Distribution of Virulence Genes among Enterococcus species Isolated from Patients of Urinary Tract Infection Attended in a Tertiary Care Hospital of Bangladesh.

Enterococcus species was frequently considered to be commensal organisms but last few decades it has emerged as an important cause of health care associated infections. The presence of virulent genes is one of a key factor for which Enterococcus spp. is gaining attention. In this study, we aim to determine the frequency of virulence genes in uropathogenic Enterococcus species. A total of 46 Enterococcus strains isolated from January 2017 to December 2017. Urine samples were collected from adult clinically suspected urinary tract infected patients from the inpatient and outpatient department of Dhaka Medical College Hospital, Bangladesh irrespective of sex and antibiotic intake. Potential virulence genes such as asa, esp, ace, ebp, cyl, gelE, pilA, pilB, sprE, scm, fms8, ecbA and hyl were detected by PCR using specific primers. Among 46 culture positive Enterococcus, 33(71.74%) were E. faecalis, 11(23.91%) were E. faecium, 2(4.35%) were unidentified. Of the 44 identified Enterococci (33 E. faecalis and 11 E. faecium), 43(97.73%) were positive for pilB, 41(93.18%) for both scm and fms8, 39(88.64%) were positive for ebp, 34(77.27%) for gelE, 32(72.78%) for esp, 31(70.45%) for ecbA, 30(68.18%) for sprE, 28(63.67%) for pilA, 25(56.82%) for ace, 21(47.73%) for cyl, 20(45.45%) for asa and 3(6.82%) for hyl gene. Different virulence factors could be associated with the pathogenicity of E. faecalis and E. faecium and these genes are extensively available among the Enterococcus species.

Carbapenem Resistance among Klebsiella pneumoniae in a Tertiary Care Hospital in Bangladesh.

Carbapenem-resistant K pneumoniae (CRKP) clinical isolates have spread widely now-a-days throughout the world. This study was designed to investigate the carbapenem resistance among Klebsiella pneumoniae and to see anitimicrobial susceptibility of these CRKP isolates to other antimicrobials in a tertiary care hospital in Bangladesh. K pneumoniae was detected by standard methods and various biochemical tests like Triple Sugar Iron (TSI) agar media, Simmons citrate agar media and Motility-Indole-Urea (MIU) agar media. Imipenem resistance was used as the indicator for carbapenem resistance. Agar dilution method was used to determine MIC of imipenem. CRKP were tested for their antimicrobial susceptibility by Kirby-Bauer modified disc-diffusion technique as per Clinical and Laboratory Standard Institute (CLSI) guidelines and United States Food and Drug Administration (FDA) guidelines. Total 75 K pneumoniae were isolated. Among the isolated K pneumoniae, 28(37.33%) were resistant to carbapenem. Most of the CRKP were recovered from intensive care unit. MIC of CRKP ranged from ≥32µg/ml to ≤4µg/ml. Most of the CRKP were resistant to other antimicrobials. Carbapenem resistance in K pneumoniae is increasing in Bangladesh, which is very alarming and we should give importance on standard guideline of antimicrobials use.

Prevalence of Colistin Resistance in Klebsiella pneumoniae Isolated from a Tertiary Care Hospital in Bangladesh and Molecular Characterization of Colistin Resistance Genes among Them by Polymerase Chain Reaction and Sequencing.

Resistance to colistin, the last resort of treatment for multidrug resistant organisms has increased now-a-days. This cross-sectional study was conducted in the Department of Microbiology of Dhaka Medical College, Dhaka, Bangladesh, from July 2016 to June 2017 and was designed to investigate the colistin resistance profile along with the genetic background of colistin resistance among Klebsiella pneumoniae in a tertiary care hospital in Bangladesh. K. pneumoniae was detected by colony morphology on culture media and various biochemical tests. Agar dilution method was used to determine MIC of colistin. PCR was done for detection of colistin resistance genes and sequencing of the amplified mgr B gene products was done. Total 75(23.73%) K. pneumoniae were isolated. Among the isolated K. pneumoniae, 8(10.67%) were resistant to colistin. MIC of colistin of resistant isolates ranged from ≥64µg/ml to ≤4µg/ml. Out of 8 colistin resistant K. pneumoniae, 4(50.00%) were positive for mgr B gene and 3(37.50%) were positive for pho Q gene. Colistin resistance in K. pneumoniae is increasing in Bangladesh, which is very alarming and we should give importance on standard guideline of antimicrobials use.