Urinary tract infection (UTI) is common ailment worldwide with female predominance. Catheter associated urinary tract infection (CAUTI) is the most common healthcare related infection commonly used in urinary obstruction and incontinence in critically ill patients with prolonged indwelling catheterization means more than 30 days, which is almost invariable in all patients within 14 days of catheterization which increases morbidity and mortality and treatment expenses. Approximately 80% of nosocomial UTI is CAUTI. CAUTI may be asymptomatic and symptomatic. 2-4% cases may develop bacteraemia. Organisms responsible for CAUTI is similar to UTI as Escherichia coli the commonest than proteus, Pseudomonas, Klebsiella, Enterobacter, Enterococci, Candida, Serratia and rarely with Delftia tsuruhatensis, Achromobacter xylosoxidans and few others. CAUTI can be multibacterial. In CAUTI infective organisms form biofilm and propagate from there. E. coli is the most common isolate of CAUTI but Enterobacter cloacae exhibit highest biofilm production. CAUTI organisms are more antibiotic resistance than UTI. Even due to extensive use of antibiotics now Extended Spectrum Beta Lactamase (ESBL) producing CAUTI organisms are isolated from catheter biofilm.

Background Antimicrobial resistance is an emerging concern globally in recent years. Management of common infectious diseases like urinary tract infection (UTI) has become challenging. In this context, the purpose of this study is to compare the shifting trends in bacteriology and antibiotic resistance pattern among uropathogens to similar studies conducted at various times in Bangladesh. Methods It was a cross-sectional study conducted at the CUMILLA MEDICAL COLLEGE HOSPITAL’S MEDICINE DEPARTMENT in three phases (2011, 2016, 2021. Patients who visited the outpatient and inpatient departments of the study center with symptoms suggestive of a urinary tract infection were undergone urine culture. Those who yielded positive growth in urne culture were finally included in the study. Results Escherichia coli (62% in 2021, 86% in 2016 and 76% in 2011) and Klebsiella species (11% in 2021, 10% in 2016 and 11% in 2011) were the most frequently isolated bacteria. Overall, in Gram-negative organisms, resistance was almost > 50% to all the tested antibiotics. Very high frequency of resistance ranging from 66.67 to 93.75% to cotrimoxazole, ciprofloxacin, cefuroxime, cephradine, amoxicillin and nalidixic acid, moderately high resistance to ceftriaxone (64.52%) and gentamicin (53.13%) and low resistance to nitrofurantoin (25.38%) were shown by the most commonly isolated organisms. Resistance to common antibiotics has been significantly increased over time in the isolated orgnaisms, especially in carbapenem and aminoglycoside group. Conclusion Resistance of uropathogens against conventional antibiotics used to treat UTI is high and the proportion has been increased over time. The situation might be grave in upcoming years if rational consumption of antibiotics is not warranted.

Aims: The cost of treatment and monitoring of rheumatoid arthritis patients with more effective disease‐modifying drugs like methotrexate and sulphasalazine is prohibitive. This open random clinical trial was carried out with a view to assessing the status of chloroquine, the cheapest disease‐modifying drug, in the treatment of rheumatoid arthritis. Method: A total of 47 cases were included in the study. Thirty subjects were randomly assigned to methotrexate and 14 to chloroquine groups. During 6 months follow‐up, five cases (three in chloroquine and two in methotrexate) dropped out because of side‐effects and inefficacy. Out of the remaining 42, 35 were female and five were male, with a mean age of 46.05 ± 14.12 years. Mean duration of the disease at the time of presentation was 5.53 ± 6.33 years. The two groups did not differ significantly in baseline demographics and disease activity variables. Results: In both groups, most indices showed significant decrease in the disease activity. The difference in decreases in swollen joint count, tender joint count, joint swelling index and duration of morning stiffness were higher in the methotrexate compared to the chloroquine group. Inter‐group differences in the magnitudes of decreases were insignificant in other variables. At the end of 6 months, the response rate, according to the WHO/ILAR criteria, were 75% and 64% in methotrexate and chloroquine groups, respectively. The difference was not significant. Anorexia and nausea were the most common side‐effects in both groups and subsided with the passage of time despite continuation of therapy. Conclusion: Considering low cost and a lesser need for close monitoring, chloroquine may be considered a choice in rheumatoid arthritis patients with mild disease and who are from underprivileged communities.

not available Central Medical College Journal Vol 6 No 2 Jauly 2022 Page: 57

not available Central Medical College Journal Vol 5 No 1 Jan 2021 PP 02