Imported syringes triggered meningitis in Sri Lanka
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《英国医生杂志》
Health authorities in Sri Lanka have said that imported injection syringes might have triggered an outbreak of meningitis in patients who had received spinal anaesthesia in four hospitals in the country.
Two maternity and two teaching hospitals reported 14 cases of meningitis associated with spinal anaesthesia or other procedures, such as lumbar puncture, during a three week period last month, government epidemiologists said. Four of the patients have died.
Investigations indicate that contaminated syringes and needles might have caused the outbreak, said a report released last week by the epidemiological unit of the Sri Lankan Ministry of Health. Among the 14 cases, eight patients had a recent history of spinal anaesthesia—five mothers who had undergone caesarean sections, a young boy who had undergone lumbar puncture for diagnosis of a fever of unknown origin, and two adults who had received intrathecal chemotherapy.
The report said that a possible source of contamination could have been unsatisfactory storage conditions. "Some imported syringes have been found contaminated," Athula Kahandalinayage, director general of health services told the BMJ. However, the source of contamination is still unknown and detailed investigations are now under way to determine whether this occurred during manufacture, transit, or storage, he said.
Studies at the National Hospital of Sri Lanka have confirmed the presence of fungus (aspergillus, candida) and bacilli in the contaminated syringes, officials said. Some syringes had been procured through international tenders while others had come in as donations, they said. Health officials have declined to name the source countries for the syringes.
Some doctors on the island said that they find it hard to believe that unsatisfactory storage alone was responsible for the contamination of the syringes. "Fungal particles were visible in some syringes with intact wrapping," said Shirani Hapuarachchi, president of the College of Anaesthesiologists of Sri Lanka. "In some instances, the contamination was not on the surface of syringes but inside the syringes," she said.
Health authorities have asked doctors to "avoid or minimise" spinal anaesthesia, lumbar puncture, myelograms and intrathecal drug administration during the crisis period and are replacing 1.5 million syringes.
The World Health Organization has said that Aspergillus fumigatus has not previously been described as a cause of nosocomial meningitis after spinal anaesthesia. "This has left us stunned. We抳e never experienced anything like this," said Antonette Warnakulasuriya, general secretary of the College of Anaesthesiologists of Sri Lanka.(New Delhi Ganapati Mudur)
Two maternity and two teaching hospitals reported 14 cases of meningitis associated with spinal anaesthesia or other procedures, such as lumbar puncture, during a three week period last month, government epidemiologists said. Four of the patients have died.
Investigations indicate that contaminated syringes and needles might have caused the outbreak, said a report released last week by the epidemiological unit of the Sri Lankan Ministry of Health. Among the 14 cases, eight patients had a recent history of spinal anaesthesia—five mothers who had undergone caesarean sections, a young boy who had undergone lumbar puncture for diagnosis of a fever of unknown origin, and two adults who had received intrathecal chemotherapy.
The report said that a possible source of contamination could have been unsatisfactory storage conditions. "Some imported syringes have been found contaminated," Athula Kahandalinayage, director general of health services told the BMJ. However, the source of contamination is still unknown and detailed investigations are now under way to determine whether this occurred during manufacture, transit, or storage, he said.
Studies at the National Hospital of Sri Lanka have confirmed the presence of fungus (aspergillus, candida) and bacilli in the contaminated syringes, officials said. Some syringes had been procured through international tenders while others had come in as donations, they said. Health officials have declined to name the source countries for the syringes.
Some doctors on the island said that they find it hard to believe that unsatisfactory storage alone was responsible for the contamination of the syringes. "Fungal particles were visible in some syringes with intact wrapping," said Shirani Hapuarachchi, president of the College of Anaesthesiologists of Sri Lanka. "In some instances, the contamination was not on the surface of syringes but inside the syringes," she said.
Health authorities have asked doctors to "avoid or minimise" spinal anaesthesia, lumbar puncture, myelograms and intrathecal drug administration during the crisis period and are replacing 1.5 million syringes.
The World Health Organization has said that Aspergillus fumigatus has not previously been described as a cause of nosocomial meningitis after spinal anaesthesia. "This has left us stunned. We抳e never experienced anything like this," said Antonette Warnakulasuriya, general secretary of the College of Anaesthesiologists of Sri Lanka.(New Delhi Ganapati Mudur)