Background Severe COVID-19 infections have already taken more than 4 million lives worldwide. Factors, such as socio-demographics, comorbidities, lifestyles, environment, and so on, have been widely discussed to be associated with increased severity in many countries. The study aimed to determine the risk factors of severe–critical COVID-19 in Bangladesh. Methods This was a comparative cross-sectional study among various types of COVID-19 patients (both hospitalized and non-hospitalized) confirmed by reverse transcription polymerase chain reaction (RT-PCR). We have selected 1500 COVID-19 positive patients using a convenient sampling technique and analyzed lifestyle and comorbidity-related data using IBM SPSS-23 statistical package software. Chi-square test and multinomial logistic regression were used to determine risk factors of life-threatening COVID-19 infection. Results The mean age of the study participants was 43.23 (±15.48) years. The study identified several lifestyle-related factors and common commodities as risk factors for severe–critical COVID-19. The patient’s age was one of the most important predictors, as people >59 years were at higher risk (AOR=18.223). Among other lifestyle factors, active smoking (AOR=1.482), exposure to secondary smoking (AOR=1.728), sleep disturbance (AOR=2.208) and attachment with SLT/alcohol/substance abuse (AOR=1.804) were identified as significant predictors for severe–critical COVID-19. Patients those were overweight/obese (AOR=2.105), diabetic (AOR=4.286), hypertensive (AOR=3.363), CKD patients (AOR=8.317), asthma patients (AOR=2.152), CVD patients (AOR=7.747) were also at higher risk of severe–critical COVID-19 infection. Conclusion This study has identified several vital lifestyles and comorbidity-related risk factors of severe–critical COVID-19. People who have these comorbidities should be under high protection, and risky lifestyles of the general population should modify through the proper educational campaign.

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Background: Clarithromycin and Levofloxacin are most frequently included in the standard triple therapies for H. pylori eradication in our country. Resistance to clarithromycin and fluoroquinolones are particularly related with treatment failure. Objectives: The objective of this study was to detect, clarithromycin and levofloxacin resistance associated with gene mutations in H. pylori directly from gastric biopsies using an allele specific primer-PCR (ASP-PCR) assay. Materials and Methods: Gastric biopsy specimens were collected from 143 adult dyspeptic patients, from Department of Gastroenterology, BSMMU and Dhaka Medical College Hospital (DMCH), during the period of March, 2018 to February, 2019. H. pylori was identified by rapid urease test, ureC gene by PCR, histological staining and culture. ASP-PCR was used to identify 23S rRNA gene and gyrA gene mutation predictive of clarithromycin and levofloxacin resistant H. pylori respectively. Results: H. pylori positive cases were 32.9% based on the case definition used in the study. Among 42 ureC positive H. pylori cases, point mutations in 23Sr RNA gene for clarithromycin resistance were detected only at A2142G position in 9 (21.4%) cases and gyrA gene mutations for levofloxacin resistance were detected in 16 (38.1%) cases. Only 1 (2.4%) case had mutation both in 23Sr RNA and gyrA gene. Conclusion: Those findings may guide toward the therapeutic choices in our country. PCR based diagnostic assays can be the alternative approach for rapid detection of antibiotic resistances of H. pylori directly from gastric biopsies, where culture and susceptibility tests are not routinely performed. Bangladesh J Med Microbiol 2019; 13 (1): 12-19

Background: Acinetobacter baumannii is responsible for nosocomial infections which are related to biofilm formation of this pathogen. Biofilm formation helps the bacteria in surviving stressed environmental conditions and bacteria growing in biofilms are resistant to most of the commonly used antibiotics. Objectives: The objective of this study was to detect A. baumannii, to see antibiotic sensitivity and biofilm formation in different clinical samples. Methods: Total 108 Acinetobacter spp. were collected from different clinical samples which were identified by conventional microbiological procedures. Out of 108 Acinetobacter spp, 85 were identified as A. baumannii by polymerase chain reaction by detecting blaOXA-51 gene which is intrinsic to A. baumannii. Antibiotic sensitivity was detected by modified disc diffusion method and biofilm formation was detected by Tissue culture plate method. Results: Among 85 isolates, 45.9% A. baumannii were obtained from tracheal aspirate followed by blood (21.2%), wound swab (15.3%), urine (10.6%), pus (5.9%) and pleural fluid (1.1%). More than 80% 0f A. baumannii was resistant to cephalosporin, aminoglycosides, quinolone, carbapenem. By Tissue culture plate method, 78.8% of isolates showed biofilm formation. Biofilm formation in tracheal aspirate was 82.1%, in blood 72%, in wound swab 92%, in urine 44.4%, in pus 100% and in pleural fluid 100%. Conclusion: Detection rate of A. baumannii was more in tracheal aspirates. Biofilm producing A. Baumannii was resistant to most of the antibiotics. Bangladesh J Med Microbiol 2018; 12 (2): 4-9

Clostridium difficile (C. difficile) has become a global public health challenge as C. difficile associated-diarrhea (CDAD) is increasing in incidence and severity of disease in several countries during recent years. This cross sectional study evaluated the frequency of CDAD among 100 adult patients who were clinically diagnosed as nosocomial diarrhoea in various clinical wards of Bangabandhu Shiekh Mujib Medical University (BSMMU) and Dhaka Medical College and Hospital (DMCH). CDAD diagnosis was based on detection of C. difficile along with clinical symptoms of diarrhea. Stool microscopy was done for cytology followed by anaerobic culture in cycloserine cefoxitin fructose agar (CCFA) media, confirmed by latex agglutination of culture isolates. Toxin genes (both A and B) were detected by multiplex Polymerase chain reaction (PCR) from culture isolates. Out of 100 diarrhoeal stool samples collected, 25% samples were pus cell positive in microscopy, culture yielded growth of C. difficile in 10% samples and all isolated C. difficile were confirmed by both latex agglutination and PCR. Out of 10 isolates, 7 were only tpi (triose phosphate isomerase) gene positive which is species-specific for C. difficile indicating the presence of non-toxigenic C. difficile and 3 isolates had both tpi and toxin genes (both tcdA and tcdB gene) on PCR indicative of toxigenic C. difficile respectively. C. difficile toxin gene detection by PCR along with culture is highly specific and sensitive diagnostic modality for CDAD. Differentiation between toxigenic and non-toxigenic strains by PCR may facilitate the appropriate patient management. Bangladesh J Med Microbiol 2018; 12 (1): 4-9