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Journal Cover 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  [48 journals]
  • Editorial

    • Abstract: No abstract available Published on 2017-10-29 14:02:09
       
  • Antibiotic sensitivity pattern for non-beta lactam antibiotics and
           carbapenems in extended-spectrum beta-lactamase (ESBL) producing
           uropathogens versus non-ESBL producing uropathogens

    • Abstract: Introduction and Objectives: Urinary tract infections (UTIs) are frequent and predominantly caused by coliforms. ESBL producers are increasing in number limiting therapeutic options. It is therefore vital to institute precise, empiric antibiotic guidelines in order to prevent life-threatening urosepsis. The objective of this study was to compare antibiotic sensitivity (ABST) pattern of ESBL producers and non-ESBL producers against selected non-beta lactams and carbapenem antibiotics. Methodology: Retrospective analysis of ABST of significant urinary coliform isolates was done.
      Study setting: Department of Medical Microbiology, Faculty of Medicine, University of Kelaniya and Base Hospital, Wathupitiwala, Sri Lanka.
      Study period: 01.01.2012 - 01.01.2016.
      Study groups: ESBL producers and non-ESBL producers, 63 in each group. Sensitivity profiles of amikacin, gentamicin, netilmicin, nitrofurantoin, nalidixic acid, norfloxacin, ciprofloxacin, imipenem and meropenem were analyzed. Statistical analysis: R programming language. Level of significance P<0.05.Results: ESBL producers were present in 63 patients, 36 (57.1%) of whom were females and 39 were inpatients (61.9%). Non-ESBL producers were isolated from urine of 63 patients, of whom 49 (77.8%) were females and 17 (26.9%) inpatients. Antibiotic sensitivity of ESBL producers ranged from 82.2% to 100% for netilmicin, amikacin, meropenem and imipenem, 65% for nitrofurantoin and from 14.8% to 32.1% for nalidixic acid, ciprofloxacin, norfloxacin and gentamicin. Antibiotic sensitivity of the non-ESBL producers ranged from 56.7% for nalidixic acid and from 76.8% to 85.1% for ciprofloxacin, nitrofurantoin, norfloxacin and gentamicin.Conclusion: A female predominance was noted in both non ESBL and ESBL producers but there was a significant dominance of ESBL producers in male patients. ESBL producers were significantly common amongst inpatients than outpatients. ESBL-producers had significantly high resistance against nalidixic acid, ciprofloxacin, norfloxacin and gentamicin compared to non-ESBL producers. However, more than 2/3rd of isolates in both groups were sensitive to nitrofurantoin. Published on 2017-10-18 04:54:09
       
  • Knowledge among nursing students of blood borne viruses and practices to
           prevent transmission

    • Abstract: Objectives: The main objectives of this study were to determine the knowledge about blood borne viruses and practices to prevent its transmission among nursing students of a teaching hos-pital in North East India. Methodology: A cross sectional study was conducted in a nursing college in North East India among the nursing students involved in clinical practice. The study duration was of two months. Sample size of 200 for the study was arrived at by applying the formula 4pq/l2+(4pq/N) where(4pq/N) is the finite population correction factor where N is equal to 357 which is the total estimated population and l is the allowable error which is taken as 10%. Statistical analysis was carried out by using software SPSS version 20 and frequency, proportions and percentages were calculated. A pre-tested questionnaire regarding the knowledge, and practices related to blood borne infections was used. Results: Majority of the students (62.5%) had knowledge about the three most serious blood borne infections though only 25% were aware that HIV is transmitted by infected blood, unpro-tected sexual intercourse, tattooing and piercing instruments, mother to child during pregnancy and during labour. This study also showed that the majority of the students (89%) knew that be-ing a healthcare worker puts them at risk of acquiring Hepatitis B, C and HIV. Conclusions: The present study concludes that the nursing students of Sikkim Manipal Institute of Medical Sciences have a fair knowledge of the cause of blood borne infections. Awareness and practices regarding use of personal protective equipment was also good. However, the nurs-ing education programme should prepare nurses for providing effective and efficient nursing care for patients and use adequate protective measures to minimize risk of occupational hazards to themselves. Published on 2017-10-18 03:28:25
       
  • An outbreak investigation of bacteraemia due to Burkholderia cepacia
           complex at the National Hospital of Sri Lanka

    • Abstract: Burkholderia cepacia complex (BCC) is an opportunistic pathogen in immunocompromised patients and well distributed in the natural environment. Nosocomial outbreaks of BCC are due to contaminated solutions and medical devices. However, in Sri Lanka, there have been no nosocomial outbreaks of BCC reported in the past. We report here an outbreak investigation of bacteraemia due to BCC in the wards and ICUs of the National Hospital of Sri Lanka (NHSL) during the period of August 14th 2017 to September 13th 2017 which an extensive investigation traced to a contaminated nebulizer solution of a particular brand of ipratropium bromide. The blood culture isolates from the patients with bacteraemia and from the particular nebulizer solution were found to be identical and confirmed as BCC. There had been outbreaks in other hospitals with the same organism in the recent past but they were not able to find the common source for the outbreak. The incident was reported officially to the relevant authorities and other hospitals, and an alternative agent for the use of nebulization was strongly recommended to prevent further cases immediately. Published on 2017-10-17 13:39:43
       
  • Burkholderia cepacia; an unusual cause of multiple splenic abscesses : A
           case report

    • Abstract: Burkholderia cepacia is an uncommon, multidrug resistant pathogen. We present a patient with a history of recent malignancy and uncontrolled diabetes, who presented with bacteraemia and multiple splenic abscesses due to this organism. She was managed conservatively, and made a good recovery. A high index of suspicion is required to arrive at the microbiological diagnosis and provide effective management. Published on 2017-10-16 13:22:43
       
  • Madurella grisea: a case report on an uncommon cause for mycetoma

    • Abstract: Madura foot is a disfiguring, disabling condition, found in the tropics and subtropics. We present a case of a farmer who presented with swelling and multiple discharging sinuses in his left foot. The offending organism, Madurella grisea was identified by fungal culture. The patient was managed with local excision combined with systemic antifungal therapy. So far, the patient has made an uneventful recovery, with no recurrences. The laboratory diagnosis proved difficult, given the limited resources. We wish to highlight the difficulties faced in diagnosis and management of this condition, as response to antifungals are dependent on the pathogen, and adherence to long term antifungals are crucial. Published on 2017-10-16 13:12:23
       
  • Melioidosis presenting as parotid abscess in children: two consecutive
           cases

    • Abstract: Melioidosis is an emerging infection in Sri Lanka with increasing case reports, mostly in adults but also in children. We report two children with parotid abscess, which is one of the common clinical manifestations in the paediatric population in Southeast Asia but rare in Northern Australia. Both were previously healthy. The children recovered completely after surgical drainage and antibiotic treatment according to standard guidelines. Because the spectrum of disease in childhood is different from that in adults and underlying predisposing factors are usually not seen in children, a high index of suspicion is required for the diagnosis of paediatric melioidosis. Raising awareness among paediatricians in Sri Lanka of the clinical presentations of melioidosis in childhood is a prerequisite for improved ascertainment. The key role of the microbiology laboratory in the diagnosis of melioidosis is highlighted. Published on 2017-10-16 12:26:25
       
  • "Coma vigil a rare neuropsychiatric complication of a pan sensitive
           Salmonella infection"

    • Abstract:
      A 25 year old previously healthy male presented with low grade intermittent fever for ten days and confusion for two days. On examination he was febrile and confused, making abnormal unpurposeful gestures with his hands. He was not aggressive. There was no nuchal rigidity or cervical lymphadenopathy. He was started on empirical intravenous antibiotics and steroids to cover meningo encephalitis. He had a marginally elevated CRP, a normal full blood count and an unremarkable CSF analysis. The patient was started on chloramphenicol to cover typhus encephalitis. The CSF culture was sterile. Salmonella enterica serovar Typhi was isolated from blood culture. Published on 2017-10-16 11:50:26
       
  • Utility of a modified silver staining technique for detection of
           Leptospira

    • Abstract: Background: Leptospira are spiral thin and highly motile pathogenic bacteria that are best visualized by dark ground microscopy. Although these bacteria are not stained by the Gram’s stain, the Fontana stain, which is a silver impregnation staining method, can be used successfully for light microscopy. It is important to investigate the usefulness of Fontana stain method for direct demonstration of Leptospirain human body fluids. Objectives: To determine the usefulness and sensitivity of a modified Fontana silver staining method for microscopic detection of Leptospirain clinical specimens.

      Methodology: 6×108 organisms/ml of Leptospira interrogans serovar Icterohaemorrhagiae and Canicola were spiked into PBS (Phosphate Buffered Saline), alkalinized urine and serum in triplicate and serial dilutions were made (6×106 to 6×101 organisms/ml). Smears were prepared using 10 µl of each dilution. In addition, centrifuged sediment of urine were also used to prepare smears. Slides were stained by modified Fontana method as reported by Gangadhar et al.(1998) and examined. Numbers of leptospires per field (×100) were recorded. Results: Leptospira spiked in PBS and urine appeared as thin slender bacteria with characteristic hooked ends after Fontana staining under the light microscope. Serum could not be used for the detection of Leptospiraby this method. Leptospires could be detected by staining the spiked PBS and urine at 6x103 – 6x106 organisms/ml. Conclusion: Leptospires could be detected by Fontana staining in spiked PBS, urine (uncentrifuged and sediment). Serum was not suitable for detection of leptospires by Fontana staining. The detection limit of leptospires in PBS and urine by Fontana stain was found to be 6000 organisms/ml. Published on 2017-10-15 14:48:06
       
  • Leptospirosis in Sri Lanka

    • Abstract: Leptospirosis has become one of the most important infectious diseases in Sri Lanka over the last few years. Though it was well documented and investigated in the 1960’s and 70’s, the disease was mostly forgotten for more than 30 years. Leptospirosis has not been among the diseases under scientific investigation in Sri Lanka even after an outbreak in 2003. However, it has become a priority research area following a large outbreak of leptospirosis in 2008 with more than 7000 reported cases.Leptospirosis is endemic in all but one district in Sri Lanka. Reported cases are mostly males and different occupational categories are listed as risk groups. The commonest exposure risk is for people engaged in farming or with exposure in paddy fields. The case fatality ratio varies between 2-3% in all cases, whereas it may be as high as 33% in complicated cases.Thirteen different strains of Leptospira in five species have been isolated from human cases from Sri Lanka and 10 serogroups have been reported. Diagnosis is a major challenge faced by the treating physicians and further studies are required to understand the clinicopathology of disease. Published on 2017-10-15 14:21:11
       
 
 
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