Browsing by Author "Perera, R.R.D.P."

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Analysis of data of urine culture isolates of 2013 sent from four laboratories of National Laboratory Based Surveillance of Sri Lanka College of Microbiologists
(Sri Lanka College of Microbiologists, 2014) Jayatilleke, S.K.; Karunaratne, G.K.D.; Perera, J.; Perera, R.R.D.P.; Wijesooriya, W.R.P.L.I.; Sunil-Chandra, N.P.
OBJECTVES: To determine the aetioiogical agents of midstream urine cultures with a colony count of > 10 5CFU/ml. To analyse the antimicrobial susceptibility of those isolates. METHOD: The National Laboratory Based Surveillance on Antimicrobial Resistance is a collaborative project of the Ministry of Health and the Sri Lanka College of Microbiologists. At the initial phase decided to analyse midstream urine cultures with a colony count of >105 CFU/ml. The specimens were processed according to the standard protocol specified in the laboratory manual in microbiology. Antibiotic susceptibility tests were performed according to the method established in the centre which is either by CLSI method or by Stake's comparative disk diffusion method. Data of 2013 sent by the participating laboratories were analysed using WHONET software. RESULTS: The data was received from four centres. They were Sri Jayewardenapura General Hospital, Lady Ridgeway those isolates. ATotal of 1175 significant isolates were analysed. The majority were Gram negative enteric organisms, com¬monly known as coiforms, with 922 (78.5%) isolates. The others were Enterococcus species 83 (7%), Candida species 60 (5.1%), Pseudomonas species 38 (3.2%), Acinetobacter species 21 (1.8%), Group B beta-haemolytic Streptococcus 20 (1.7%), coagulase negative Staphylococcus species 10 (0.85%), Streptococcus species 9 (0.8%), Staphylococcus aureus 7 (0.6%), and Staphylococcus saprophyticus 5 (0.4%). The susceptibility of coliforms were 11.6% (92/795) to ampicillin, 71.1% (621/873) to nitrofurantoin, 25.9% (223/ 862) to cephalexin, 46% (392/853) to cefuroxime, 29.4% (255/866) to nalidixic acid, 47.8% (422/883) to cefo-taxime, 92.6% (665/718) to meropenem, 70.3% (601/ 855) to gentamicin, 41.6% (341/819) to amoxicillin-clavulanic acid and 38.4% (318/829) to ciprofloxacin. None of the 13 isolates of Acinetobacter species tested were sensitive to meropenem while only 55% (16/29) of Pseudomonas sp. were sensitive to meropenem. 74% (60/81) of Enterococcus species were sensitive to ampicillin. CONCLUSION: Coliforms constitute the commonest organism causing urinary tract infections (UTI). A high resistance rate was noted in coliforms for broad spectrum antibiotics like cefotaxime and ciprofloxacin. Acinetobacter sp. shows a very high resistance rate even for carbapenems. Ampicillin can be recommended as empirical therapy to treat UTI due to enterococcus species.
Analysis of data of urine culture isolates of 2014 sent from seven laboratories of National Laboratory Based Surveillance of Sri Lanka College of Microbiologists
(Sri Lanka College of Microbiologists, 2015) Jayatilleke, S.K.; Patabendige, G.; 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, P.; Dasanayake, M.
OBJECTIVES: To determine the aetiological agents of midstream urine cultures with a colony count of >105 CFU/ml. To analyse the antimicrobial susceptibility patterns of urine culture isolates of 2014. METHOD: The National Laboratory Based surveillance on antimicrobial resistance is a collaborative project of the Ministry of Health and the Sri Lanka College of Microbiologists. In this project midstream urine cultures with a colony count of >105 CFU/ml were analysed. The specimens were processed according to the standard protocol specified in the laboratory manual in microbiology. Antibiotic susceptibility tests were performed according to the method established in the centre which is either by CLSI method or by Stake's comparative disk diffusion method. Data of 2014 sent by the participating laboratories were analysed using WHONET 5.6 software. RESULTS: The data was received from seven centres. They were The National Hospital of Sri Lanka, Sri Jayewardenapura General Hospital, Lady Ridgeway Childrens' Hospital, Faculty of Medicine, Colombo, Faculty of Medicine, Ragama, Faculty of Medicine, Sri Jayewardenapura and North Colombo Teaching Hospital, Ragama. A total of 4441 significant isolates were analysed. The majority were Gram negative enteric organisms, commonly known as conforms, with 3975/4979 (79.8%) isolates. The others were Candida species 408, Enterococcus species 254, Pseudomonas species 194, coagulase negative Staphylococcus species 59, Staphylococcus aureus 36, Acinetobacter species 35 and Group B beta-haemolytic Streptococcus 18. The coliforms from adults who were attending outpatient clinics had 55.2% (112/203) susceptibility to cephalexin andcephradine, 54% (161/298) to amoxycillin/clavulanic acid, 65.1% (278/427) to nitrofurantoin, 48.3% (144/298) to norfloxacin, 63.4% (189/298) to cefotaxime, 97.4% (113/116) to imipenem and 100% (90/90) to meropenem. The adult inward patients had 39.5% (519/1313) susceptibility to cefotaxime, 87.9% (445/506) to meropenem, 62.6% (812/1298) togentamicin and 31.9% (405/1281) to ciprofloxacin. The coliforms from paediatric outpatients had 58.5% (69/118) susceptibility to cephalexin and cephradine, 58.5% (76/130) to amoxycillin/clavulanic acid, 80% (16/20) to nitrofurantoin, 85% (17/20) to cefotaxime and 89.7% (26/29) to meropenem. The paediatric inward patients had 64.6% (53/82) susceptibility to cefotaxime, 90.5% (19/ 21) to meropenem and 80.2% (65/81)togentamicin. CONCLUSION: Coliforms, the commonest organism causing urinary tract infections (UTI), had high resistance rate in in-wardpatients but the resistance was less in outpatients, especially in the paediatric age group.
Antibiotics supplemented culture media can eliminate non-specific bacteria from human semen during sperm preparation for intra uterine insemination
(Medknow Publications, 2014) Dissanayake, D.M.A.B.; Amaranath, K.A.; Perera, R.R.D.P.; Wijesinghe, P.S.
RATIONALE: Bacterial flora can be isolated from many semen samples of subfertile males. Bacteriospermia can compromise the outcome of intra uterine insemination (IUI) by contaminating thepost-processed sperm sample. OBJECTIVES: The objective of the present study is to determine the efficacy of penicillin and streptomycin in eliminating the bacteria from semen samples in the sperm processing procedure, and to assess the effects of antibiotics on sperm motility, survivability, and pregnancy rates.DESIGN AND SETTINGS: A prospectively controlled study was carried out using couples undergoing IUI with their informed consent. INTERVENTION: Sperm processing using the swim-up technique in penicillin and streptomycin supplemented culture medium. SUBJECTS AND METHODS: Couples were consecutively allocated in two groups for sperm processing (a) Group AB+ (antibiotics supplemented culture medium, n = 33) and (b) Group AB- (antibiotic free culture medium, n = 33). Semen culture was performed before and after sperm processing. Sperm motility was assessed immediately after processing and after 24 h of incubation.RESULTS: Bacterial isolates were found in 20 (60.6%) and 22 (66.1%) of samples before processing in Groups AB+ and AB- respectively. Addition of antibiotics resulted in completely eliminating non-specific bacteria from semen samples without affecting sperm motility. In vitro survival rate of sperm enhanced in AB+ group compared with AB- group (motile sperm after 24 h), 62.21% (standard deviation [SD]: 37.27) versus 41.36% (SD: 30.78), P = 0.012. Pregnancy rate, was comparable between two groups (9% in Group AB+ vs. 6% in Group AB-, P = 0.45). CONCLUSION: Penicillin streptomycin combination could completely eliminate non-specific bacteria from semen samples during sperm processing in this population. The types of antibiotics and dosage used did not seem to have any harmful effects on human sperm.
Efficacy of two sperm preparation techniques in reducing non-specific bacterial species from human semen
(Medknow Publications, 2013) Abeysundara, P.K.; Dissanayake, D.M.A.B.; Wijesinghe, P.S.; Perera, R.R.D.P.; Nishad, A.A.N.
CONTEXT: Artificial reproductive techniques using seminal preparations with bacteria may cause pelvic inflammatory disease and its sequalae. AIMS: To assess efficacy of two sperm preparation techniques to clear bacteria and the effect of bacteriospermia on sperm recovery rates. SETTINGS AND DESIGN: A descriptive cross-sectional study was carried out among males of subfertile couples. SUBJECTS AND METHODS: Semen samples were randomly allocated into swim-up method (group S, n = 68) and density gradient method (group D, n = 50) for sperm preparation. Seminal fluid analysis and bacterial cultures were performed in each sample before and after spermpreparation. STATISTICAL ANALYSIS: McNemar's chi-squared test and independent samples t-test in SPSS version 16.0 were used. RESULTS: Organisms were found in 86 (72.88%) out of 118 samples, before sperm preparation; Streptococcus species (n = 40, 46.51% of which 14 were Group D Streptococcus species), Coagulase negative Staphylococcus species (n = 17, 19.76%), Staphylococcus aureus (n = 13, 15.11%), Coliform species (n = 11, 12.79% of which 09 were Escherichia coli) and Corynebacterium species (n = 5, 5.81%). There was a statistically significant reduction of culture positive samples in raw vs. processed samples; in group S, 49 (72.05%) vs. 16 (23.52%) and in group D, 37 (74%) vs. 18 (36%). In group S and D, mean (SD) recovery rates of culture positive vs. culture negative samples were 39.44% (SD-14.02) vs. 44.22% (SD-22.38), P = 0.39 and 52.50% (SD-37.16) vs. 49.58% (SD-40.32), P = 0.82 respectively. CONCLUSIONS: Both sperm preparation methods significantly reduced bacteria in semen, but total clearance was not achieved. Spermrecovery rate was not affected by bacteriospermia.
A preliminary study on bacteriospermia in males of subfertile couples
(Sri Lanka Medical Association, 2011) Abeysundara, I.D.H.P.K.; Dissanayake, D.M.A.B.; Wijesinghe, P.S.; Perera, R.R.D.P.
INTRODUCTION AND OBJECTIVES: Bacteriospermia is common in subfertile men. Responsible organisms and their antibiotic sensitivity patterns vary between populations Aim of this study was to identify the types of bacteria and their ABST pattern among males of subfertile couples. METHODS: A descriptive cross sectional study was carried out. Semen samples of 105 males from subfertile couples were cultured in blood, chocolate and McConkey agar. Antibiotic sensitivity tests were done using the Clinical and Laboratory Standard Institute technique. RESULTS: Mean age of the study population was 32.77 yrs (rage 22-48 yrs), mean duration of subfertility was 3 yrs (Range 1-12 yrs). In 98 couples there was primary subfertility. Bacterial growth was noted in 63 samples. Positive cultures were found in 58.2% with primary subfertility and in 85.7% with secondary subfertility. A single organism was cultured in 44. Mltiple organisms were cultured in 19 samples. In 21 samples a significant growth of >104 of colony forming units were noted. Organisms found were Streptococci (n=28 out of them 8 were group D), coagulase negative Staphylococci (n=27), Diptheroids (n=T2), coliforms (n=7 of which 3 were Escherichia colt), Staphyhcoccus aureus (n^5), Acinetobacter (n=2), and Candida albicans (n=l). A single antibiotic or a combination which covers most organisms was not found. CONCLUSIONS: In this study population 20% had a significant bacterial growth. Organisms were found to have varied ABST patterns. The effect of bacteriospermia on subfertility needs further evaluation. Acknowledgements: This study was supported by National Research Council (09-69).