No abstract

Hospital acquired infections (HAI) are important causes of morbidity and mortality. The purpose of this study was to see the type of HAI and causative organisms of these infections among the paediatric patients in tertiary level hospitals of Dhaka city. This cross sectional study was conducted in three tertiary level hospitals in Dhaka City over a period of two years. A total of 1055 patients were observed and the study population comprised of all the admitted paediatric patients irrespective of sex and basic diseases who were found present during data collection period as admitted patients in the paediatric wards of the hospitals under study. Among 1055 pediatric patients admitted in all the three hospitals under study a total of 115 (10.9%) were affected by hospital acquired infections. Higher prevalence (14.0%) of Hospital-Acquired Infections (HAI) was found in surgery ward and the lower prevalence (9.2%) of HAI was found in medicine ward. The most common type of HAI was surgical wound infection 26(22.6%). Out of 115 HAI patients highest number 44(38.3%) were affected by staphylococcus aureusfollowed by E. coli23(20%). Update Dent. Coll. j: 2019; 9 (1): 23-28

Background: Carbapenem-resistant Enterobacter (CRE) is an emerging threat spread rapidly around the world in the past few years, posing substantial hazards to human health. Objective: The study was conducted to evaluate the prevalence of carbapenem resistance and to detect carbapenemase producers phenotypically from patients of a major tertiary care hospital, in Bangladesh. Methods: Prospective cross-sectional study was conducted from July 2018 to June 2019, at the Dhaka Medical College hospital. Patients admitted to different wards, and intensive care units, visited the outpatient department, and samples received in the microbiology department were included in this study. A total of 350 clinical samples were collected, inoculated, and incubated in accordance to the standard protocol. Identification was done using the standard biochemical method. Antimicrobial susceptibility testing of commonly used antibiotics including imipenem was done using Kirby Bauer disk diffusion method. All the clinical isolates of Enterobacter were screened for carbapenem resistance as per CLSI guidelines. Such strains were then subjected to phenotypic confirmation of carbapenemase production by the Modified Hodge test. All isolates that gave a positive screening test were further evaluated for Metallo-β lactamase (MBL) production. MBL was further detected by Combined Disc Test (CD) using a combination of Imipenem and Imipenem-EDTA and double disc synergy (DDS) test. Result: A total of 350 clinical specimens were analyzed, of which 224 (65.14%) isolates yielded growth. Among them, 28 (12.28%) Enterobacter were isolated of which 12 (42.86%) were found to be Imipenem resistant (14.25%) and were labeled 'Carbapenem-resistant Enterobacter" or CRE. Minimum inhibitory concentration (MIC) was determined among the carbapenem-resistant clinical isolates. Modified Hodge test (MHT) performed on the 12 carbapenem-resistant isolates showed 9 (75%) isolates to be carbapenemase enzyme producers. Nine out of twelve carbapenem-resistant isolates are Metallo-beta-lactamase producers detected by combined disc test (CDT) and eight (66.67%) MBL producers detected by DDS test. Conclusion: The finding from this study revealed a high prevalence of carbapenem resistance among isolated Enterobacter species in hospital settings as well as community levels. As there are limited treatment regimens, therefore, the timely and accurate detection of carbapenem-resistant Enterobacter species is essential for the clinical treatment and prevention of infections. Simple phenotypic methods like MHT can be used for the rapid detection of carbapenemases, and these are expected to be used routinely in clinical microbiology laboratories. Update Dent. Coll. j: 2023; 13(1): 17-22

The primary clinical tool for predicting the lineage potential of leukemic blasts is the characterization of protein expression by immunophenotyping. It is common for acute leukemias to aberrantly express protein markers more typically associated with other lineages. Therefore, this study was designed to assess the frequency of aberrant antigens expression in childhood acute leukemia. Peripheral blood and bone marrow samples were collected from 76 clinically suspected and morphologically diagnosed untreated cases of acute leukemia (children of 0-<18 years). Flow cytometry immunophenotyping was carried out with the help of Flow cytometer (BD FACSVerse). Total 9 (11.84%) cases showed aberrant antigens expression. Out of 9 aberrantly expressed cases, 2 (22.22%) AML cases showed aberrant lymphoid marker CD7 expression. Co-expression of myeloid markers CD13 and CD117 found in 2 (22.22%) B-ALL cases and 2 (22.22%) cases of B-ALL expressed myeloid marker CD117. Myeloid marker CD33 expressed by 2 (22.22%) case of B-ALL. Only 1(11.11%) T-ALL case co expressed myeloid markers CD33 and CD117. These findings may help to recognize patients with high risk group and low remission rate as aberrant antigen expression may represent a poor prognostic indicator. Further studies are needed to confirm the correlation between aberrant phenotypes with prognosis and therapeutic response of acute leukemia. Bangladesh J Med Microbiol 2018; 12 (1): 10-14

Host factors, environmental factors, genetic diversity and distinct phylogeographic distribution of Mycobacterium tuberculosis (MTB) contribute to regional differences in drug resistance. Bangladesh remains among the top 20 high Multi drug resistant tuberculosis (MDR-TB) burden countries of the world. This cross sectional study was conducted to identify the socio demographic characteristics and the risk factors contributing Pulmonary tuberculosis (PTB) infection. These characteristics and risk factors were further investigated among the clustered isolates. Total 60 culture isolates consist of 40 RR and 20 rifampicin sensitive (RS) isolates were enrolled in this study. Laboratory works were done in National Tuberculosis Reference Laboratory