Browsing by Author "Dassanayake, M."

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Analysis of urine culture isolates from seven laboratories of Sri Lanka: National Laboratory Based Surveillance of Sri Lanka College of Microbiologists in 2014
(Sri Lankan Society for Microbiology, 2016) Jayatilleke, S.K.; Patabendige, G.; Dassanayake, M.; Karunaratne, G.K.D.; Perera, J.; Perera, R.R.D.P; Wijesooriya, W.R.P.L.I.; Sunil-Chandra, N.P.; Kottahachchi, J.; Athukorala, D.; Dissanayake, T.
INTRODUCTION: National Laboratory Based Surveillance of Antimicrobial Resistance in urinary isolates conducted by the Sri Lanka College of Microbiologists was started in 2011 in collaboration with the Ministry of Health of Sri Lanka. METHODS: Pooled susceptibility data of urine culture isolates with a colony count of ≥105 CFU/ml from samples of non-catheterised patients received in 2014 were analysed using WHONET 5.6 software. RESULTS: The majority of the isolates (3975/4979:79.8%) were Gram negative enteric organisms, commonly known as coliforms. The other bacterial isolates identified were Enterococcus spp. (254), Pseudomonas spp. (194), coagulase negative staphylococci (59), Staphylococcus aureus (36), Acinetobacter spp. (35) and Group B β-haemolytic streptococci (18). The coliforms isolated from adults attending outpatient clinics (n=277) had 55.2% susceptibility to cephalexin and cephradine, 54% to amoxycillin/clavulanic acid, 65.1% to nitrofurantoin, 48.3% to norfloxacin, 63.4 % to cefotaxime, 86.4% to gentamicin, 97.4% to imipenem and 100% to meropenem. The isolates from adult hospitalized patients (n=1297) had 39.5% susceptibility to cefotaxime, 87.9% to meropenem, 62.6% to gentamicin and 31.9% to ciprofloxacin. Coliforms isolated from paediatric outpatients (n=182) had 58.5% susceptibility to cephalexin and cephradine, 58.5% to amoxycillin/clavulanic acid, 80% to nitrofurantoin, 85% to cefotaxime, 86.5% to gentamicin and 89.7% to meropenem. Those from paediatric hospitalized patients (n= 663) had 64.6% susceptibility to cefotaxime, 90.5% to meropenem and 80.2% to gentamicin. CONCLUSION: Coliforms, the commonest category of organisms isolated had high resistance rate in hospitalized patients whereas the resistance was less in outpatients, especially in the paediatric age group.
Human bocavirus in patients with encephalitis, Sri Lanka, 2009-2010
(Centers for Disease Control and Prevention (CDC), 2013) Mori, D.; Ranawaka, U.; Yamada, K.; Rajindrajith, S.; Miya, K.; Perera, H.K.K.; Matsumoto, T.; Dassanayake, M.; Mitui, M. T.; Mori, H.; Nishizono, A.; Soderlund-Venermo, M.; Ahmed, K.
We identified human bocavirus (HBoV) DNA by PCR in cerebrospinal fluid from adults and children with encephalitis in Sri Lanka. HBoV types 1, 2, and 3 were identified among these cases. Phylogenetic analysis of HBoV1 strain sequences found no subclustering with strains previously identified among encephalitis cases in Bangladesh.
Secondary bacteraemia in adult patients with prolonged dengue fever
(Sri Lanka Medical Association, 2015) Premaratna, R.; Dissanayake, D; Silva, F.H.D.S.; Dassanayake, M.; de Silva, H.J.
INTRODUCTION: Although dengue management guidelines do not advice on use of antibiotics in dengue shock syndrome, unrecognised bactraemia is likely to contribute to morbidity and mortality. OBJECTIVES: To assess the occurance of secondary bacteraemia in adult patients with prolonged dengue fever. METHODS: A prospective study was conducted recruiting patients with confirmed acute dengue infection who had prolonged fever (>5 days). Two sets of blood cultures were taken in such patients prior to institution of antibiotic therapy. Demographic, clinical, haematological and biochemical parameters were recorded. Development of ascites and pleural effusions were detected using ultrasonography. RESULTS: Fourty patients (52.5% males) with a mean age of 29.8 years (SD 13.6) were studied. The average duration of fever was 7.9 days (SD 1.8). Ten patients (25%) had bacterial isolates in their blood cultures; Staphylococcus aureus (n=2), coliforms (n=3), pseudomonas (n=1) and 4 had mixed growths. The culture positive group had severe body aches at admission and higher fever, third space fluid accumulation, a significant drop in platelets and a higher CRP. CONCLUSIONS: A quarter of dengue patients with prolonged fever had a bacterial isolate. Culture positive patients appeared more ill with body aches and had higher degrees of fever during the latter part of the illness. Increased vascular permeability may predispose to bacterial seepage into blood. Although white cell count is not helpful in detecting bacteraemia, low platelet count and elevation of CRP seem to be helpful.
Secondary Bacteraemia in Dengue patients with Prolonged Fever
(Sri Lanka Medical Association, 2013) Dissanayake, G.N.D.; Silva, F.H.D.S.; Dassanayake, M.; Premaratna, R.
INTRODUCTION AND OBJECTIVES: In dengue infection, fever usually lasts 5- 7 days. Less than 5% develop Dengue Shock Syndrome due to fluid leakage. Some of the patients with third space fluid accumulation (TSFA) continue to have prolonged high fever. Few studies have shown growth of bacterial species in blood cultures which suggest secondary bacteraemia. This is probably caused by translocation of gut bacteria by disruption of intestinal mucosal and vascular integrity. Clear understanding of secondary bacterial infections is necessary to treat the severe dengue infections effectively. Our objective was to assess the prevalence and risk of bacteraemia in patients with dengue who had prolonged fever. METHODS: A prospective, descriptive study was conducted at the Professorial Medical Unit of Colombo North Teaching Hospital, Ragama. Forty six patients with seropositive, acute dengue infection and prolonged fever (>5 days) were recruited. Two sets of blood cultures were obtained Haematological and biochemical tests were carried out. Clinical diagnosis of TSFA (ascites/ pleural effusions) were recorded. None of the patients were treated with antibiotics prior to obtaining blood cultures. RESULTS: Thirty (65.2%) patients had no evidence of fluid leakage and none of them had positive blood culture isolate. Of the 16 (34.8%) patients who had third space leakage, 10 (62-5%) patients had positive blood culture growths; Coliforms (3), Staphalococcus aureus (2), Pseudomonas sp.(l), mixed growths (4). CONCLUSIONS: Patients with prolonged fever and fluid leakage are at risk of developing secondary bacteraemia compared to those without fluid leakage.