Biodegradation of polyethylene (PE), polypropylene (PP), and polystyrene (PS) microplastics by floc-forming bacteria, Bacillus cereus strain SHBF2, isolated from a commercial aquafarm.

The ubiquitous proximity of the commonly used microplastic (MP) particles particularly polyethylene (PE), polypropylene (PP), and polystyrene (PS) poses a serious threat to the environment and human health globally. Biological treatment as an environment-friendly approach to counter MP pollution has recent interest when the bio-agent has beneficial functions in their ecosystem. This study aimed to utilize beneficial floc-forming bacteria Bacillus cereus SHBF2 isolated from an aquaculture farm in reducing the MP particles (PE, PP, and PS) from their environment. The bacteria were inoculated for 60 days in a medium containing MP particle as a sole carbon source. On different days of incubation (DOI), the bacterial growth analysis was monitored and the MP particles were harvested to examine their weight loss, surface changes, and alterations in chemical properties. After 60 DOI, the highest weight loss was recorded for PE, 6.87 ± 0.92%, which was further evaluated to daily reduction rate (k), 0.00118 day-1, and half-life (t1/2), 605.08 ± 138.52 days. The OD value (1.74 ± 0.008 Abs.) indicated the higher efficiency of bacteria for PP utilization, and so for the colony formation per define volume (1.04 × 1011 CFU/mL). Biofilm formation, erosions, cracks, and fragments were evident during the observation of the tested MPs using the scanning electron microscope (SEM). The formation of carbonyl and alcohol group due to the oxidation and hydrolysis by SHBF2 strain were confirmed using the Fourier transform infrared spectroscopic (FTIR) analysis. Additionally, the alterations of pH and CO2 evolution from each of the MP type ensures the bacterial activity and mineralization of the MP particles. The findings of this study have confirmed and indicated a higher degree of biodegradation for all of the selected MP particles. B. cereus SHBF2, the floc-forming bacteria used in aquaculture, has demonstrated a great potential for use as an efficient MP-degrading bacterium in the biofloc farming system in the near future to guarantee a sustainable green aquaculture production.

Development of a Python-based electron ionization mass spectrometry amino acid and peptide fragment prediction model.

The increased fragmentation caused by harsher ionization methods used during mass spectrometry such as electron ionization can make interpreting the mass spectra of peptides difficult. Therefore, the development of tools to aid in this spectral analysis is important in utilizing these harsher ionization methods to study peptides, as these tools may be more accessible to some researchers. We have compiled fragmentation mechanisms described in the literature, confirmed them experimentally, and used them to create a Python-based fragment prediction model for peptides analyzed under direct exposure probe electron ionization mass spectrometry. This initial model has been tested using single amino acids as well as targeted libraries of short peptides. It was found that the model does well in predicting fragments of peptides composed of amino acids for which the model is well-defined, but several cases where additional mechanistic information needs to be incorporated have been identified.

Vaccination Utilization and Subnational Inequities during the COVID-19 Pandemic: An Interrupted Time-Series Analysis of Administrative Data across 12 Low- and Middle-Income Countries.

BACKGROUND: During and after the SARS-CoV-2 (COVID-19) pandemic, many countries experienced declines in immunization that have not fully recovered to pre-pandemic levels. This study uses routine health facility immunization data to estimate variability between and within countries in post-pandemic immunization service recovery for BCG, DPT1, and DPT3. METHODS: After adjusting for data reporting completeness and outliers, interrupted time series regression was used to estimate the expected immunization service volume for each subnational unit, using an interruption point of March 2020. We assessed and compared the percent deviation of observed immunizations from the expected service volume for March 2020 between and within countries. RESULTS: Six countries experienced significant service volume declines for at least one vaccine as of October 2022. The shortfall in BCG service volume was ~6% (95% CI -1.2%, -9.8%) in Guinea and ~19% (95% CI -16%, 22%) in Liberia. Significant cumulative shortfalls in DPT1 service volume are observed in Afghanistan (-4%, 95% CI -1%, -7%), Ghana (-3%, 95% CI -1%, -5%), Haiti (-7%, 95% CI -1%, -12%), and Kenya (-3%, 95% CI -1%, -4%). Afghanistan has the highest percentage of subnational units reporting a shortfall of 5% or higher in DPT1 service volume (85% in 2021 Q1 and 79% in 2020 Q4), followed by Bangladesh (2020 Q1, 83%), Haiti (80% in 2020 Q2), and Ghana (2022 Q2, 75%). All subnational units in Bangladesh experienced a 5% or higher shortfall in DPT3 service volume in the second quarter of 2020. In Haiti, 80% of the subnational units experienced a 5% or higher reduction in DPT3 service volume in the second quarter of 2020 and the third quarter of 2022. CONCLUSIONS: At least one region in every country has a significantly lower-than-expected post-pandemic cumulative volume for at least one of the three vaccines. Subnational monitoring of immunization service volumes using disaggregated routine health facility information data should be conducted routinely to target the limited vaccination resources to subnational units with the highest inequities.

Hospitalizations Among Adults With CKD in Public Renal Specialty Practices: A Retrospective Study From Queensland, Australia.

Rationale & Objective: Little is known about hospital admissions in nondialysis patients with chronic kidney disease (CKD) before death or starting kidney replacement therapy (KRT). Study Design: Retrospective observational cohort study. Setting & Participants: Hospitalizations among 7,201 patients with CKD from 10 public renal clinics in Queensland (QLD), enrolled in the CKD.QLD registry starting in May 2011, were followed for 25,496.34 person-years until they started receiving KRT or died, or until June 30, 2018. Predictors: Demographic and clinical characteristics of patients with CKD. Outcomes: Hospital admissions. Analytical Approach: We evaluated the association of demographic and clinical features with hospitalizations, length of hospital stay, and cost. Results: Approximately 81.5% of the patients were admitted at least once, with 42,283 admissions, costing Australian dollars (AUD) 231 million. The average number of admissions per person-year was 1.7, and the cost was AUD 9,060, 10 times and 2 times their Australian averages, respectively. Single (1-day) admissions constituted 59.2% of all the hospital episodes, led by neoplasms (largely chemotherapy), anemia, CKD-related conditions and eye conditions (largely cataract extractions), but only 14.8% of the total costs. Approximately 41% of admissions were >1-day admissions, constituting 85.2% of the total costs, with cardiovascular conditions, respiratory conditions, CKD-related conditions, and injuries, fractures, or poisoning being the dominant causes. Readmission within 30 days of discharge constituted >42% of the admissions and 46.8% costs. Admissions not directly related to CKD constituted 90% of the admissions and costs. More than 40% of the admissions and costs were through the emergency department. Approximately 19% of the hospitalized patients and 27% of the admissions did not have kidney disease mentioned as either principal or associate causes. Limitations: Variable follow-up times because of different dates of consent. Conclusions: The hospital burden of patients with CKD is mainly driven by complex multiday admissions and readmissions involving comorbid conditions, which may not be directly related to their CKD. Strategies to prevent these complex admissions and readmissions should minimize hospital costs and outcomes. Plain-Language Summary: We analyzed primary causes, types, and costs of hospitalizations among 7,201 patients with chronic kidney disease (CKD) from renal speciality clinics across Queensland, Australia, over an average follow-up of 3.54 years. The average annual cost per person was $9,060, and was the highest in those with more advanced CKD, higher age, and with diabetes. More than 85% of costs were driven by more complex hospitalizations with longer length of stay. Cardiovascular disease was the single largest contributor for hospitalizations, length of hospital stay, and total costs. Readmission within 30 days of discharge, particularly for the same disorder, and multiday admissions should be the main targets for mitigation of hospital costs in this population.

ʟ-glutamic acid modulates antioxidant defense systems and nutrient homeostasis in lentil (Lens culinaris Medik.) under copper toxicity.

Copper (Cu), an essential micronutrient, can generate reactive oxygen species (ROS) at its supra-optimal level in living cells as a transition metal, thus producing oxidative stress in plants. Therefore, protecting plants from Cu-induced oxidative stress via the exogenous application of chemical substances, particularly L-glutamic acid (L-Glu), could be a viable strategy for mitigating the toxicity of Cu. The aim of our present study was to investigate how ʟ-Glu protects lentil seedlings from oxidative stress produced by toxic Cu and allows them to survive under Cu toxicity. The results exhibited that when lentil seedlings were exposed to excessive Cu, their growth was inhibited and their biomass decreased due to an increase in Cu accumulation and translocation to the root, shoot, and leaves. Exposure to toxic Cu also depleted photosynthetic pigments, imbalanced water content, and other essential nutrients, increased oxidative stress, and reduced enzymatic and non-enzymatic antioxidants. However, pre-treatment of ʟ-Glu improved the phenotypic appearance of lentil seedlings, which was distinctly evidenced by higher biomass production, maintenance of water balance, and an increase in photosynthetic pigments when exposed to toxic Cu. ʟ-Glu also protected the seedlings from Cu-induced oxidative stress by reducing the oxidative stress marker, specifically by the efficient action of enzymatic and non-enzymatic antioxidants, particularly ascorbate, catalase, monodehydroascorbate, and glutathione peroxidase and maintaining redox balance. Furthermore, ʟ-Glu assisted in maintaining the homeostasis of Cu and other nutrient in the roots, shoots, and leaves of lentil. Collectively, our results provide evidence of the mechanism of ʟ-Glu-mediated protective role in lentil against Cu toxicity, thus proposed as a potential chemical for managing Cu toxicity not only in lentil but also other plants.

Microplastics pollution in mud crab (Scylla sp.) aquaculture system: First investigation and evidence.

Microplastics (MPs) occurrence in farmed aquatic organisms has already been the prime priority of researchers due to the food security concerns for human consumption. A number of commercially important aquaculture systems have already been investigated for MPs pollution but the mud crab (Scylla sp.) aquaculture system has not been investigated yet even though it is a highly demanded commercial species globally. This study reported the MPs pollution in the mud crab (Scylla sp.) aquaculture system for the first time. Three different stations of the selected aquafarm were sampled for water and sediment samples and MPs particles in the samples were isolated by the gravimetric analysis (0.9% w/v NaCl solution). MP abundance was visualized under a microscope along with their size, shape, and color. A subset of the isolated MPs was analyzed by scanning electron microscope (SEM), and Fourier transform infrared spectroscopy (FTIR) for the surface and chemical characterization respectively. The average MPs concentration was 47.5 ± 11.875 particles/g in sediment and 127.92 ± 14.99 particles/100 L in the water sample. Fibrous-shaped (72.17%) and transparent-colored (59.37%) MPs were dominant in all the collected samples. However, smaller MPs (>0.05-0.5 mm) were more common in the water samples (47.69%) and the larger (>1-5 mm) MPs were in the sediment samples (47.83%). SEM analysis found cracks and roughness on the surface of the MPs and nylon, polyethylene, polypropylene, and polystyrene MPs were identified by FTIR analysis. PLI value showed hazard level I in water and level II in sediment. The existence of deleterious MPs particles in the mud crab aquaculture system was well evident. The other commercial mud crab aquafarms must therefore be thoroughly investigated in order to include farmed mud crabs as an environmentally vulnerable food security concern.

Dengue presenting as a case of acute pancreatitis-A rare case report.

Atypical presentations may be presented with the common symptoms in Dengue. We, hereby, present a case of Dengue who was admitted in our hospital with the complaints of fever, upper abdominal pain, and vomiting, literally diagnosed as a case of acute pancreatitis.

Microplastics biodegradation by biofloc-producing bacteria: An inventive biofloc technology approach.

Microplastics pollution has become a threat to aquaculture practices, as nearly all farming systems are saturated with microplastics (MPs) particles. Current research on MPs is limited considering their effects on aquatic organisms and human health. However, limited research has been conducted on potential cures and treatments. In today's world, bioremediation of needful parameters in different culture systems is being successfully practiced by introducing floc-forming bacteria. Researchers had found that some bacteria are efficacious in degrading microplastics particles including polyethylene (PE), polystyrene (PS), and polypropylene (PP). In addition, some bacteria that can form floc, are being used in fish and shellfish culture systems to treat toxic pollutants as the heterotrophic bacteria use organic compounds to grow and are effective in degrading microplastics and minimizing toxic nitrogen loads in aquaculture systems. In this review, the ability of biofloc bacteria to degrade microplastics has been summarized by collating the results of previous studies. The concept of this review may represent the efficacy of biofloc technology as an implicit tool in the fish culture system restricting the MPs contamination in water resources to safeguard ecological as well as human health.

Chronic kidney disease in public renal practices in Queensland, Australia, 2011-2018.

AIM: To describe adults with (non-dialysis) chronic kidney disease (CKD) in nine public renal practice sites in the Australian state of Queensland. METHODS: 7,060 persons were recruited to a CKD Registry in May 2011 and until start of kidney replacement therapy (KRT), death without KRT or June 2018, for a median period of 3.4 years. RESULTS: The cohort comprised 7,060 persons, 52% males, with a median age of 68 yr; 85% had CKD stages 3A to 5, 45.4% were diabetic, 24.6% had diabetic nephropathy, and 51.7% were obese. Younger persons mostly had glomerulonephritis or genetic renal disease, while older persons mostly had diabetic nephropathy, renovascular disease and multiple diagnoses. Proportions of specific renal diagnoses varied >2-fold across sites. Over the first year, eGFR fell in 24% but was stable or improved in 76%. Over follow up, 10% started KRT, at a median age of 62 yr, most with CKD stages 4 and 5 at consent, while 18.8% died without KRT, at a median age of 80 yr. Indigenous people were younger at consent and more often had diabetes and diabetic kidney disease and had higher incidence rates of KRT. CONCLUSION: The spectrum of characteristics in CKD patients in renal practices is much broader than represented by the minority who ultimately start KRT. Variation in CKD by causes, age, site and Indigenous status, the prevalence of obesity, relative stability of kidney function in many persons over the short term, and differences between those who KRT and die without KRT are all important to explore.

Quantum Bitcoin Mining.

This paper studies the effect of quantum computers on Bitcoin mining. The shift in computational paradigm towards quantum computation allows the entire search space of the golden nonce to be queried at once by exploiting quantum superpositions and entanglement. Using Grover's algorithm, a solution can be extracted in time O(2256/t), where t is the target value for the nonce. This is better using a square root over the classical search algorithm that requires O(2256/t) tries. If sufficiently large quantum computers are available for the public, mining activity in the classical sense becomes obsolete, as quantum computers always win. Without considering quantum noise, the size of the quantum computer needs to be ≈104 qubits.

The impact of COVID-19 on tertiary educational institutions and students in Bangladesh.

The COVID-19 forced to transform face-to-face mode of teaching to virtual in educational institutions around the globe that not only impact institutional stakeholders, but also posed as a threat to entire humanity because, all parties related to education had to change their activities. The intentions of this study therefore firstly, to determine the content analysis by interviewing tertiary students and secondly, to determine the frequency distribution by questionnaire developed from results of the content analysis. To better understand the consequences of this outbreak, we took an interview from forty respondents, including undergraduate and postgraduate students across Bangladesh. Results of Content analysis revealed that stakeholders of tertiary education are encountering severe problems in mental health, financial, technical, and study. A questionnaire was designed based on results were obtained through content analysis and distributed using email, WhatsApp, LinkedIn, Telegram, Facebook, and Instagram from May 20 to May 30, 2021. A total number of 505 valid questionnaires were received from respondents. Frequency distribution analysis disclosed that 60% respondents have no separate reading rooms. Laptops and desktops are commonly used for online classes, but unfortunately, 21% respondents have no personal electronic gadgets. Moreover, 55% reported spending less time to study during the coronavirus outbreak. Furthermore, 88% respondents reported experiencing mental health-related stress, anxiety, and depression problems. The proportion that suffered financial crisis, family disruptions, internet and technology related problems were 79%, 83% and 72% respectively. Since coronavirus pandemic is a totally new phenomenon in the world, not much empirical literature exist. So we fill the gap, investigating the issue empirically using content and frequency distribution analysis. Policy implications and recommendations are discussed accordingly.

Concurrent IgG4-Related disease and clear cell renal cell carcinoma.

We report a case of a 54-year-old man with a concurrent diagnosis of IgG4-related disease (IgG4-RD) and clear cell renal cell carcinoma (ccRCC) following asymptomatic submandibular lymphadenopathy with an incidental finding of a left renal mass. Partial nephrectomy revealed ccRCC with surrounding lymphoplasmacytic infiltrate, storiform fibrosis and a strong positivity for IgG4 on immunoperoxidase staining. The IgG4+:IgG + ratio was >40% and serum IgG4 levels were elevated at 159mg/dL. This case highlights the concurrent diagnosis of a unique dual pathology within the same organ and emphasises the importance of malignancy screening in patients with IgG4-RD and vice versa.

Appraisals of the Bangladeshi Medicinal Plant Calotropis gigantea Used by Folk Medicine Practitioners in the Management of COVID-19: A Biochemical and Computational Approach.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first recognized in Wuhan in late 2019 and, since then, had spread globally, eventually culminating in the ongoing pandemic. As there is a lack of targeted therapeutics, there is certain opportunity for the scientific community to develop new drugs or vaccines against COVID-19 and so many synthetic bioactive compounds are undergoing clinical trials. In most of the countries, due to the broad therapeutic spectrum and minimal side effects, medicinal plants have been used widely throughout history as traditional healing remedy. Because of the unavailability of synthetic bioactive antiviral drugs, hence all possible efforts have been focused on the search for new drugs and alternative medicines from different herbal formulations. In recent times, it has been assured that the Mpro, also called 3CLpro, is the SARS-CoV-2 main protease enzyme responsible for viral reproduction and thereby impeding the host's immune response. As such, Mpro represents a highly specified target for drugs capable of inhibitory action against coronavirus disease 2019 (COVID-19). As there continue to be no clear options for the treatment of COVID-19, the identification of potential candidates has become a necessity. The present investigation focuses on the in silico pharmacological activity of Calotropis gigantea, a large shrub, as a potential option for COVID-19 Mpro inhibition and includes an ADME/T profile analysis of that ligand. For this study, with the help of gas chromatography-mass spectrometry analysis of C. gigantea methanolic leaf extract, a total of 30 bioactive compounds were selected. Our analyses unveiled the top four options that might turn out to be prospective anti-SARS-CoV-2 lead molecules; these warrant further exploration as well as possible application in processes of drug development to combat COVID-19.

Chemical Profiles and Pharmacological Properties with in Silico Studies on Elatostema papillosum Wedd.

The current study attempted, for the first time, to qualitatively and quantitatively determine the phytochemical components of Elatostema papillosum methanol extract and their biological activities. The present study represents an effort to correlate our previously reported biological activities with a computational study, including molecular docking, and ADME/T (absorption, distribution, metabolism, and excretion/toxicity) analyses, to identify the phytochemicals that are potentially responsible for the antioxidant, antidepressant, anxiolytic, analgesic, and anti-inflammatory activities of this plant. In the gas chromatography-mass spectroscopy analysis, a total of 24 compounds were identified, seven of which were documented as being bioactive based on their binding affinities. These seven were subjected to molecular docking studies that were correlated with the pharmacological outcomes. Additionally, the ADME/T properties of these compounds were evaluated to determine their drug-like properties and toxicity levels. The seven selected, isolated compounds displayed favorable binding affinities to potassium channels, human serotonin receptor, cyclooxygenase-1 (COX-1), COX-2, nuclear factor (NF)-κB, and human peroxiredoxin 5 receptor proteins. Phytol acetate, and terpene compounds identified in E. papillosum displayed strong predictive binding affinities towards the human serotonin receptor. Furthermore, 3-trifluoroacetoxypentadecane showed a significant binding affinity for the KcsA potassium channel. Eicosanal showed the highest predicted binding affinity towards the human peroxiredoxin 5 receptor. All of these findings support the observed in vivo antidepressant and anxiolytic effects and the in vitro antioxidant effects observed for this extract. The identified compounds from E. papillosum showed the lowest binding affinities towards COX-1, COX-2, and NF-κB receptors, which indicated the inconsequential impacts of this extract against the activities of these three proteins. Overall, E. papillosum appears to be bioactive and could represent a potential source for the development of alternative medicines; however, further analytical experiments remain necessary.

In vivo neuroprotective, antinociceptive, anti-inflammatory potential in Swiss albino mice and in vitro antioxidant and clot lysis activities of fractionated Holigarna longifolia Roxb. bark extract.

Background The study investigated the in vivo neuroprotective, antinociceptive, anti-inflammatory potential and in vitro antioxidant and clot lysis activities of crude methanol extract with its different solvent-soluble fractions like petroleum ether (PESF), carbon tetrachloride (CTSF), chloroform (CSF) and aqueous (AQSF) of Holigarna longifolia Roxb. Methods Phenobarbitone-induced sleeping time method was used for the neuroprotective activity, writhing response experimental model introduced by acetic acid was designed for antinociceptive efficacy, carrageenan-induced paw edema model was carried out for anti-inflammatory activity, DPPH free radical scavenging activity was assessed for antioxidant activity and clot lysis model was investigated for the thrombolytic potential of the plant. Results On investigation it was found that methanol extract and CS fraction revealed statistically meaningful (p<0.05) neuroprotective activity by increasing phenobarbitone-induced sleeping time of mice, produced substantial (p<0.05) inflammation inhibitory efficacy compared to standard diclofenac sodium and also exhibited statistically significant (p<0.01) oxidative stress inhibitory efficacy by inhibiting free radical formation compared to ascorbic acid as standard. Only methanol extract produced significant (p<0.05) antinociceptive activity by inhibiting abdominal writhes produced by acetic acid compared to standard analgesic drug diclofenac sodium. And only aqueous soluble fraction exhibited moderate clot lysis activity compared to streptokinase as standard. Conclusion The findings demonstrate that H. longifolia could be potential neuroprotective due to its justified antioxidative capacity as well as clot lysis properties.

Appraising spatial variations of As, Fe, Mn and NO3 contaminations associated health risks of drinking water from Surma basin, Bangladesh.

This study aims to appraise the spatial variations and pathways of groundwater contaminations and associated health risks in the Surma basin, Bangladesh using geostatistics, Fuzzy GIS technique and health risk modelbased on ninety groundwater samples. The results show that the mean concentrations of As, Fe, Mn and NO3 are below the Bangladesh water quality standard, whereas As, Fe and Mn concentrations exceed World Health Organization guideline values in several sampling sites. The compositional study identifies weathering of source rocks, reductive dissolution of Fe and Mn-oxyhydroxide minerals and various anthropogenic inputs as the key sources of groundwater contamination. The kriged maps show the elevated risks of Fe, Mn and NO3 concentrations from the south to northern parts and As concentration from the north to southwestern parts of the Surma basin. The results of fuzzy GIS maps confirm the outcomes of kriged maps. Cross validation results show better performance of indicator kriging over probability kriging. The results also show a spatial heterogeneity with As, Fe, Mn and NO3 concentrations, indicating the low to medium risk categories. A health risk assessment is performed using hazard quotient (HQ) and hazard index (HI). The HQ values imply that the risk of contamination through oral ingestion pathway is medium to high levels for both adults and children as the trace elements show HQ values more than one. It is found that drinking water of several upazilas exhibits high contamination and that children are more susceptible to the non-carcinogenic and carcinogenic risks than adults in the study area.

An exploration of nitrate concentrations in groundwater aquifers of central-west region of Bangladesh.

Groundwater and river water samples were collected from the study area to investigate the spatial distribution of nitrate (NO(3)(-)) in the central-west region of Bangladesh. The shallow and deep groundwater nitrate concentrations ranged from <0.10 to 75.12 and <0.10 to 40.78 mg/L, respectively. Major river water NO(3)(-) concentrations were ranged from 0.98 to 2.32 mg/L with an average of 1.8 mg/L. The average Cl(-)/NO(3)(-) ratio (4.9) of major river water has been considered as reference point to delineate denitrification processes. The alluvial fan, alluvial, deltaic and coastal deposits shallow groundwater having C1(-)/NO(3)(-) values less than that of the average river water value (4.9), suggested denitrification processes within the aquifers. On the other hand, denitrification processes are insignificant in the Pleistocene terraces area aquifers related to relatively higher concentrations of nitrate. Iron pyrite has been found as insignificant effect on denitrification.

Haemophilus influenzae type-b and non-b-type invasive diseases in urban children (<5years) of Bangladesh: implications for therapy and vaccination.

OBJECTIVE: To prospectively study the epidemiology and antibiotic resistance of Haemophilus infuenzae isolates from invasive infections in children. METHODS: Children (<5years) with pneumonia, meningitis and septicemia from three hospitals in Dhaka, Bangladesh were enrolled (1999-2003); clinical and laboratory data, and blood for cultures were collected. Cerebrospinal fluid (CSF) of meningitis cases was analyzed (Gram stain, culture and biochemical tests). Hib antigen was detected by latex agglutination (LA) in culture-negative pyogenic CSF and PCR was done for bexA gene in culture- and LA-negative pyogenic CSF. Antibiotic susceptibility was determined by E-Tests and beta-lactamase by nitrocefin stick. RESULTS: Seventy-three cases of H. influenzae infections (46 of 293 meningitis cases, 25 of 1493 pneumonia cases, 2 of 48 septicemia cases) were detected; 63%, 34% and 3% of them had meningitis, pneumonia and septicemia respectively. H. influenzae type b (Hib) caused infections in 80.8% of cases (60.3% meningitis, 20.5% pneumonia). Most (86%) infections clustered in 4-12month infants. The case-fatality in pneumonia was 8% compared to 19% in meningitis. H. influenzae isolates from pneumonia and meningitis children were equally resistant to antibiotics (46% vs 43%). Of 10 drugs tested, isolates were resistant to ampicillin (31%), chloramphenicol (42%), trimethoprim-sulfamethoxazole (44%) and azithromycin (1.4%). Multidrug-resistant (MDR) strains were equally prevalent in Hib (31%) and non-b-type (29%) isolates, and in pneumonia (31%) and meningitis (34%) cases. None was resistant to amoxicillin-clavulanate, ceftriaxone, ciprofloxacin, levofloxacin, moxifloxacin, and gatifloxacin. Of all H. influenzae infections, 40%, 4.4% and 100% of pneumonia, meningitis and septicemia cases were caused by other serotypes or non-typeable strains. All ampicillin-resistant-strains produced beta-lactamase without detection of beta-lactamase-negative-ampicillin-resistant (BLNAR) strains. CONCLUSION: Hib is a leading cause of invasive bacterial infections in infants. Multidrug-resistant H. influenzae is common and requires amoxicillin-clavulanate, ceftriaxone or azithromycin as empirical therapy with specific recommendation for use of ceftriaxone for treatment of meningitis particularly MDR cases. New fluoroquinolines has potential utility. An effective national Hib vaccination programme is essential in Bangladesh although non-Hib infections will remain an issue.