title: Drug resistance and molecular epidemiology of aerobic bacteria isolated from puerperal infections in Bangladesh.
abstract: Puerperal infection is a common complication during postnatal period in developing countries. Bacterial species, drug resistance, and genetic characteristics were investigated for a total of 470 isolates from puerperal infections in Bangladesh for a 2-year period (2010-2012). The most common species was Escherichia coli (n=98), followed by Enterococcus faecalis (n=54), Staphylococcus haemolyticus (n=33), Proteus mirabilis (n=32), Staphylococcus aureus (n=27), Klebsiella pneumoniae (n=22), and Enterobacter cloacae (n=21). S. aureus and Acinetobacter baumannii were isolated at a higher frequency from wound infections after cesarean section, while E. coli, E. cloacae, and K. pneumoniae were isolated from community-acquired endometritis and urinary tract infections. Resistance to third-generation cephalosporins was frequent for Enterobacteriacae, and was mainly mediated by blaCTX-M-1 group beta-lactamases. The CTX-M gene in E. coli from the four phylogroups was identified as blaCTX-M-15, and phylogroup B2 isolates with blaCTX-M-15 were classified into ST131 with O25b allele, harboring aac(6')-Ib-cr and various virulence factors. Carbapenemase genes blaNDM-1 and blaNDM-7 were identified in one isolate each of phylogroup A E. coli. Methicillin-resistant S. aureus isolates had type IV or V SCCmec, including isolates of ST361 (CC672), which is related to an emerging ST672 clone in the Indian subcontinent. This study revealed the recent epidemiological status of aerobic bacteria causing puerperal infections in Bangladesh, providing useful information to improve clinical practice and infection control.
authors.affiliation: 1Department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh.
authors.forename: Salma
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: 2Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Mitsuyo
authors.initials: M
authors.lastname: Kawaguchiya
authors.affiliation: 2Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan.|3Department of Biomedical Sciences, Ross University School of Veterinary Medicine, St. Kitts, West Indies.
authors.forename: Souvik
authors.initials: S
authors.lastname: Ghosh
authors.affiliation: 1Department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh.
authors.forename: Shyamal Kumar
authors.initials: SK
authors.lastname: Paul
authors.affiliation: 2Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Urushibara
authors.affiliation: 1Department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh.
authors.forename: Chand
authors.initials: C
authors.lastname: Mahmud
authors.affiliation: 4Department of Gynecology and Obstetrics, Mymensingh Medical College, Mymensingh, Bangladesh.
authors.forename: Kamrun
authors.initials: K
authors.lastname: Nahar
authors.affiliation: 1Department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh.
authors.forename: Mohammad Akram
authors.initials: MA
authors.lastname: Hossain
authors.affiliation: 2Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Nobumichi
authors.initials: N
authors.lastname: Kobayashi
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001459:Bangladesh / Q000453:epidemiology; D001483:Base Sequence; D002511:Cephalosporins / Q000494:pharmacology; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D004755:Enterobacteriaceae / Q000145:classification / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D015964:Gene Expression Regulation, Bacterial; D006801:Humans; D008826:Microbial Sensitivity Tests; D017720:Molecular Epidemiology; D008969:Molecular Sequence Data; D058885:Multilocus Sequence Typing; D010802:Phylogeny; D010957:Plasmids / Q000737:chemistry / Q000378:metabolism; D011645:Puerperal Infection / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D017422:Sequence Analysis, DNA; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D013211:Staphylococcus aureus / Q000145:classification / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D041162:Staphylococcus haemolyticus / Q000145:classification / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D001618:beta-Lactamases / Q000235:genetics* / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D001618:beta-Lactamases