Objective: Pathogenic resistance against antibiotics is substantially mounting in the developing countries including Bangladesh. Present study thus attempted to obtain the baseline information on such resistance among the community people coming to the local dispensaries around the city of Dhaka for treatment. Materials and Methods: A total of 2,700 clinical specimens were examined for the presence of Gram positive and Gram negative pathogens. Antibiotic susceptibility tests of the isolates were carried out. Extended spectrum b- lactamase (ESBL) activity, and the presence of methicillin resistant Staphylococcus aureus (MRSA) and S. epidermidis (MRSE) were also detected. Results: Escherichia coli were most prevalent (45.5%) among 1044 pathogenic bacteria isolated from 2,700 samples. E. coli predominated urine, pus, wound swab, blood, high vaginal swab (HVS) and sputum specimens, and exhibited the highest frequency of ESBL activity (35%). Prevalence of Klebsiella spp. and S. aureus among the clinical specimens were 11.5% and 9.86%, respectively. Most of the Gram negative bacilli were found resistant against ciprofloxacin (5 mg), tetracycline (30 mg) and cotrimoxazole (25 mg). Majority of Pseudomonas spp. were found resistant against most of the commonly used antibiotics. Interestingly, around half of the S. aureus isolates were observed to be methicillin resistant, but not vancomycin resistant. Conclusion: Overall, such a revelation of increased antibiotic resistance demands for restrictive and appropriate antibiotic usage in accordance with the updated antibiotic prescribing policy in Bangladesh. DOI: http://dx.doi.org/10.3329/bjms.v12i1.13351 Bangladesh Journal of Medical Science Vol. 12 No. 01 January’13 pp.34-42

BackgroundMelioidosis an infectious disease, caused by a Gram negative bacterium called Burkholderia pseudomallei, is endemic in Bangladesh. This organism is sensitive to limited number of antimicrobial agents and need prolonged treatment. There is no comprehensive data on the antimicrobial susceptibility profile of B. pseudomallei isolated in Bangladesh over last several years. The present study aimed to determine the antimicrobial susceptibility pattern of B. pseudomallei isolated in a tertiary care hospital of Dhaka city from 2009 to 2015.MethodsAll B. pseudomallei isolated from melioidosis patients over a period of 7 years (2009–2015) in the Department of Microbiology of a 725-bed tertiary care referral hospital in Dhaka city, Bangladesh were included in the study. B. pseudomallei was identified by Gram stain, culture, specific biochemical tests, serology and PCR using specific primers constructed from 16s rRNA region of B. pseudomallei. Antimicrobial susceptibility to specific agents was determined by disk diffusion and minimum inhibitory concentration methods.ResultsA total of 20 isolates of B. pseudomallei which were isolated from patients coming from different geographic locations of Bangladesh were included in the study. All the isolates were uniformly sensitive (100%) to ceftazidime, imipenem, piperacillin–tazobactam, amoxicillin–clavulanic acid and tetracycline by both disk diffusion and MIC methods. Two strains were resistant to trimethoprim–sulfamethoxazole by disk diffusion method but were sensitive by MIC method. The MIC50 and MIC90 values of the above antimicrobial agents were almost similar. All the isolates were resistant to amikacin by both MIC and disk diffusion methods.ConclusionThe results of the study suggest that B. pseudomallei prevalent in Bangladesh were still susceptible to all recommended antimicrobial agents used for the treatment of melioidosis. However, regular monitoring is needed to detect any emergence of resistance and shifting of MIC50 and MIC90 values.

Background and objectives: Candida auris is an emerging multidrug-resistant fungal pathogen that has been associated with nosocomial infections with a high mortality. The organism has been reported from several countries of the world except Bangladesh. The present study describes the presence of C. auris in clinical samples obtained from a large hospital of Dhaka city, Bangladesh. Materials and methods: The A total of 100 Candida species isolated from different clinical samples were purposively included in the present study. Samples were obtained from patients attending a 750 bed hospital of Dhaka city. C. auris was identified by growth characteristics, biochemical and carbohydrate assimilation test and further confirmed by polymerase chain reaction and sequencing using ITS1 and ITS2 targeting the conserved regions of 5.8S rRNA. Antifungal susceptibility of identified C. auris was performed by disk diffusion and minimum inhibitory concentration (MIC) methods. Results: Out of 100 Candida sp. tested, 21 isolates were identified as C. auris. Of the 21 C. auris, 14 (66.7%) were isolated from blood samples and the remaining 7 (33.4%) were from urine. Most of the C. auris isolated were from patients admitted in intensive care units. Out of 21 C. auris, 17 (81.0%), 7 (33.3%) and 3 (14.3%) were sensitive to amphotericin B, fluconazole and voriconazole respectively by disk diffusion method. Out of 14 fluconazole resistant isolates, 5 were susceptible dose-dependent (SS-D) by MIC method. Conclusion: The present study is the first report demonstrating the presence of C. auris in clinical samples obtained from a large hospital of Bangladesh. Majority of isolates showed resistance to fluconazole and variable susceptibility to other antifungal agents. Further study is suggested to find its true magnitude and its susceptibility pattern to a range of antifungal agents. Ibrahim Med. Coll. J. 2019; 13(2): 18-22

Background and objectives: Helminthic infestation is one of the commonest health problems in a developing country like Bangladesh. The objectives of the current study were to determine the prevalence of helminthic infestations, associated risk factors and its effects among the rural children in Bangladesh. The trend of helminthic infestation rate over time was also analyzed. Methodology: A cross-sectional study was conducted among the rural primary school children of Sreepur Upazilla of Gazipur District. The area is located about 40 km north-east of capital Dhaka. A total of 593 students aged 5-13 years were enrolled from 5 primary schools. Out of 593 children, 204 agreed to provide fecal samples. A semi-structured questionnaire was used to collect data by face to face interview method and several anthropometric measurements along with clinical examinations were also carried out. Helminth ova were detected by direct microscopy of fecal smear and floatation concentration methods. Data were analyzed using the software IBM SPSS (Version 20). Result: Out of 204, 80 (39.2%) children were infested with at least one species of helminth. Ascaris lumbricoides, Trichuris trichiura and mixed infection was 23%, 12.8% and 3.4% respectively. Overall prevalence of infection was higher among female students compared to male students (p<0.05). Living in mud-floor and thatch walled houses were significantly (p<0.05) associated with increased helminthic infestation. The risk behaviors commonly related to helminthic infestation revealed no difference between infected and non- infected groups of children. Height, weight, mid-upper arm circumference (MUAC), skin fold thickness, and waist and hip circumference of worm infested children were not significantly different from those without worm infestation. Conclusion: The results reflect that the deworming program of Sreepur Upazilla was not fully successful. Poor socio-economic condition and lack of awareness of personal hygiene played an important role in prevalence of parasite infestation. IMC J Med Sci 2019; 13(1): 004