Analyzing antibiotic susceptibility pattern of uropathogens help to overcome the therapeutic difficulties created by the rising antimicrobial resistant bacteria and guides in choosing appropriate antibiotics. Hence, we aimed at evaluating the pathogens causing UTI and study their antibiogram. Midstream urine samples were collected, cultured and appropriate biochemical tests were performed for proper identification of urinary pathogens in BSMMU from January 2013 to December 2013. The most common isolated Gram negative uropathogens were Escherichia coli (63.93%) followed by Klebsiella pneumoniae (17.09%), other bacterial species, named Pseudomonas spp. Enterobacter Acinetobacter spp. Citrobacter spp Proteus spp. Morganella. Among Gram positive organism S. aureus S. saprophyticus S. agalectiae and Enterococci were found. Urinary tract infections were more prevalent in women than men (61.68% vs. 38.32%). High level of sensitivity was found to imipenem, amikacin, nitrofurantoin, ceftriaxone, gentamicin, cefuroxime in most of the isolates. Almost all the test organisms exhibited multiple antibiotic resistances. The high multiple antibiotics resistance identified makes it necessary for antibiotic susceptibility testing to be conducted prior to antibiotic(s) prescription.Bangladesh J Med Microbiol 2016; 10 (01): 22-26

Meningitis caused by Mycobacterium tuberculosis remains an important cause of morbidity and mortality worldwide, and presents particular challenges in terms of diagnosis and management. The prevalence of TB meningitis remains largely underestimated due to nonspecific clinical manifestation. At early stages diagnosis is largely based on microscopy and culture which are often less sensitive and time consuming. This study was aimed to evaluate the diagnostic potentials of urinary polymerase chain reaction (PCR) by using TRC4 and IS6110 primers. Further the results were also compared by culture on Lowenstein-Jensen (LJ) media and AFB smear by Zeihl-Nelson (ZN) staining. A total of 20 CSF samples were studied from clinically suspected cases of tubercular meningitis. All the samples were processed for conventional ZN staining, TB culture on LJ media and TB-PCR by IS6110 and TRC4 primers by standard protocols. Of the total 20 samples, 12 cases were diagnostically positive TB meningitis samples among which bacteriological test were positive in only 1(8.33%) cases. PCR assay detected MTb in 10(83.33%) patients by TRC4 primers and in 8 (66.67%) patients by IS6110 primers. Since some strains of MTB may lack the IS6110 element in their genome using TRC4 primer instead of IS6110 is superior in diagnosing tubercular meningitis by PCR assay.Citation: Sattar ANI, Setu SK, Firoz TH, et al. Diagnosis of tuberculosis meningitis by using Trc4 and Is611o primers in Bangladesh.

The prevalence of Tuberculous meningitis remains largely underestimated due to nonspecific clinical manifestation at early stages. A total of 20 CSF samples were studied from clinically suspected cases of tuberculous meningitis. All the samples were processed for ZN staining, TB culture on LJ media and TB-PCR using IS6110 and TRC4 primers by standard protocols. Of the total 20 CSF samples, 12 cases were diagnosed as TB meningitis. Most of the tuberculous meningitis cases were found positive by PCR using TRC4 primers (83.33%) followed by IS6110 primer (66.67%) and culture on L-J media(8.33%). None were found positive by ZN staining. TB-PCR usingTRC4 primer showed higher positivity than using IS6110 in detecting tuberculous meningitis, since some strains of MTB may lack the IS6110 element in their genome. PCR assay using TRC4 primer is superior in diagnosing tuberculous meningitis. This study was aimed to evaluate the diagnostic potentials of CSF polymerase chain reaction (PCR) by using TRC4 and IS6110 primers. Further the results were also compared with culture on Lowenstein-Jensen (LJ) media and AFB smear by ZeihlNelson (ZN) staining.

Background: This study aimed to investigate the epidemiology and antibiogram of clinical Staphylococcus aureus isolates from three tertiary care hospitals in Dhaka , Bangladesh. Methods: A total of 185 clinical S. aureus isolates were studied from March 2016 to February 2017 and identified by standard microbiological methods and an antibiogram was determined by disc diffusion method. A duplex polymerase chain reaction (PCR) assay was performed on all isolates to detect femA and mecA genes of S. aureus. Results: Among the 185 isolates, all (100%) were positive for the femA gene, 76 (41.1%) were methicillinresistant S. aureus (MRSA), and 109 (58.9%) were methicillin-susceptible S. aureus (MSSA). The highest and the lowest frequency of both MRSA were isolated from pus and urine specimens, respectively. All 185 S. aureus were 100% sensitive to both vancomycin and linezolid and were highly sensitive towards rifampicin (94%), meropenem (87%), gentamicin (85.4%), and cotrimoxazole (82.2%), whereas the highest resistance was against penicillin G (94.6%) followed by amoxicillin/clavulanic acid (82.7%), azithromycin (72.4%), amoxicillin (66.5%), and ciprofloxacin (63.2%). After vancomycin and linezolid, MRSA showed good susceptibility to rifampicin, cotrimoxazole, and gentamicin, while MSSA exhibited high sensitivity toward rifampicin, gentamicin, cefoxitin, meropenem, cloxacillin, ceftriaxone, and cotrimoxazole. Furthermore, MRSA was significantly more resistant to antibiotics than MSSA (P value<0.05), and the majority of S. aureus (81.1%), MRSA (97.4%), and MSSA (69.7%) were multidrug-resistant (MDR). Conclusion: Our findings can guide physicians to provide effective antibiotic therapy, implement monitoring and control strategies to reduce antimicrobial resistance, and prevent the dissemination of MRSA and MDR in the environment.

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