Background: Wound infections are global problem in the field of surgery associated with long hospital stay, higher treatment expenditure, morbidity and mortality. Objective: To isolate and identify the bacteria causing wound infection and to determine the antimicrobial susceptibility pattern. Methods: This retrospective study was conducted in the Department of Microbiology at Shaheed Suhrawady Medical College, Dhaka from January 2017 to December 2017 for a period of one (01) year. A total of 190 wound swabs were collected from the patients who were visited in outpatient department and were admitted at inpatient department with skin and soft tissue infection. Swabs from the wound were inoculated on appropriate media and cultured and the isolates were identified by standard procedures as needed. Antimicrobial susceptibility testing was done by disc diffusion method according to ‘The Clinical Laboratory Standard Institute’ guidelines. Results: In this study, out of 190 cases 115 (60.52%) were male and 75 (39.47%) were female and majority 85(44.73%) were in the age group of 16 to 30 years. A total number of 190 isolates were obtained, among which 124 (65.25%) were culture positive cases. Among the isolated organisms predominant bacteria was Staphylococcus aureus 68 (35.79%) followed by Escherichia coli 30 (15.79%), Pseudomonas 14 (7.37%), Klebsiella 6 (3.16%), Proteus 4 (2.10%) and Acinetobacter 2 (1.05%). Staphylococcus aureus was sensitive to linezolid (94.11%), vancomycin (88.23%) and amikacin (70.58%). Among the Gram negative isolates Escherichia coli was predominant and showed sensitivity to imipenem (80%), amikacin (70%), ceftazidime (60%), piperacillin+ tazobactum (56.66%), colistin (53.33%). Pseudomonas showed sensitivity to colistin (78.57%), imipenem (71.42%). Klebsiella showed sensitivity to imipenem (83.33%), amikacin (66.66%), piperacillin+ tazobactum (66.66%), and colistin(66.66%). Conclusion: Staphylococcus aureus was the most frequently isolated pathogen from wound swab and the antibiotic sensitivity pattern of various isolates will guide for appropriate selection of antibiotics against wound infection, so as to reduce the spread of resistant bacteria. J Shaheed Suhrawardy Med Coll, June 2019, Vol.11(1); 65-68

Infections due to multidrug resistant E.coli range from uncomplicated urinary tract infections to life-threatening sepsis. A retrospective study was conducted to determine the patterns of antimicrobial susceptibility in 173 (12.84%) Escherichia coli strains isolated from 1347 clinical specimens of different types. Isolation and identification of E.coli were done as per routine laboratory protocol directed by Cheesbrough1. The isolation rate of E.coli was 48.57% in stool followed by 17.68% in urine, 25% in wound swabs, and 15.38% in tracheal aspirate etc. Among the 173 isolates 102 (59%) were from males and 71 (41%) were from females. Patients were classified into five age groups: 0-15, 16-30, 31-45, 46-60 and >60 years. E.coli was found highest number in females (13.9%) of age range 31-45 years and in males (22%) belonged to age group of over 60 years. Antimicrobial susceptibility testing by the disk diffusion method was conducted for 22 different antibiotics. The majority of isolated E.coli were highly sensitive to Imipenem (98.18%), Meropenem (97.37%), Amikacin (91.67%), Amoxiclav (80%), Ceftazidime (73.33%), and Gentamycin (71.76%). The antibiotics Tobramycin and Azithromycin were found as moderately sensitive against E.coli with the susceptibility rate of 52.5% and 50% respectively. The isolates show low degree of susceptibility to Penicillin G (9.52%), Carbenicillin (10%), Erythromycin (19.48%), Amoxycillin (19.59%), and Ampicillin (25%). These findings have clinical and epidemiological significance and provide a benchmark for future studies on the pattern of susceptibility of clinical isolates of E.coli in this region as well as may help the clinician to prescribe the right empirical treatment.KYAMC Journal Vol. 7, No.-1, Jul 2016, Page 681-686

Carbapenem resistant Enterobacteriaceae (CRE) is becoming a major public health concern globally. Detection of carbapenem hydrolyzing enzyme carbapenemase in Enterobacteriaceae is important to institute appropriate therapy and to initiate preventive measures. This study was designed to determine the presence of carbapenemase producers among the CRE isolated from patients at Dhaka Medical College Hospital, Bangladesh. Twenty-nine CRE strains detected by disk diffusion technique were included in the study. Minimum inhibitory concentration of imipenem and tigecycline was determined by agar dilution method. Carbapenemase production was phenotypically detected by Modified Hodge test while MBL producers were detected by combined disk and double disk synergy tests. Genes encoding blaNDM-1, blaKPC,, blaOXA-1-group were identified by polymerase chain reaction (PCR).Out of 29 CRE, nineteen (65.6%) were positive for carbapenemase by any of the three phenotypic tests namely MHT, CD or DD tests. Those 19 isolates were also positive either for blaNDM-1 or blaOXA-181/blaOXA-48 by PCR. Of the 19 PCR positive isolates, the rate of positivity for blaNDM-1, blaOXA-181/blaOXA-48 and blaNDM-1+ blaOXA-181/blaOXA-48 was 73.7% (14/19), 57.9% (11/19) and 31.6% (6/19) respectively. Both blaOXA-181 and blaOXA-48 co-existed. All the carbapenemase producing organisms harboured blaCTX-M-15 except one C. freundii strain. The rate of resistance to different classes of antibiotics ranged from 63.2% to 100% except colistin and tigecycline. Organisms positive for OXA-181/OXA-48 had a low level of resistance to carbapenem (MIC 1 -4 ì g/ml) while with NDM-1 had high level resistance to imipenem (MICs 16 -≥ 32 ì g/ ml). Out of 19 carbapenemase positive isolates, 12 (63.16%) were extensively drug-resistant (XDR) and were only sensitive to tigecycline and colistin.The result of this study showed the presence of blaOXA-181/ blaOXA-48, blaNDM-1 positive strains in Bangladesh and colistin and tigecycline were the most effective drugs against carbapenemase producing Enterobacteriaceae (CPE). Epidemiological monitoring of carbapenemase producing organisms in Bangladesh is important to prevent their dissemination.Ibrahim Med. Coll. J. 2015; 9(2): 45-51

Background: Macrovascular complications cause much of the serious morbidity and mortality in patients with diabetes. The aim of the study was to determine the prevalence and risk factors of different macrovascular complications among type 2 diabetic patients.Materials and Methods: We studied two fifty cases of type 2 diabetic patients in this cross-sectional study which was conducted in the out-patient department of BIRDEM hospital, Bangladesh. The randomly selected patients were evaluated for the presence of coronary heart diseases (CHD), stroke and peripheral vascular diseases (PVD) through the review of their registered diabetic guide book. We included sociodemographic information, blood pressure, anthropometry (height, weight, body mass index) and lipid profile of the patients. Glycaemic status was assessed by HbA1c (HbA1c was categorized into 3 groups) and plasma glucose levels. We used logistic regression analysis to determine and quantify the association of CHD, stroke and PVD with various risk factors. Results: Two hundred and fifty cases of type 2 diabetic patients (male 129 and female 121 were studied. The prevalence of macro-vascular complications was 28.8%. Among them CHD was 21.2% (95% CI: 16.13- 26.27%), stroke in 8.4% (95% CI: 4.96-11.84%) and PVD in 7.2% (95% CI: 4-10.4%). Logistic regression models showed that macrovascular complications were more common in females; the risk increased significantly with age, longer duration of diabetes, lacking of physical exercise, presence of hypertension, HbA1c, Fasting Blood Glucose (FBG) and blood glucose 2 hours ABF.Conclusions: CHD is the most common macrovascular complication among type 2 DM patients. Advanced age, longer duration of diabetes, hypertension, poor glycaemic control, lacking of physical exercise etc. are significant risk factors of macrovascular complications in type 2 diabetic patients.KYAMC Journal Vol. 7, No.-1, Jul 2016, Page 662-667

Ventilator-associated pneumonia (VAP) is one of the major causes of morbidity and mortality among the critically ill patients of intensive care units (ICU). The present cross sectional study was conducted to isolate and identify bacterial causes of VAP among the patients admitted in intensive care unit (ICU) of Dhaka Medical College Hospital. The study was conducted between July, 2013 to June 2014. A total of 65 endotracheal aspirate (ETA) and blood samples were collected from patients with clinically suspected ventilator associated peumonia(VAP). Samples were collected from patients on mechanical ventilation for more than 48 hours. ETA and blood samples were cultured aerobically. Multiplex PCR was performed with ETA to detect Mycoplasma pneumoniae, Legionella pneumophila and Chlamydia pneumoniae. Among the atypical bacteria, M. pneumoniae were detected in 5 (7.69%), L. pneumophila in 4 (6.15%) cases by multiplex PCR in ETA from VAP cases. No C. pneumoniae was detected. The study revealed that in VAP cases atypical bacteria should be considered as a possible bacterial agents.Ibrahim Med. Coll. J. 2015; 9(1): 22-25