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Sri Lankan Journal of Infectious Diseases
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  This is an Open Access Journal Open Access journal
     ISSN (Print) 2012-8169
     Published by Sri Lanka Journals Online Homepage  [41 journals]
  • Editorial

    • Authors: Vasanthi Thevanesam
      Abstract: No abstract
      DOI : http://dx.doi.org/10.4038/sljid.v4i1.6634
      PubDate: 2014-02-28
      Issue No: Vol. 4 (2014)
       
  • Antibiotic resistance in Helicobacter pylori: Recent insights

    • Authors: D Weerasekara, DMBT Dissanayake, GIDDAD Athukorala, MM Weerasekara, SSN Fernando
      Abstract: The discovery that Helicobacter pylori (H. pylori) infection is the main cause of most gastro duodenal diseases has dramatically changed the management of these diseases. Antibiotics are the mainstay of treatment. However, prevalence of H. pylori antibiotic resistance is increasing worldwide, and is the main factor affecting the efficacy of current therapeutic regimens. In Sri Lanka, although eradication therapy for H. pylori by antibiotics is commonly advocated, due to a lack of susceptibility data, it has not been possible to formulate suitable guidelines for clinical use.
      DOI : http://dx.doi.org/10.4038/sljid.v4i1.5986
      PubDate: 2014-02-28
      Issue No: Vol. 4 (2014)
       
  • Antimicrobial susceptibility patterns and empirical prescribing practices
           in adult in patients with urinary tract infection: is there a need for
           changing clinical practices'

    • Authors: CN Wijekoon, KMMP Dassanayake, A Pathmeswaran
      Abstract: Introduction: Knowledge of local antimicrobial susceptibility is essential for prudent empiric therapy for urinary tract infection (UTI).The aim of this study was to describe antimicrobial susceptibility patterns and empirical prescribing practices in adult in patients with UTI. Methods: The study was carried out at a tertiary care hospital in Sri Lanka. Data was collected prospectively from consecutive adult in patients with positive urine culture and clinical features compatible with UTI. Sensitivity testing was done using Joan Stokes method. The etiological uropathogens, antibiotic susceptibility rates, association between antimicrobial susceptibility rates and background variables and empirical prescribing practices were analyzed. Results: 745 subjects were studied. Mean (SD) age was 48.2 (19) years and 441(59.2%) were females. Coliforms were the commonest isolates (85.6%). Overall, 76.8% of the isolates were susceptible to nitrofurantoin. (coliforms-74.9%; Streptococcus spp.-100%; Staphylococcus spp.-95.6%). Overall susceptibility was < 50%, to many antimicrobials. Among coliforms and pseudomonas isolates susceptibility to ciprofloxacin was 37.7% and 29.4% respectively.  The susceptibility rates of coliforms varied according to age, gender, origin of UTI and presence of co-morbidities. 381(51.1%) subjects received empirical antimicrobials. Ciprofloxacin was the most frequently prescribed empirical antimicrobial (208/381; 54.6%). Despite high susceptibility nitrofurantoin was prescribed in 9.2% only. Conclusions: Susceptibility was low to many first line and second line antimicrobials used to treat UTI in adults. There was obvious discrepancy between empirical prescribing practices and the susceptibility pattern of isolates. Incorporation of local surveillance data in to clinical practice will be useful to optimize the use of empirical antimicrobial therapy.
      DOI : http://dx.doi.org/10.4038/sljid.v4i1.6229
      PubDate: 2014-02-28
      Issue No: Vol. 4 (2014)
       
  • To determine the sensitivity and specificity of Polymerase chain reaction
           (PCR) in the diagnosis of visceral leishmaniasis

    • Authors: MS ANJUM, U ANSARI, F HUSSAIN, N KALSOOM
      Abstract: Introduction: Leishmaniasis is a disease caused by a protozoan parasite of the genus Leishmania, which is transmitted through bites of infected sandflies. It has been reported that the polymerase chain reaction (PCR) is a more sensitive and specific test for the diagnosis of visceral leishmaniasis than bone marrow examination. This recent study is a renewed effort to validate the role of PCR in the diagnosis of visceral leishmaniasis. Objective: The objective of this study was to determine the sensitivity and specificity of PCR in the diagnosis of visceral leishmaniasis. Study design: Cross sectional (validation) study carried out in the Haematology department, Armed Forces Institute of Pathology, Rawalpindi. from 25th March 2011 to 24th March 2012. Subjects and Methods: A total number of 59 patients with visceral leishmaniasis diagnosed on microscopic bone marrow examination with equal number of negative controls were studied. The subjects were tested for the presence of visceral leishmaniasis by the polymerase chain reaction. Results: All the 59 patients were found to be positive for visceral leishmaniasis by PCR. None of the negative controls were positive by PCR. Conclusion: The study validates that PCR is equal to microscopic bone marrow examination in the diagnosis of visceral leishmaniasis. 
      DOI : http://dx.doi.org/10.4038/sljid.v4i1.6036
      PubDate: 2014-02-28
      Issue No: Vol. 4 (2014)
       
  • Proportion of Superficial fungal infections among the cleaning staff
           members at University of Sri Jayewardenepura

    • Authors: J Kottahachchi, S Perera, S Rajakulasooriya, MM Weerasekera, C Gunasekera, A Bogahawatta, N Fernando
      Abstract: IntroductionSuperficial fungal infections (SFIs) are infections of the keratinous tissue caused by dermatophytes, yeasts and non-dermatophyte fungi.  Cleaning staff are identified as a risk category for the SFI as they are frequently exposed to moist environment.ObjectiveTo determine the proportion of infection, knowledge, attitudes, practices and risk factors of superficial fungal infections among the cleaning staff members at University of Sri JayewardenepuraMethodsEighty two cleaning staff members were included in the study. Clinical examination for SFIs was done by a medical officer and sample processing was carried out at the Department of Microbiology at University of Sri Jayewardenepura between May to October 2012. Laboratory identification of the fungal organisms was done using direct microscopy (10% KOH) followed by culture on Sabouraud's Dextrose Agar. Morphological and physiological methods were used to specieate the isolated fungi. An interviewer administrated questionnaire was carried out to assess the knowledge, attitudes and practices (KAPs) on SFIs. Data were categorized and scored based on variables that were to be analyzed. Results Forty one of 82 participants (51.2%) had SFIs. Out of the 56 clinically suspected cases 76 specimens were collected from different infected sites. Four skin scrapings were identified as Pityriasis versicolor by direct smear. Out of 57 scrapings and nail clippings, 45 (79%) were KOH positive, twelve (21%) were negative for direct smear.  Out of direct smear positive specimens only 28 were culture positive while 17 were culture negative. Aspergillus niger was the commonest organism isolated from these specimens (20) followed by the non albicans Candida spp. (7), Candida albicans (2), dematiaceous fungi (7), Pityriasis versicolor (4), Fusarium spp. (3) and dermatophyte species. Multiple fungal species were isolated in 4 specimens.Regarding total marks presentation of KAPs, our study population had an unsatisfactory level of knowledge 35(42.2%) while majority 40 (48.8%) had good attitudes, and 48 (58.5%) were shown to have a satisfactory level of safety practices.Describing the risk factors for SFIs among cleaning staff was one objective of our study. However our study showed that there was no statistically significant relationship between the risk factors with SFIs. ConclusionAspergillus niger was the commonest pathogen causing SFIs in the study group. Although participants have a satisfactory level of knowledge, attitudes and practices towards the SFIs regular examination of this population is recommended because they are at high risk for SFIs.
      DOI : http://dx.doi.org/10.4038/sljid.v4i1.6061
      PubDate: 2014-02-28
      Issue No: Vol. 4 (2014)
       
  • Suspicion vs. reality – Influenza A and B associated acute
           respiratory tract infection in a group of children in Sri Lanka

    • Authors: F Noordeen, H Pandithasundara, SK Senavirathna, SB Abeykoon, MAM Faizal, AJ Morel, RM Mudiyanse
      Abstract: No abstract
      DOI : http://dx.doi.org/10.4038/sljid.v4i1.5988
      PubDate: 2014-02-28
      Issue No: Vol. 4 (2014)
       
  • “Apophysomyces elegans causing Rhino-Orbital Mucormycosis.”

    • Authors: AB Akhuj, A Banerjee, S Roy, K Karak, B Saha Dalal, S Bhattacharya
      Abstract: We describe here is a recent case of mucormycosis caused by Apophysomyces elegans in a 60 year old female from South Bengal with uncontrolled diabetes mellitus for two years. She presented with massive orbital oedema and pain in the periorbital area with proptosis of the right eye. Deep tissue obtained by endoscopic sinus sampling from the right middle meatus grew Apophysomyces elegans. The diagnosis was confirmed by histopathology which showed aseptate broad hyphae. Computed tomography scan showed right sided pan-sinusitis involving the right maxillary, ethmoid, frontal and sphenoid sinuses with an antrochoanal polyp and right retro orbital involvement of soft tissue. She required eye exenteration and extensive surgical debridement in addition to intravenous amphotericin B and antidiabetic drugs. She responded to the treatment.
      DOI : http://dx.doi.org/10.4038/sljid.v4i1.5861 
      PubDate: 2014-02-28
      Issue No: Vol. 4 (2014)
       
  • Risk factors for acquiring varicella zoster virus (VZV) infection, and
           sero-prevalence of anti-VZV immunoglobulin G antibodies in adolescents
           from a tropical population

    • Authors: F Noordeen, R Dissanayake, IKB Weerasekara, PVR Kumarasiri, MH Wijedasa
      Abstract: Introduction: Little is known about the sero-prevalence of anti-VZV antibodies among adolescents in the Kandy district of Sri Lanka although adulthood VZV infections are very common in this part of the country.Design: Socio-demographic data and blood samples were collected between November 2004 and April 2005 from a total of 271, 12- to 19-year-old, school students from urban, rural and estate communities. Sera were tested for anti-VZV IgG antibodies using a stranded enzyme-linked immunosorbent assay.Results: Sero-prevalence of anti-VZV antibodies among the adolescents was found to be 34%. Number of siblings (adolescents without siblings were non-immune; of those with 2 siblings - 27% were immune; of those with more than 2 siblings - 39% were immune) and areas of residence (urban, estate and rural) were significantly associated with the presence of anti-VZV IgG antibodies (p<0.001).Conclusions: Sero-prevalence of anti-VZV IgG antibodies was low among adolescents in the Kandy district. Adolescents who lived in the urban areas had a significantly higher rate of anti-VZV IgG antibodies than those who lived in rural areas (p<0.001). Adolescents who grow up without siblings are at risk of evading the childhood VZV infection and form a potential target group for adulthood chicken pox.
      DOI : http://dx.doi.org/10.4038/sljid.v4i1.5852 
      PubDate: 2014-02-25
      Issue No: Vol. 4 (2014)
       
 
 
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