Current status of gonococcal antimicrobial susceptibility with special reference to azithromycin and ceftriaxone: report from a tertiary care hospital in bangladesh

Objectives: Successful treatment of gonorrhea has always been jeopardized by the emergence of resistance to antibiotics recommended as first-line therapies. The present investigation was carried out to demonstrate the current status of antimicrobial susceptibility of N. gonorrhoeae with a special reference to azithromycin and ceftriaxone

Methods: Microscopical detection in Gram-stained smear and isolation by culture in Thayer-Martin medium were done for 60 clinically suspected gonorrhea patients using urethral discharge or prostatic secretion for male and endocervical secretion for female. Isolates of N. gonorrhoeae were subjected to antimicrobial susceptibility testing by modified Kirby Bauer disk diffusion method against eight antimicrobial drugs including azithromycin and ceftriaxone

Results: Culture yielded a total of 25[42%] isolates of N. gonorrhoeae from 60 clinically suspected patients of both sexes; 21 from male [17 from urethral discharge and 04 from prostatic secretion] and 04 from female [endocervical secretion]. Isolates of N. gonorrhoeae showed moderate to high resistance [60 to 88%] to penicillin, tetracycline, cotrimoxazole, erythromycin, ciprofloxacin and cefixime. While resistance to azithromycin and ceftriaxone was 60% and 48% respectively, which was also moderate

Conclusion: Our findings indicate moderate to the high resistance of N. gonorrhoeae to conventional antibiotics. It also showed moderate resistance to azithromycin and ceftriaxone, current dual therapy recommended by the WHO for the treatment of genital gonorrhea, which is alarming

Role of serum eosinophil cationic protein as a biological marker to assess the severity of bronchial asthma

The study was carried out to evaluate the role of serum eosinophil cationic protein [ECP] as a biological marker for the diagnosis and to assess the severity of bronchial asthma. This observational cross-sectional study was conducted among 70 bronchial asthma patients and 45 disease controls [tuberculosis-15, chronic obstructive pulmonary disease-15, interstitial lung disease-15] enrolled from patients attending the outpatient department of the National Institute of Disease of the Chest and Hospital [NIDCH], Dhaka, Bangladesh during July 2010 to June 2011. Global Initiative of Asthma Management and Prevention [GINA] criteria were followed for selection of both atopic and non-atopic patients with intermittent or persistent [mild, moderate and severe] asthma. Serum level of eosinophil cationic protein [ECP], IgE, forced expiratory volume in 1 second [FEV[1]% predicted] and circulatory eosinophil [CE] count were estimated. Mean serum ECP level [28.8 +/- 42.9 vs. 6.82 +/- 3.5 ng/mL; P < 0.001], IgE level [383.59 +/- 225.3 vs. 135 +/- 131.8 IU/mL; P < 0.001] and percent circulatory eosinophil count [9.95 +/- 3.7 vs. 5.95 +/- 1.4; P < 0.024] were all found significantly raised among asthma patients than disease controls but%FEV[1] was equivocal. All grades of persistent asthma patients had significantly [P < 0.025 and P < 0.002] higher mean ECP level than intermittent cases but serum IgE level and CE count did not differ significantly. FEV[1]% predicted correlated well among moderate and severe persistent asthma but was equivocal for intermittent and mild persistent cases. This study has reinforced that serum eosinophil cationic protein is a dependable biological marker with more discriminatory power over other indicators for bronchial asthma and to assess its severity

Imunochromatographic strip test detection of anti-rK39 antibody for the diagnosis of Kala-azar in an endemic zone of Bangladesh

A rapid immunochromatographic dipstick test [ICT] has become available for the qualitative detection of anti-Leishmania antibody using recombinant rK39 antigen. This study was carried out at the department of Microbiology of Rajshahi Medical College, Bangladesh, in order to evaluate the diagnostic potential of immunochromatographic dipstick test. A total of one hundred cases including 60 admitted patients with strong clinical suspicion of kata-azar and 40 healthy controls were investigated for the performance of the ICT Splenic smears were examined for microscopic detection of Leishman Donovan [LD] bodies obtained from the admitted patients only and smear-positive cases were considered as gold standard as well as confirmed cases of kala-azar. Out of 60 suspected patients, fifty three [88.33%] were found smear-positive and fifty nine [98.33%] were positive for immunochromatographic strip test. All smear-positive cases were also positive for strip test. Voluntary healthy controls [40], which included twenty persons from the endemic zone and twenty from non-endemic zone of kala-azar, were found all negative for the strip test. The sensitivity and specificity of immunochromatographic strip test were found to be 100.00% and 86.95% respectively. Present study findings again reinforce that the immunochromatographic strip test is a simple, reliable and easy-to-perform non-invasive diagnostic toot for visceral leishmaniasis in the endemic area of Bangladesh

Ectopic enterobiasis: a case report and review of literature

A case of ectopic pinworm abscess detected in the right inguinoscrotal swelling is described. A male aged 55 years presented with occasional pain at his right inguinal area for three months followed by accentuation of pain associated with fever and gradual swelling of that area for two weeks. Fine needle aspiration of the swelling revealed frank thick pus. Papanicolaou-stained smear for cytological examination showed frequent ova of Enterobius vermicularis along with fibrinopurulent exudates. A brief review of literature for ectopic enterobiasis is given