Bangladesh Journal of Infectious Diseases

3-7

Authors: Fatema Nusrat, K.M. Shahidul Islam, S.M. Shamsuzzaman, Md. Abdullah Yusuf, Aleya Farzana, Samia Afrin

Background: Antibiotic sensitivity pattern of Neisseria gonorrhoae is changing frequently. Objective: The purpose of the present study was to see the antibiotic sensitivity pattern of Neisseria gonorrhoae isolated from women presented with cervicitis. Methodology: This cross sectional study.carried out in the Department of Microbiology at Dhaka Medical College, Dhaka from July 2011 to December 2012 for a period of one and half year. All the women presented with or without the clinical features of cervicitis at child bearing age (15 to 49 yrs) with or without pregnancy were enrolled as study population. Endocervical swabs were collected for Gram staining, culture, biochemical test from clinically diagnosed patients of cervicitis for presumptive identification of Neisseria gonorrhoeae. The isolates with presumptive identification were confirmed by rapid carbohydrate utilization test (RCUT), which differentiates N.gonorrhoeae from other Neisseria. Antimicrobial susceptibility test was done according CLSI guideline. Result: A total 245 females were recruited of which N. gonorrhoeae were detected from 39(15.9%) cases. Among 39 positive cases of gonococcal cervicitis, 19 (48.71%) were detected in the age group of 21-30 years. 56.41% were sensitive and 30.76% were resistant to ceftriaxone. Similarly 51.28% were sensitive and 23.07% were resistant to cefuroxime; 23.07% sensitive, 30.76% moderately sensitive and 46.15% resistant to ciprofloxacin. Conclusion: Gonococcal cervicitis is found in a high frequency rate with a reduced sensitivity to antibiotics especially ciprofloxacin, second and third generation cephalosporins.

12-17

Authors: Mostaqimur Rahman, M. Mujibur Rahman, Waseka Akhter Jahan

Extended Spectrum β-lactamases (ESBLs) can confer resistance to all extended spectrum cephalosporins, all penicillins and monobactam. Being plasmid and transposon mediated has facilitated the spread of these enzymes to other species of bacteria. This is a challenge for the laboratory to detect ESBL-containing Gramnegative bacilli because they can appear susceptible in vitro to certain beta-lactam antimicrobial agents yet result in clinical treatment failure. Till now there is no gold standard test for detection of ESBLs. CLSI recommended the phenotypic method as confirmatory test. However, the traditional methods need much labor and time for cultivation and require at least overnight incubation after isolated colonies are available from primary culture. Therefore, about 48 hours is required for ESBLs reporting by traditional methods. Molecular characterization of the isolated ESBL was also not possible in maximum laboratories due to lack of facilities. But rapid detection of ESBLs from the patient with severe infection is urgently required; otherwise it may be fatal. In this present review this diagnostic dilemma of ESBL has been discussed.