Characterization of biofilm formation and multi-drug resistance among Pseudomonas aeruginosa isolated from hospital wastewater in Dhaka, Bangladesh.

Hospital wastewater has been identified as a hotspot for the emergence and transmission of multidrug-resistant (MDR) pathogens that present a serious threat to public health. Therefore, we investigated the current status of antibiotic resistance as well as the phenotypic and genotypic basis of biofilm formation in Pseudomonas aeruginosa from hospital wastewater in Dhaka, Bangladesh. The disc diffusion method and the crystal violet assay were performed to characterize antimicrobial resistance and biofilm formation, respectively. Biofilm and integron-associated genes were amplified by the polymerase chain reaction. Isolates exhibited varying degrees of resistance to different antibiotics, in which >80% of isolates showed sensitivity to meropenem, amikacin, and gentamicin. The results indicated that 93.82% of isolates were MDR and 71 out of 76 MDR isolates showed biofilm formation activities. We observed the high prevalence of biofilm-related genes, in which algD+pelF+pslD+ (82.7%) was found to be the prevalent biofilm genotypic pattern. Sixteen isolates (19.75%) possessed class 1 integron (int1) genes. However, statistical analysis revealed no significant association between biofilm formation and multidrug resistance (χ2 = 0.35, P = 0.55). Taken together, hospital wastewater in Dhaka city may act as a reservoir for MDR and biofilm-forming P. aeruginosa, and therefore, the adequate treatment of wastewater is recommended to reduce the occurrence of outbreaks.

Factors determining preventive practices of the healthcare workers regarding COVID-19 in Bangladesh.

PURPOSE: Identifying the factors influencing the preventive practices of the healthcare workers (HCWs) is crucial during the ongoing coronavirus disease 2019 (COVID-19) because the HCWs are exposed to unparalleled levels of risks. Such concern is starting to be explored worldwide although there is only a single study available in Bangladesh with a limited scope of explorations of the domain. Therefore, this study aimed to identify the factors determining better preventive practices of HCWs toward COVID-19. MATERIALS AND METHODS: A cross-sectional one-to-one survey was carried out using a validated questionnaire from December 15, 2020 to March 15, 2021 among a sample of 640 HCWs from Khulna, a southwestern division of Bangladesh, consisting of ten districts. The measures included socio-demographics, knowledge, attitude, and preventive practices related information. A binary logistic regression analysis was conducted to identify factors determining preventive practices of HCWs toward COVID-19. RESULTS: More than half of the respondents (62%) were following better preventive practices. Besides, around 70% of them had better knowledge and attitudes toward the disease. Regression analysis showed a number of major determining factors of the HCWs' better preventive practices including being a nurse or other professionals (ie, radiologists and pathologists), being graduates, working in coronavirus isolation units, managing COVID-19 patients, having previous training, and having better attitudes toward COVID-19. CONCLUSION: The findings confirmed that the HCWs were generally practicing preventive manners although these trends followed were not at the standard level. So, providing guidance and information from authentic sources and organizing proper training could possibly enhance the preventive behavior in managing COVID-19 patients.

Relative expression of proinflammatory molecules in COVID-19 patients who manifested disease severities.

Aggressive immune response, due to overexpressed proinflammatory molecules, has been characterized in coronavirus disease 2019 (COVID-19) patients. Some of those mediators have a dual and opposite role on immune systems at play behind differential disease severities. We investigated the expression of some cytokines and chemokines in COVID-19 patients in Bangladesh. We diagnosed the patients by detecting severe acute respiratory syndrome coronavirus 2 RNA in nasal swab samples by the real-time RT-PCR method. Thirty adult patients were preselected based on their disease severities and grouped into mild, moderate, and severe cases. Nine healthy volunteers participated in this study as a control. Relative expression of nine cytokines/chemokine in total leukocytes was semi-quantified in SYBRgreen-based real-time quantitative reverse-transcriptase polymerase chain reaction. We performed statistical tests on transformed log data using SPSS 24.0. At the onset of symptoms (Day 1), angiotensin-converting enzyme 2 (ACE2) (p < 0.05) and interleukin (IL)-6 (p > 0.05) were upregulated in all COVID-19 groups, although the expression levels did not significantly correlate with disease severities. However, expressions of IL-6, monocyte chemotactic protein-1, macrophage inflammatory protein-1α, tumor necrosis factor-α (TNF-α), RANTES (regulated upon activation, normal T cell expressed and secreted), and ACE2, on Day 14, were positively correlated with disease severities. Relative viral load at Day 1 showed no significant correlation with cytokine expression but had a significant positive correlation with RANTES and ACE2 expression on Day 14 (p < 0.05). Male patients had a higher level of IL-6 than female patients on Day 1 (p < 0.05). All COVID-19 patients showed upregulated cytokines and chemokines on Day 14 compared to Day 1 except TNF-α. Female patients had a higher expression of ACE2 and IL-12 on Day 14. Upregulated cytokines/chemokines at the convalescent stage, especially IL-6, may help in targeting anticytokine therapy in post-COVID-19 patients' management.