Introduction Data on causative agents and antibiotic susceptibility patterns of blood stream infections in Sri Lanka is scarce. Information on trends of antibiotic resistance is necessary for the prescribers to treat patients effectively and policy makers to develop policies and guidelines.Objectives To lay the foundation for a national data base on antimicrobial resistance in Sri Lanka.Methods A prospective study was carried out in seven hospitals to study the Gram negative aetiological agents and their susceptibility patterns in patients suspected of having bacteraemia. We reviewed 817 patients with clinically significant blood cultures including both adults and children.Results Data were complete for analysis in 733 Gram negative isolates only. Of the 733 isolates, 488 were from adults (> 12 years), 109 were from children (1-12 years) and 136 were from infants (<1 year). Intensive care units represented 18.4% of the isolates (123 adult patients and 27 paediatric patients). The highest number of isolates (33.7%) was from patients with septicaemia of unknown origin. Enteric fever, pyelonephritis and respiratory tract infections accounted for 20% of the isolates. Bacteraemia with underline malignancies were responsible for 24.5% of infections. Salmonella paratyphi A was the commonest cause of enteric fever in adults with 92% resistance to ciprofloxacin. The prevalence of extended spectrum beta lactamase (ESBL) producing Escherichia coli and Klebsiella pneumoniae was high in this study population.Conclusions It is essential to introduce multidisciplinary interventions to reduce the inappropriate use of antibiotics to increase the lifespan of precious antibiotics. Introduction of a National antibiotic policy with strict implementation and a well-planned stewardship programme is essential to control antimicrobial resistance in our country.
Background: Personal items such as mobile phones and wrist watches are commonly used by doctors working in the operation theatre. The hands and personal use items of anaesthetic doctors working in the operation theatre may serve as vectors for transmission of nosocomial pathogens among surgical patients. Our aim was to determine the hand contamination among anaesthetists working in the operation theatre and contamination of mobile phones and wrist watches of anaesthetic doctors. Method : Forty five anaesthetic doctors working in the operation theatres at Colombo South Teaching Hospital and Ratnapura General Hospital were enrolled in the study. Swabs from fingertips, keypads of mobile phones and wrist watches were taken using moist sterile swabs and plated on Mac Conkey and Blood agar plates. The bacteria isolated were identified by biochemical tests. Results: Hand washing was performed by 60% (n=27/45) doctors entering the theatre. 95% (n=43/45) brought their mobile phone to the theatre and 78.5% used it at least once during the theatre session. A wrist watch was worn by 71% (n=32/45) of the anaesthetic doctors working in the theatre. Bacterial growth was detected from 84% wrist watch swabs, 71% fingertip swabs and 70% mobile phone swabs. Staphylococci were predominantly cultured from all three specimens tested. MRSA was isolated from 22% of swabs taken from fingertips, 15% mobile phones and 25% wrist watches respectively. Methicillin sensitive Staphylococcus aureus (MSSA) was isolated from 33%, 46.5% and 37.5% swabs from fingertips, mobile phones and wrist watches respectively. Coagulase negative Staphylococci was isolated from wrist watches (15%) and fingertip specimens (2%). 29% fingertip swabs and 30% mobile phone swabs did not show bacterial growth.
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