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In this investigation, 12 ciprofloxacin resistant Salmonella were isolated from medical waste samples. Identified Salmonella isolates were then subjected to sensitivity analysis against five antibiotics. All the ciprofloxacin resistant Salmonella isolates were resistant to ampicillin, amoxicillin, and penicillin and were considered multidrug resistant. Growth of four ciprofloxacin resistant Salmonella from four medical samples at various concentrations (50 to 500 mg/ml) was measured. Three of four Salmonella isolates from medical samples showed growth even against 500 mg/ml of ciprofloxacin. The occurrence of these highly resistant isolates in medical samples indicated the high percentage of undigested ciprofloxacin in medical waste sample. Agarose gel electrophoresis of these 12 isolates showed no plasmid DNA band indicating that observed resistance might be chromosomal gene mediated. Key words: Hospital wastes; Salmonella; Ciprofloxacin; Multidrug resistant DOI: http://dx.doi.org/10.3329/bjm.v27i1.9160 BJM 2010; 27(1): 6-9

Typhoid fever and Salmonella typhi bacteremia among the patients were evaluated at Dhaka Shishu Hospital, Popular Diagnostic Center, Kumudiny Hospital and other sites throughout Bangladesh. Among the 943 Salmonella typhi isolates studied, 57.4% showed resistance to ampicillin (MIC > 256 mg/ml), 58 % to cotrimoxazole (MIC > 32 mg/ ml) and 58.6% to chloramphenicol (MIC > 256 mg/ml). Significant resistance (97.8%) was observed against first generation quinolone, nalidixic acid (MIC > 256 mg/ml) whereas only 11 isolates (1.1%) were resistant to second generation fluoroquinolone, ciprofloxacin. Among 943 isolates E-strip test of 411 isolates for ciprofloxacin showed that 53 isolates were very sensitive (MIC < 0.125 mg/ml), 252 were sensitive (MIC between 0.125 mg/ ml and 0.5 mg/ ml), 95 were moderately sensitive (MIC between 0.5 mg/ml and 2.0 mg/ml) and the rest were resistant (MIC >2.0 ìg/ml) or very highly resistant (MIC 512 mg/ml). However, all isolates including ciprofloxacin resistant S. typhi were found sensitive to a third generation cephalosporin ceftazidime. All the isolates resistant to ciprofloxacin were found to be identical by API 20 E (Analytical Profile Index) score (4404552) and VNTR typing. Digestion of PCR product (195 bp gyrase A) of ciprofloxacin resistant strain with Hind l did not make any change, compared to the undigested product of the same strains in the electrophoresis banding pattern, indicating the presence of mutations at both the ser-83 and asp-87 sites of the genome Gyr A. In contrast, the PCR product from nalidixic acid susceptible control strain cleaved at both sites, ser-83 and asp-87. Key words: VNTR; Antibiotic resistance; Quinolone; Salmonella DOI: http://dx.doi.org/10.3329/bjm.v27i2.9169 BJM 2010; 27(2): 38-41

The study of the trend of infection, susceptibility to antibiotics and molecular level analysis of the cause of reduced susceptibility of Salmonella typhi isolates from the patients in Bangladesh were studied. Out of 9040 blood cultures obtained during the study period, 1266 (14.0%) showed significant growth. Nearly three?fourths of the positive blood cultures were due to S. typhi and rests were mostly of S. paratyphi A. The prevalence was highest between the age group 25 and 60 months. Male showed slightly higher rate of infection than female. Among all 943 S. typhi isolates, 42.6, 42 and 41.4% were sensitive to ampicillin, cotrimoxazol and chloramphenicol, respectively. All isolates were sensitive to ceftriaxon and ceftazidim; 9 isolates were ciprofloxacin resistant, others were moderate to highly sensitive; whereas, only 2.2% isolates were sensitive and almost all (97.8%) were found resistant to nalidixic acid. The E?strip test among 411 isolates showed the MIC value of 53 isolates nearer to the very sensitive (< 0.125 μg/ml), 252 isolates between 0.125 and 0.5 μg/ml, 95 isolates between 0.5 and 2.0 μg/ml and rest other 11 isolates showed from > 2.0 μg/ml to very highly resistant (512 μg/ml). VNTR pattern of all ciprofloxacine resistant S. typhi was also same. Restriction fragment analysis of gyrase?A gene indicated point mutations in different loci that bear the cause of being resistant to ciprofloxacin. Key words: Reduced susceptibility; Typhoid fever; Salmonella typhi; Fluoroquinolone DOI: http://dx.doi.org/10.3329/dujbs.v19i2.8955 DUJBS 2010; 19(2): 137-144