Experimental murine model of intra-abdominal infections caused by some non-albicans Candida species

Background: Even though intra-abdominal candidiasis (IAC) has been increasingly recognized, with associated high morbidity and mortality rates, its pathogenesis remains poorly understood. This model aims to study the pathogenicity and invivo susceptibility of non-albicans Candida species associated with IAC in human in order to predict the frequency of infections, outcome of clinical disease and response to antifungal therapy. Methodology: Both immunosuppressed and immunocompetent female CD-1 mice were challenged intraperitoneally with 5 x 108 CFU/ml inoculum of five non-albicans Candida strains; Candida glabrata, Candida parapsilosis, Candida lipolytica, Candida tropicalis and Candida guilliermondii. Mice were closely observed for symptoms. Treated groups received voriconazole (40 mg/kg/day) or micafungin (10 mg/kg/day) 24 hours after infection depending on invitro susceptibility results. Survival rate, mean survival time and fungal tissue burdens were recorded for all groups. Results: All infected groups developed hepatosplenomegaly, peritonitis and multiple abscesses on intra-abdominal organs and mesenteries. C. glabrata and C. lipolytica represented the most and the least virulent strains respectively in terms of survival rate, mean survival time and fungal burden in both immunosuppressed and immunocompetent models. Following treatment, all immunocompetent animals survived the entire duration of experiments (0% mortality rate), while mortality rate was relatively high (20-60%) in immunosuppressed mice. Treatment failed to eradicate the infection in immunosuppressed mice despite significant decrease of the fungal burden and increase mean survival time. Conclusion: This study reports an increasing pathogenicity of non-albicans Candida species, with persistent infection among immunosuppressed animals

Customers Satisfaction with Health Services Provided by Emergency Departments of Federal Teaching Hospitals Khartoum; 2005

The Federal Ministry of Health is trying continuously to provide the best health care through improving service quality and efficiency as expected by those who benefit from these services and to ensure their satisfaction. This study attempts to assess customers' satisfaction both (patients and co-patients); who attend the Emergency Departments of federal teaching hospitals. It also attempts to illicit their opinions and suggestions for improving the quality of these services in order to meet their expectations and achieve their satisfaction. A total of 210 patients and co patients from the Emergency Departments of the three teaching hospitals Khartoum; Khartoum north and Omdurman were selected randomly. Data was collected using a pre-coded and a pre-tested questionnaire. The results revealed high levels of satisfaction with the Emergency Department staff performance and attitude especially with the doctors' performance. Low levels of satisfaction were noticed with other aspects of health services like cleanliness; toilets; food services; the emergency general wards and lastly the Cost of some services