Attached
Objectives Antibacterial resistance (ABR) is a public
threat. Sri Lanka is a country with limited surveillance of
ABR in the community. The WHO methodology was
adapted to identify ABR in outpatient settings (nonhospitalised patients) and its link to consumption of
antibiotics.
Methods It was a cross-sectional descriptive community
based study to collect A B R data from Out Patient
Department (OPD) of two leading Teaching Hospitals in
Colombo district. The indicator organism Escherichia
coli (£ . coli) was obtained from the urine specimens of
patients who were suspected to have urinary tract
infections. Antibiotic susceptibility testing was performed
for commonly used oral antibiotics using disc diffusion
method. The antibiotic consumption aggregate data were
collected from the OPD pharmacies of the said hospitals
and expressed as Defined Daily Doses (DDD) per 1000
inhabitants per 1000 day.
Results Of the 2183 urine samples, pathogenic E. coli
was isolated in 9.3% (204), and 8% (n=16) of them were
Extended Spectrum Beta Lactamase (ESBL) producers.
E.coli was most resistant to ampicillin (85%), followed
by nalidixic acid (58.5%), trimethoprim/sulphamethoxazole (47.1%), ciprofloxacin (46.2%), norfloxacin (43.7%)
amoxicillin /clavulanic acid (36.3%) and nitrofurantoin
(15%). Multi-drug resistance was seen in 44%. Amoxicillin
was the most frequently consumed antibacterial agent
(2.65 DDD per 1000 inhabitants per day).
Conclusions There is an alarmingly high antibiotic
resistance in the non-hospitalised patients indicating
high prevalence of E. coli resistance in the community.
