RESUMEN
Healthcare providers colonized with Staphylococcus aureus may transmit the organism to patients and community. This study was carried out to determine the rate of nasal colonization of Methicillin resistant Staphylococcus aureus (MRSA) and Vancomycin resistant Staphylococcus aureus (VRSA) among healthcare providers. This cross sectional study was conducted among healthcare providers in a tertiary care hospital, Bangladesh. Nasal swabs from anterior nares of 250 physicians, nurses, and helping staffs working in Dhaka Medical College Hospital were analyzed. Methicillin resistance among MRSA was detected by disc diffusion technique using oxacillin, cefoxitin disc and MIC of oxacillin and methicillin resistance was confirmed by PCR detecting mec-A gene. Considering PCR for mec-A gene as gold standard the sensitivity and specificity of both cefoxitin disc diffusion method and MIC of oxacillin was 100%. Cefoxitin disc diffusion method was better alternative of oxacillin disc diffusion method for detection of MRSA. Nasal colonization by S. aureus was found among 23.2% healthcare providers and 7.2% were colonized with MRSA and no VRSA was detected. MRSA colonization was detected among 5% physicians, 6.43% nurses and 16.67% of helping staffs. Isolated MRSA strains were highly resistant to ciprofloxacin (88.9%), gentamicin (77.8%), erythromycin (72.2%) and Co-trimoxazole (72.2%). All the isolated MRSA were sensitive to linezolid and vancomycin. Periodic screening of healthcare providers should be done to find out MRSA carrier and should be treated accordingly to terminate chain of transmission of the multi-drug resistant organism.
Asunto(s)
Personal de Salud , Staphylococcus aureus Resistente a Meticilina , Cavidad Nasal , Infecciones Estafilocócicas , Antibacterianos , Bangladesh , Estudios Transversales , Humanos , Meticilina , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Pruebas de Sensibilidad Microbiana , Cavidad Nasal/microbiología , Infecciones Estafilocócicas/diagnóstico , Staphylococcus aureus , Centros de Atención TerciariaRESUMEN
Hepatitis and AIDS are major public health problem globally. The aim of this study was to determine the sero-prevalence of hepatitis B, C virus and HIV infection among Bangladeshi overseas job seekers. This cross sectional study was carried out in the Department of Microbiology of Dhaka Medical College, Dhaka, Bangladesh from February 2013 to August 2013. A total of 2254 adult (18-45 years) male job seekers to Malaysia attending for health check up were enrolled. HBsAg, Anti-HCV, Anti-HIV were detected from venous blood by ELISA method using commercial kits. From the positive people, further history and information were collected by predesigned questionnaire. Prevalence of HBV was 2.35%, HCV was 0.13% and none was found positive for HIV. Prevalence of hepatitis was higher in the age group of 21-30 year and infection was more prevalent in married group. No significant relationship was found between hepatitis infection and religion, localities, profession. Only a few cases had history of possible major known route of transmission of virus. But most of them had history of taking injection or sharing blades in barber shop and history of circumcision. About 96% population had no history of hepatitis B vaccination. None was co-infected with HBV and HCV. Prevalence of hepatitis B virus infection in adult population appears to be on decline and hepatitis C and HIV infection is still low in Bangladesh. In majority of the positive person, routes of transmission of viruses were not well established.
Asunto(s)
Infecciones por VIH , Hepatitis B , Hepatitis C , Adolescente , Adulto , Bangladesh/epidemiología , Estudios Transversales , VIH , Infecciones por VIH/epidemiología , Infecciones por VIH/transmisión , Hepacivirus , Hepatitis B/epidemiología , Hepatitis B/transmisión , Antígenos de Superficie de la Hepatitis B , Virus de la Hepatitis B , Hepatitis C/epidemiología , Hepatitis C/transmisión , Humanos , Masculino , Prevalencia , Factores de Riesgo , Adulto JovenRESUMEN
Central venous catheter-related bloodstream infections (CVC-BSI) are associated with morbidity and mortality especially in critically ill patients. This study was performed to find out the rate of CVC-BSI and CVC colonization, causative organism and their antibiogram in patients of Intensive Care Unit (ICU) and Department of Nephrology of tertiary care hospitals. A total of 100 patients from Bangabandhu Sheikh Mujib Medical University (BSMMU) and Dhaka Medical College Hospital (DMCH) who had-CVC and clinically suspected of septicemia were included in the study. Paired CVC blood and peripheral venous blood (PVB) samples were collected from each patient and were cultured by automated blood culture method. CVC-BSI was diagnosed in 11% and CVC colonization in 43% patients by Differential time to positivity (DTP) method. Rate of CVC-BSI was 8/1000 CVC days and 11/1000 CVC days in BSMMU and DMCH respectively whereas CVC colonization rate was 32/1000 CVC days and 47.5/1000 CVC days in BSMMU and DMCH. The most common bacteria causing CVC-BSI was Klebsiella spp. (36.4%) followed by Acinetobacter spp. (27.3%), Pseudomonas spp. (18.2%) and E. coli (18.2%). Among bacteria isolated from CVC colonization majority were Pseudomonas spp. (30.23%) and Staphylococcus epidermidis (30.23%) followed by Acinetobacter spp. (27.91%), Enterococcus spp. (6.98%). Most of the isolated bacteria causing CVC-BSI were resistant to commonly used antibiotics, but showed good sensitivity to imipenem and colistin. Information about CVC-BSI, -colonization and antibiogram of this study can help to guide the selection of suitable antibiotics for empirical therapy and to improve infection control measures of the hospital.