Browsing by Author "Sigera, L.S.M."

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Bordete//a pertussis specific Immunoglobulin G antibody levels among asymptomatic individuals aged 4-24 years admitted to two selected hospitals in Sri Lanka
(Sri Lanka College of Microbiologists, 2015) Sigera, L.S.M.; Perera, J.; Samaranayake, D.; Ediriweera, E.P.D.S.
INTRODUCTION: Pertussis continues to circulate in the community and cases among adolescents and adults have been increasing. Waning of pertussis-specific immunity following natural infection or immunisation may contribute to the persistent circulation. Even though it is not included in the extended programme of immunization in Sri Lanka, the booster doses including the adolescent booster dose of dTap, (acellular pertussis) are included into the list of recommended immunizations in several countries. Even though the protective titre yet not established, information on immunity to pertussis in this age group is needed before any vaccination policy can be considered. OBJECTIVES: To determine the antibody levels against pertussis toxin to determine the need and the optimal age for booster immunization. METHODS: The quantitative determination of specific IgG antibodies to Bordetella pertussis toxin was done by the ELISA using sera of 385 asymptomatic individuals aged 4-24 years admitted to surgical units of Lady Ridgeway Hospital, Colombo and Colombo South Teaching Hospital, Kalubowila. Mann-Whitney U test and Kruskal-Wallis test were used in analysis and p<0.05 was taken as significant. RESULTS: Median age was 12 years (IQR 8-19) with 212 (55.1 %) females. The median (IQR) anti PT antibody level was 3.31 lU/ml (0.73-15.12) and 352 (91%) had anti PT level <55 ID/ml. Median {IQR) anti PT levels were 3.18 ILJ/ml (0.591 -8.00) for 4-7 years, 1.43 Ill/ml (0.336-6.27) for 8-11 years, 4.28 lU/ml (0.978-13.39) for 12-15 years, 6.14 lU/ml (1.44-63.25) for 16-19 years and 4.89 lU/ml {1.11 -16.78) for 20-24 years and all of these difference were statistically significant (Spearman Correlation Coefficient P=0.0121). Females (p<0.003) and those having a sibling above 12 years (p=0.017) had significantly higher anti PT lev els. CONCLUSION: The majority of the study population, especially 8 to 11 years age group had very low anti PT IgG levels. The infection may occur in early adolescents, A booster dose of acellular pertussis vaccine could be considered.
Bordetella pertussis serological profile among asymptomatic individuals aged 4-24 years.
(Sri Lanka Medical Association, 2014) Sigera, L.S.M.; Perera, J.; Samaranayake, D.; Ediriweera, E.P.D.S.
INTRODUCTION AND OBJECTIVES: To determine the antibody levels against pertussis toxin to determine the need and the optimal age for booster immunization. METHODS: The quantitative determination of specific IgG antibodies to Bordetellajiertussistox'm was done by the ELISA using sera of 385 asymptomatic individuals aged 4 -24 years admitted to surgical units of Lady Ridgeway Hospital, Colombo and Colombo South Teaching Hospital, Kalubowila. Mann-Whitney U test and Kruskal-Waliis test were used in analysis and p<0.05 was taken as significant. RESULTS: Median age was 12 years {IQR 8-19) with 212 (55.1%) females. The median (1QR) anti PT antibody level was 3.31 lu/ml (0.73-15.12) and 352 (91%) had anti PT level <55 lU/ml. Median {IQR) anti PT levels were 3.18 ILJ/ml (0.591-8.00) for 4-7 years, 1.43 lU/ml (0.336-6.27) for 8-11 years, 4.28 lU/ml (0.978-13.39) for 12-15 years,6.14 lU/ml (1.44-63.25) for 16-19 years and 4.89 lU/ml (1.11-16.78) for 20-24 years and this difference was statistically significant (p=0.000). Females (p<0.003) and those having a sibling above 12 years (p=0.017) had significantly higher anti PT levels. CONCLUSIONS: The majority of the study population, especially 8 to 11 years age group had very low anti PT IgG levels. The infection may occur in early adolescents. A booster dose of acellular pertussis vaccine could be considered.
Species distribution and in-vitro antifungal susceptibility pattern of Candida clinical isolates
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Sigera, L.S.M.; Jayasekera, P.I.; Shabry, U.L.F.
BACKGROUND: An increase in incidence of Candida infections and isolation of resistant isolates were common occurrences in recent years due to increase in immunocompromised patients and advances in medical field. OBJECTIVES: To determine the Candida species isolated from various clinical specimens received at the Department of Mycology, Medical Research Institute from 08/08/14 - 25/10/14 and to determine their antifungal susceptibility pattern for commonly used antifungals in Sri Lanka. METHODS: Identification of 90 clinical isolates was done by using conventional methods of Candida identification and API kits. In-vitro antifungal susceptibility pattern of isolates to fluconazole, amphotericine B, ketoconazole, itraconazole, miconazole, nystatin, clotrimazole and voriconazole were determined according to CLSI M44A. RESULTS: Candida tropicalis (37.7%) was the most frequently isolated species, followed by C.albicans (36.6%), C.parapsilosis (24.4%) and C.krusei (1.1%). C.tropicalis was the predominant isolate from blood, sterile fluids and urine specimens. Majority of the isolates from scraping specimens were C.parapsilosis while C.albicans was the commonest in respiratory specimens. Variations in resistance were seen, depending on the species and the respective type of specimens. All Candida isolates were sensitive to amphotericin B. Twenty-three (24.44%) fluconazole resistant isolates were detected from blood, urine, pus, sterile fluids and respiratory and scraping specimens. Variable sensitivity patterns were observed for voriconazole, miconazole, itraconazole, ketoconazole, nystatin and clotrimazole. CONCLUSIONS: All clinical yeast isolates should be identified up to species level and antifungal susceptibility testing should be performed to prevent therapeutic failures. Resistance to fluconazole, is an alarming sign for emerging antifungal resistance in Sri Lanka.