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The authors have no conflict of interest and no funding was received for this study.

A prospective study was carried out to determine the distribution of ESBL producing uropathogens in different units of a tertiary care hospital in Colombo and in community acquired UTIs presenting to this hospital. A total of 2303 urine samples from adult patients were received in the microbiology laboratory of the hospital during a four-month period, of which 626 were significant positive cultures. Escherichia coli and Klebsiella species accounted for 46% (n=286) of the total isolates with the majority (n=228, 80%) being E. coli. Thirty three percent (n=94) of these isolates produced extended-spectrum β-lactamases (ESBLs). Half (50%) of the Klebsiella isolates were ESBL producers while 29% of the E. coli produced ESBLs. Ten of 11 isolates in the intensive care unit and 6 of 8 in the genito-urinary unit were ESBL producers. The ESBL rate in the general medical and surgical wards and the out-patient department were 33% and 14% respectively. Out of the 181 isolates from community acquired UTIs, 13% produced ESBLs. Resistance to multiple drugs was considerably higher in ESBL positives compared to ESBL negative isolates. Urinary catheters, diabetes mellitus, previous antibiotic use, urinary tract abnormalities and recurrent urinary tract infections were associated with a higher risk of acquiring ESBL producing organisms (P<0.001).

The increasing antimicrobial resistance exhibited by microorganisms causing superficial skin infections has led to extensive research on the therapeutic potential of Ayurvedic preparations. Medicinal plants contain many types of naturally occurring and side effectsfree anti microbial compounds that can be effectively used against microbial infections. We tested the antimicrobial activity of twenty-eight Ayurvedic preparations used to treat superficial infections in a local Ayurvedic healthcare institution. They were tested against Trichophyton rubrum, Microsporum gypseum, Candida albicans, Malassezia furfur, Staphylococcus aureus and Streptococcus pyogenes. Twelve preparations showed significant antimicrobial activity and gave inhibition zones >10 mm. Two Ayurvedic preparations (Mixture containing Terminella chebula, Terminella bellerica and Emblica officinalis and one of Terminella chebula only ) showed antimicrobial activity against all the microorganisms tested. We suggest that these two decoctions could be effectively used against all the above tested strains.

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