Background: One of the most significant public health concerns in today's world is the persistent upsurge of infections caused by multidrug resistant bacteria. As a result, clinicians are being forced to intervene with either less effective backup drugs or ones with substantial side-effects. Colistin is a last resort antimicrobial agent for the treatment of infections caused by multi-drug resistant gram-negative bacteria.Methods: Escherichia coli (n = 65) isolated from street food (n = 20), hand rinse (n = 15), surface water (n = 10), and healthy human stool (n = 20) were tested for colistin resistance gene mcr-1 and response to antimicrobial agents. Antimicrobial resistance genes and virulence genes were detected by employing polymerase chain reaction. DNA fingerprinting of the strains were determined by pulsed-field gel electrophoresis. Results:Screening of E. coli allowed us to confirm colistin resistance marker gene mcr-1 in 13 strains (street food, n = 4; hand rinse, n = 2; surface water, n = 4; and stool, n = 3); and two of these E. coli strains carrying mcr-1 harbored bla TEM gene encoding extended spectrum beta lactamase. Antibiotic assay results revealed all 13 E. coli strains carrying mcr-1 to be multi-drug resistant (MDR), including to colistin. The minimum inhibitory concentration (MIC) for colistin ranged from 2 to 6 μg/ml. DNA sequencing confirmed homogeneity of the nucleotide sequence for mcr-1, but the E. coli strains were heterogenous, as confirmed by pulsed-field gel electrophoresis suggesting horizontal transmission of colistin resistance in Bangladesh. Conclusion:Widespread dissemination of E. coli strains carrying mcr-1 encoding resistance to colistin in the present study is alarming as this is the last resort drug for the treatment of infections caused by MDR gram-negative bacteria resistant to almost all drugs used commonly.

Background The Cholera-Hospital-Based-Intervention-for-7-days (CHoBI7) mobile health (mHealth) program was a cluster-randomized controlled trial of diarrhea patient households conducted in Dhaka, Bangladesh. Methods Patients were block-randomized to three arms: standard recommendation on oral rehydration solution use; health facility delivery of CHoBI7 plus mHealth (no home visits); and health facility delivery of CHoBI7 plus two home visits and mHealth. The primary outcome was reported diarrhea in the past two weeks collected monthly for 12 months. The secondary outcomes were stunting, underweight, and wasting at a 12 month follow-up. Analysis was intention-to-treat. The trial is registered at ClinicalTrials.gov (NCT04008134). Results Between December 4, 2016 and April 26, 2018, 2626 participants in 769 households were randomly allocated to three arms: 849 participants to standard message, 886 to mHealth with no home visits, and 891 to mHealth with two home visits. Children under five years had significantly lower 12-month diarrhea prevalence in both the mHealth with two home visits arm (Prevalence Ratio(PR): 0.73 (95% Confidence Interval(CI): 0.61, 0.87)) and the mHealth with no home visits arm (PR: 0.82 (95% CI: 0.69, 0.97)). Children under 2 years were significantly less likely to be stunted in both the mHealth with two home visits arm (33% vs. 45%, Odds Ratio(OR): 0.55, 95% CI: 0.31, 0.97) and the mHealth with no home visits arm (32% vs. 45%, OR: 0.54, 95% CI: 0.31, 0.96) compared to children in the standard message arm. Conclusion The CHoBI7 mHealth program lowered pediatric diarrhea and stunting among diarrhea patient households.

Mycobacterium tuberculosis (M. tb), the etiological agent of tuberculosis (TB), poses a severe challenge for public health and remains the number one cause of death as a single infectious agent. There are 10 million active cases of TB per year with 1.5 million deaths, and 2–3 billion people are estimated to harbor latent M. tb infection. Moreover, the emergence of multi-drug-resistant (MDR), extremely-drug-resistant (XDR), and the recent totally drug-resistant (TDR) M. tb is becoming a global issue that has fueled the need to find new drugs different from existing regimens. In these circumstances, probiotics can be a potential choice, so we focused on developing them as an anti-tuberculosis drug candidate. Here, we report the anti-tubercular activities of Lacticaseibacillus rhamnosus PMC203 isolated from the vaginal microbiota of healthy women. PMC203 exhibited a promising intracellular killing effect against both drug-sensitive and resistant M. tb infected murine macrophage cell line RAW 264.7 without showing any cytotoxicity. Additionally, it also inhibited the growth of M. tb under broth culture medium. PMC203 did not cause weight change or specific clinical symptoms in a 2-week repeated oral administration toxicity test in a guinea pig model. Here, we also found that PMC203 induces autophagy in a dose dependent manner by increasing the signal of well-known autophagy gene markers, suggesting a possible intracellular killing mechanism.

Objective The objective of the study was to investigate potential risk factors for growth faltering among children under 5 years of age. Method We conducted a prospective cohort study of 553 children under 5 years from diarrhoea patient households in urban Dhaka, Bangladesh. Height and weight measurements were obtained at baseline and at a 12‐month follow‐up. Caregivers of young children were administered a monthly questionnaire on household sociodemographic characteristics and hygiene practices. Results Children with caregiver reports of mouthing soil at the majority of household visits had a significant reduction in their height‐for‐age z‐scores (HAZ) from baseline to the 12‐month follow‐up (ΔHAZ: −0.28 (95% confidence interval (CI): −0.51, −0.05)). A significant reduction in HAZ was also observed for children in households with animals in their sleeping space (ΔHAZ: −0.37 (95% CI: −0.71, −0.04)). Conclusion These findings provide further evidence to support the hypothesis that child mouthing of soil and the presence of animals in the child’s sleeping space are potential risk factors for growth faltering among young children. Interventions are urgently needed to provide clean play and sleeping spaces for young children to reduce exposure to faecal pathogens through child mouthing.

We investigated the environmental and individual-level risk factors for diarrheal disease among young children in slum areas of Dhaka, Bangladesh. A prospective cohort study was conducted among 884 children under 5 years of age. Caregiver reports were collected on sociodemographic factors and hygiene behaviors. Diarrhea surveillance data was collected monthly based on caregiver-reported diarrhea for children in the past 2 weeks during the 12-month study period. Unannounced spot checks of the household compound were performed at 1, 3, 6, 9, and 12 months after enrollment to check for the presence of feces (animal or human) and the presence of animals in the child’s sleeping space, to assess child and caregiver hands for the presence of dirt, and to collect samples of the household’s source and stored drinking water. Children with feces found on the household compound during spot checks had a significantly higher odds of diarrhea (odds ratio: 1.71; 95% confidence interval: 1.23–2.38). Children residing in households with > 100 colony forming units/100 mL Escherichia coli in source drinking water had a significantly higher odds of diarrhea (OR: 1.43; 95% CI: 1.06–1.92). The presence of feces on the household compound and source drinking water with > 100 colony forming units/100 mL E. coli were significant risk factors for diarrheal disease for children < 5 years of age in slum areas of Dhaka, Bangladesh. These findings demonstrate the urgent need for comprehensive interventions to reduce fecal contamination on the household compound to protect the health of susceptible pediatric populations.