Conferences and Symposia

Permanent URI for this communityhttp://repository.kln.ac.lk/handle/123456789/10376

Conference papers presented at Conferences and Symposia organized by the Faculty of Medicine are collected under this subcommunity

Browse

Author: search.filters.author.Premaratna, B.A.H.R.Has files: No

Search Results

Now showing 1 - 4 of 4
  • No Thumbnail Available
    Item
    Antibiotic sensitivity patterns of Extended-Spectrum β-Lactamase urinary tract infections in Sri Lanka
    (Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Sebastiampillai, B.S.; Premaratna, B.A.H.R.; Luke, W.A.N.V.; Wickramasinghe, R.D.S.S.; Gunathilake, M.P.M.L.; Miththinda, J.K.N.D.
    BACKGROUND: Extended-spectrum β-lactamase (ESBL) producing organisms causing urinary tract infections (UTI) are increasing in incidence and poses a major burden to health care requiring treatment with expensive antimicrobials and prolonged hospital stay. The prevalence of ESBL producing organisms particularly in the Asian region remains unknown. OBJECTIVES: To identify common ESBL producing organisms and to evaluate the antibiotic sensitivity patterns of ESBL UTIs in Sri Lanka. METHODS: Patients admitted with ESBL-UTI to Professorial Medical Unit, Colombo North Teaching Hospital, Ragama over a period of 6 months from January 2015 were recruited. Their Urine culture and ABST reports were analysed after obtaining informed written consent. RESULTS: Of the 52 patients who consented to be on the study, 30 (57.7%) were males. Mean age was 64.11 (SD=12.59) years. E. coli was the commonest organisms (84.6%; n=44), causing the ESBL-UTI followed by Klebsiella (15.4%; n=8). Fifty (96.2%) patients were sensitive to meropenem, 38 (73.1%) to imipenem, 30 (57.7%) to amikacin and 24 (46.2%) to nitrofurantoin. Meropenem resistance was found in 2 (3.8%) cases which were due to infection with E. coli.These two patients had received multiple antibiotics including meropenem in the recent past for recurrent UTI. CONCLUSIONS: While E. coli and Klebsiella are the commonest ESBL producing organisms causing UTI, carbapenems remain as the first line therapy. However 3.8% prevalence of meropenem resistance among the study population should draw attention of clinicians and needs implementation of measures to prevent emergence of carbapenum resistant ESBL organisms.
  • No Thumbnail Available
    Item
    Prevalence of rickettsial infections in acute coronary syndromes in Sri Lanka: a case control study
    (Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Mettananda, K.C.D.; Danansuriya, D.S.T.; Bandara, N.K.B.K.R.G.W.; Premaratna, B.A.H.R.
    Background: Place of infection in atherosclerosis and or coronary heart disease has recently drawn interest. Rickettsiae are a group of obligate intracellular pathogens who invade vascular endothelial cells leading to vasculopathy. A study conducted in Thaiwan, scrub typhus was found to increase the risk of acute coronary syndromes (ACS) by 37% compared to general population after adjusting for age, sex and other known independent risk factors. Objective: To assess the prevalence of Rickettsial infections in patients with ACS residing in Western province, Sri Lanka. Methods: Patients admitted with ACS to Professorial-Medical-unit, were studied for serological prevalence of Rickettsial infections and were compared with a matched control group; who had no fever or ACS. 2ml serum samples were obtained at enrolment and 2weeks after and were assessed for IFA-IgG antibody titres against Orientiatsutsugamushi (OT) and Spotted-fever-group-rickettsioses (SFG). An IgG titre>1:128 or a rising/declining titre were considered positive for acute rickettsioses. A static titre was considered to be due to previous exposure to rickettsioses. Results: 46 ACS patients (males-23.9%, mean age 61.1 [SD=13.1] years) and 52 controls (male-50%, mean age 56.0[SD=13.6] years) were studied. None had evidence of acute Rickettsiel infection. Sero-prevalence of IgG-OT was 6.4% and IgG-SFG was 15.2% among ACS patients. Same for control group were 3.8% and 11.5% respectively. There was no significant difference in sero-prevalence of OT [OR =0.74; CI: 0.28-10.93; p=0.66] or SFG [OR=1.376; CI:0.43-4.44; p=0.59] in patients with ACS compared to controls. Conclusions: No significant difference was observed in sero-prevalence of rickettsioses in patients with acute coronary syndromes compared to controls in this study.
  • No Thumbnail Available
    Item
    Factors influencing urinary tract infections caused by extended spectrum β-lactamase producing organisms among a cohort of hospitalized patients in Sri Lanka
    (Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Luke, W.A.N.V.; Premaratna, B.A.H.R.; Fernando, S.C.; Silva, F.H.D.S.; Sebastiampillai, B.S.; Wickramasinghe, R.D.S.S.; Gunathilake, M.P.M.L.
    BACKGROUND: Urinary tract infections (UTI) caused by extended-spectrum β-lactamase (ESBL)-producing organisms are a management challenge and a health care burden. OBJECTIVES: To describe factors that influence ESBL UTI among hospitalized patients. METHODS: Fifty two consecutive patients who were admitted with culture positive ESBL UTI to the Professorial Medical Units, Colombo North Teaching Hospital, Ragama over a period of 6 month since January 2015 were recruited. Data was collected by an interviewer administered questionnaire and patients medical records after obtaining informed written consent. RESULTS: Among all 52 ESBL UTI patients, 46 (88.5%) had diabetes mellitus, 32 (61.5%) hypertension, 10 (19.2%) chronic liver disease, 18 (34.6%) a history of constipation. Four (7.7%) patients each were detected to have either hydronephrosis, hydroureter or prostatomegaly in USS assessment. Thirty two (61.5%) had received antibiotic treatment within the last 3 months: 18 (34.6%) has had penicillins and 16 (30.8%), 3rd generation cephalosporins, Twenty four (46.2%) had hospitalization in the last 3 months and 16 (30.8%) had a history of urinary catheterization. CONCLUSIONS: Diabetes, recent antibiotic treatment, hospitalization and catheterization were observed to influence ESBL UTIs. However the fact that 53.8% patients who developed ESBL UTI did not have a history of recent hospitalization, suggests high existence of community acquired ESBL.
  • No Thumbnail Available
    Item
    Rickettsial diseases: revisiting an old enemy
    (Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Premaratna, B.A.H.R.
    The history of rickettsioses in Sri Lanka dates back to 1930-1940s. Since of late, rickettsial infections have re-emerged in many parts of the world, including Sri Lanka. We observed patients presenting with serious complications such as encephalitis, myocarditis, pneumonitis and multi-organ involvement carrying high morbidity and mortality due to rickettsioses. Such presentations made us realize the importance of establishing diagnostic facilities in the country in order to face the challenge posed by rickettsioses. After initial collaborative work with the Centers for Disease Control and Prevention, Atlanta, USA, we established IFA based diagnostics in the Faculty in 2008. Subsequently we were able to describe the epidemiological pattern, different clinical presentations, and new serological cut-off points for IFA-IgG based serological diagnostics based on sero-prevalence. Thereafter, in collaboration with the University of Texas Medical Branch at Galveston, USA, we were able to describe the diverse distribution of scrub typhus serotypes in two different localities in Sri Lanka. Subsequently, in collaboration with ImmuneMed diagnostic laboratory at Incheon, South Korea, we were able to identify antibody-based rapid diagnostic tests which could be employed for rapid diagnosis and identification of scrub typhus strains in Sri Lanka.