failure is one of the main reasons for surgical site infections (SSIs). The biological indicator (BI) test is the most reliable test to check sterilization efficiencies. But 48 hours BI test result makes the monitoring process time-consuming. Rapid BI testing can be time demanding in this regard. Therefore, the objective is to determine the importance of rapid BI monitoring for the quality assurance of sterile surgical instruments. Methods This study was conducted in the Labaid Cardiac Hospital, Bangladesh from April 1, 2021, to July 8, 2021. A total of 100 steam and 100 ethylene oxide (EO) rapid BIs and an auto reader incubator were used to conduct this research. Quick BI of steam and EO were used once per day and tested by the auto reader. Later, all the tested BIs were incubated for 48 hours by a conventional incubator to confirm the auto reader's rapid BI test results. Result All the EO BI results were found negative, but the BI was found positive twice in steam sterilization. Surgical items of those two loads were re-sterilized. Again, after checking the BI result, the items were released. All BIs except positive steam rapid BIs were found with no growth after 48 hours of incubation for cross-checking of auto reader results. In positive rapid BI of steam, growth was found after 48 hours of incubation. Conclusion When sterilization failure occurred, process recall could not be possible at that time if rapid BI tests were not performed. So, integration of a rapid BI test with an auto reader can save the patient from critical SSI.