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.

24-26

Authors: Md. Badrul Islam, Md. Abdullah Yusuf, Md. Shahjahan Chowdhury, AFM Arshaedi Sattar, Samia Afrin

Background: Gram negative bacteria create a great problem during the treatment of urinary tract infection patients. Objective: This study was undertaken to determine the frequency and distribution of Gram negative bacteria among the UTI patients. Methodology: This cross sectional study was carried out in the Department of Microbiology at Sir Salimullah Medical College, Dhaka from June 2007 to May 2008 for a period of 1(one) year. All the patients presented with the clinically suspected UTI at any age with both sexes were selected as study population. Patients who were hospitalized for at least 2 days or more received different antibiotics were designated as hospital acquired UTI; on the other hand patients who were attended in OPD for the first time were considered as community acquired UTI patients. All urine samples were inoculated in Blood agar and MacConkeys agar media. Gram negative bacteria were isolated and identified by colony morphology, Gram staining and biochemical tests. Result: A total of 220 urine samples were collected from patients suspected to urinary tract infections of which 116 samples were from hospitalized patients and 104 samples were from community patients. Among 220 samples, 132(60.0%) Gram negative bacteria were isolated of which 88(66.7%) isolates were from hospitalized acquired UTI and 44(33.3%) bacteria were isolated from community acquired UTI patients. The difference was statistically significant (p=0.0001). In hospitalized patients out of 88(75.9%) isolated Gram negative bacteria, 67(76.1%) isolates were Escherichia coli, 10(11.4%) isolates were Klebsiella species, 5(5.7%) isolates were Proteus species and 6(6.8%) isolates were Pseudomonas species. Among the isolated bacteria 44(42.3%) bacterial isolates were from community patients of which 36(81.8%) isolates were Escherichia coli, 4(9.1 %) isolates were Klebsiella species, 2(4.5%) isolates were Proteus species and 2(4.5%) bacteria were Pseudomonas species. Conclusion: In the present study, it was observed that considerable numbers of Gram negative bacteria were detected from urinary tract infection cases.

32-37

Authors: Sharmina Aftab, Md. Monowar Tarik, Md. Abdullah Siddique, Md. Abdullah Yusuf

Wound infection is frequently found. Infection of the wound happened due to entry of the bacteria through breached skin. These bacteria stop healing and produce sign and symptoms. From the beginning of the civilization scientist are fighting against infection. It is evident that wound infection is a challenging situation for the physicians. Multiple organisms can cause wound infection. For the treatment of infection a large number of antibiotics are used. Both broad spectrum and narrow spectrum antibiotics are available nowadays. It is ideal to give proper antibiotic after culture and sensitivity of the wound swab, pus or infected tissue. Improper and irrational use of antibiotics and genetic and non-genetic drug resistant mechanisms of bacteria lead to drug resistance. Wound infection can be recognized by various sign symptoms. The inflammatory response is a protective mechanism that aims to neutralize and destroy any toxic agents at the site of an injury and restore tissue homeostasis. The classic signs of infection include: localized erythema, pain, heat, cellulitis and oedema. Other criteria include: Abscess, discharge, delayed healing, discolouration of tissues within and at the wound margins, friable & bleeding granulation tissue. Unexpected pain or tenderness, abnormal smell, wound breakdown wound pocketing are also seen in wound infection.