BackgroundBloodstream infections due to bacterial pathogens are a major cause of morbidity and mortality in Bangladesh and other developing countries. In these countries, most patients are treated empirically based on their clinical symptoms. Therefore, up to date etiological data for major pathogens causing bloodstream infections may play a positive role in better healthcare management. The aim of this study was to identify the bacterial pathogens causing major bloodstream infections in Dhaka, Bangladesh and determine their antibiotic susceptibility pattern.MethodsFrom January 2005 to December 2014, a total of 103,679 single bottle blood samples were collected from both hospitalized and domiciliary patients attending Dhaka hospital, icddrb, Bangladesh All the blood samples were processed for culture using a BACT/Alert blood culture machine. Further identification of bacterial pathogens and their antimicrobial susceptibility test were performed using standard microbiological procedures.ResultsOverall, 13.6% of the cultured blood samples were positive and Gram-negative (72.1%) bacteria were predominant throughout the study period. Salmonella Typhi was the most frequently isolated organism (36.9% of samples) in this study and a high percentage of those strains were multidrug-resistant (MDR). However, a decreasing trend in the S. Typhi isolation rate was observed and, noticeably, the percentage of MDR S. Typhi isolated declined sharply over the study period. An overall increase in the presence of Gram-positive bacteria was observed, but most significantly we observed the percentage of MDR Gram-positive bacteria to double over the study period. Overall, Gram positive bacteria were more resistant to most of the commonly used antibiotics than Gram-negative bacteria, but the MDR level was high in both groups.ConclusionsThis study identified the major bacterial pathogens involved with BSI in Dhaka, Bangladesh and also revealed their antibiotic susceptibility patterns. We expect our findings to help healthcare professionals to make informed decisions and provide better care for their patients. Also, we hope this study will assist researchers and policy makers to prioritize their research options to face the future challenges of infectious diseases.Electronic supplementary materialThe online version of this article (doi:10.1186/s13756-016-0162-z) contains supplementary material, which is available to authorized users.

Chromobacterium violaceum is an emerging environmental pathogen that causes life-threatening infection in humans and animals. In October 2017, a Bangladeshi farmer was hospitalized with high-grade fever due to an agricultural injury-related wound infection. Bacteriological and 16S rRNA gene investigation detected C. violaceum in the wound discharge. The patient recovered successfully after a combination treatment with meropenem and ciprofloxacin, followed by prolonged medication to avoid recurrence. We strongly propose to incorporate C. violaceum in the differential diagnosis of wound and skin infections occurring in tropical and subtropical regions, especially when the injury was exposed to soil or sluggish water.

Introduction: Urinary tract infections (UTIs) are the most common bacterial infections in women of all ages. The emergence of resistance to newer classes of antibiotics, including third generation cephalosporins, has limited the drug choices for treatment of UTI. We report here a recurrent UTI due to co-infection with multiple-antibiotic-resistant (MAR) Escherichia coli pathotypes.Case presentation: A 73-year-old woman with diabetes mellitus type 2 presented with fever, nausea, vomiting, burning sensation, painful and frequent urination. She was diagnosed with recurrent UTI (RUTI) due to co-infection with pansensitive enteroaggregative E. coli (EAEC) and MAR extended spectrum b-lactamase (ESBL)-producing uropathogenic E. coli (UPEC) and treated with azithromycin and levofloxacin (each for 10 days). Unfortunately, she did not respond. Plasmid profile analysis showed that the MAR E. coli strain harboured multiple plasmids including ,38 and ,80 MDa plasmids. PCR for detection of b-lactamase genes showed that the isolate was negative for blaTEM, blaSHV, blaOXA and blaCTX-M. To the best of our knowledge, this is the first report of co-infection with an EAEC and MAR ESBL-producer UPEC in Bangladesh. Conclusion:We recommend that all pathotypes of E. coli as well as the other more common uropathogens should be considered in the diagnosis of RUTI and multiple antibiotics should be prescribed only in severe conditions.

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A 8 months old mildly underweight baby girl was initially admitted at the Short Stay Ward of Dhaka hospital of icddr,b with acute watery diarrhea. On the next day she was transferred to Intensive Care Unit (ICU) of the same hospital for convulsion. After exclusion of potential differentials of convulsion, hypernatremia was added as new problem. She was treated for AWD and hypernatremic convulsion at the ICU following standard hospital protocol. She had also found to have pneumonia (confirmed by radiological evidence) which eventually improved with second line of antibiotics. Finally she found to have Oerskovia xanthineolytica bacteremia which was improved with the ongoing treatment of pneumonia. We report Oerskovia xanthineolytica bacteremia as the 1st case in Bangladesh.Bangladesh Crit Care J March 2016; 4 (1): 38-40