Antimicrobial resistance is a global problem. Surveillance is one of the effective tools to address this multifaceted problem. In Bangladesh a countrywide antimicrobial resistance surveillance is ongoing since 2016-2020. The main objective of the surveillance is to know the sensitivity pattern of some common bacteria which will eventually help to formulate a standard treatment guideline for the clinician and to know the gravity of the AMR problem in Bangladesh. It is a case based surveillance conducted by Institute of Epidemiology, Disease Control & Research (IEDCR) in nine sentinel sites where five types of clinical cases were selected according to case definition, tested in the microbiological department of the sites and ten types of bacteria were identified from six types of preselected specimens and their sensitivity test were done. All the laboratory works were done following the same standard operative procedure supplied by the AMR surveillance Reference laboratory at IEDCR. Total 19,263 samples were processed during the period of March 2017- March 2020 among which wound swab yielded highest growth (57%). E.coli was the highest (1717) isolated organism among the ten priority pathogens which showed highest sensitivity (91%) to Imipenem. Imipenem also showed higher sensitivity to other organisms like K. pneumoniae (77%), Salmonella species (100%), P. aeruginosa (53%) and Acb complex (29%). Third generation cephalosporin like ceftriaxone was found less than 50% sensitive to E.coli (37%) and K.pneumoniae (28%) although Salmonella spp. showed higher sensitivity (97%) to it. ACB complex, mostly isolated from ICU patients showed alarming resistance to all of the antibiotics and was less than 50% sensitive to even the highest sensitive antibiotic Imipenem (29%). Salmonella spp. isolated from blood showed higher susceptibility to most of the antibiotics except ciprofloxacin (7%). The result of the surveillance representing whole country is surely alarming as most of the bacteria are highly resistant to the commonly used as well some of the reserve group of antibiotics. So concerted effort should be taken from all concerned to curb the problem immediately.

Household food security is an emerging public health issue and the rural elderly people are one of the most vulnerable groups for the household food security. This cross-sectional study was conducted in Barobaria union of Gofargaon upazila of Mymensingh district to assess the nutritional status of rural elderly (?60 years) in relation to the household food security. A total of 118 purposively selected elderly were interviewed and measured for height and weight following a standard protocol. The mean (SD) age of the respondents was 68.6 (7.3) years and gender participation was equally represented. Majority (68.6%) of the respondents was illiterate and 92% were Muslims. Mean family size and monthly family income was estimated to be 5.5 and Taka 6106, respectively and 70% of the rural elderly were found to be dependent on their family members as they were not involved in income generation and most of the respondents were the members of joint family. Only about 29% of the total elderly were at the highest quarter of food security. Illiteracy, members of single family and larger family were found to be significantly associated with lower level of household food security (p < 0.05). Although age, sex, personal income and occupational category had no significant association, the total family income was significantly associated with household food security. Among the respondents 56% were underweight including 13% with severe chronic energy deficiency. Only 5.9% were overweight. Illiterates were three times more likely to be underweight than literates (OR 2.95 with 95% CI 1.32, 6.59). Smoking, lower family income, poor housing, single family, irregularity in treatment were significantly associated with underweight. A significant difference was found between mean body mass index of different household food security level (F =3.22, p < 0.05). There was gradual increase of mean body mass index with the improved status of food security level. Policy makers, therefore, need to consider programs that empower people to solve the problem of food insecurity and to improve the nutritional status of rural elderly people. DOI: http://dx.doi.org/10.3329/bmj.v40i3.18649 Bangladesh Medical Journal 2011 Vol.40(3):8-11

Neisseria gonorrhoeae, the causative agent of gonococcal infection, is known to frequently change their characteristics to evade host immune mechanism. Characterization of the clinical isolates of the organism can lead to identification of the circulating strains and often a sexual network in a community to help in designing the control strategy. Keeping in mind the above consideration, a total of 239 N. gonorrhoeae, isolated from high-risk populations, were characterized for serotypes and serovars by monoclonal antibodies against protein I of the organism. Majority of the serotypes were serotype B (142, 59.4%). Majority of the isolates showing resistance to at least one of the antibiotics tested were also serotype B (139, 59.2%), whereas, majority of the isolates showing resistance to any three of the antibiotics (multidrug resistant, MDR) (63%) was serotype A. A total of 41 different serovars were also identified and five of which (Arst, Bropt, Bopt, Arost, and Brop) included the highest percent (49.3%) of the isolates. Many serovars (23/41, 56.1%) were new emergent and included 58 (24.3%) of the isolates investigated. All of the new serovars were resistant to at least one of the antibiotics tested and the highest rate (40/102, 39.2%) was MDR. Serotyping and serovar determination was found contributory to understand the microepidemics of the N. gonorrhoeae isolates. Further studies including antibiogram and contact tracing can efficiently help in control of the disease.