Molecular identification and antifungal susceptibility of pathogenic fungi isolated at Assiut university hospitals

The incidence of invasive opportunistic mycoses [10Ms] has increased because of the expanding population of immunosuppressed patients raising the demand for identification of local epidemiologic trends, the degree of virulence and antifungal susceptibility pattern of fungal pathogens. Identification of the local epidemiology of l0Ms at Assiut University hospitals showed that there is a marked shift to Candida non albicans [can], rare yeasts that cause Candida like infections, zygomycetes, hyaline moulds and a wide variety of dematiaceous fungi. In vitro susceptibility testing pattern of isolated fungal pathogens against 8 antifungal agents; Amphotericin B [AP], Nystatin [NS], l;luconalole [FU], Ketoconazole [KT], Clotrimazole [CC], Voriconazole [VOR], Itraconazole [IT] andv Terbinafinc showed that these emerging pathogens are resistant to conventional antifungals, in addition, they pose a high enzymatic and toxigenic ability making them more virulent and infections caused by them more aggressive and very difficult to manage

Comparative clinical study of dry ear cleaning versus wet ear cleaning in the treatment of otomycosis

In order to evaluate the efficacy and safety of ear suction [dry ear cleaning] versus ear wash [wet ear cleaning] in patients microbiologically confirmed suffering from otomycosis, a double blind study was conducted on 126 patients to compare the efficacy of the two lines in the treatment of otomycosis. The duration of each trial period was 7 days and the various symptoms and signs of otomycosis were assessed daily by patients and the physician. Patients presented with itchy ear in 126 [100%] of patients, hypoacusis in 107 [85%] of patients, auricular fullness in 95 [75%] of patients and ear pain in 32 [25%] of patients. The most frequent clinical findings as seen by otomicroscopic examination were as follows: Erythema in 113 [90%] of cases, exudation in 95 [75%] of cases, desquamation and maceration of the external ear canal in 57 [45%] of cases. The most common objective evidence of pathogenic involvement was given by a small grey to black "cheesy lumps" in 100 [79.4%] of cases. The following organisms were isolated from these cases: Aspergillus niger in 50 [39.7%] of cases, Aspergillus fumigatus in 30 [23.8%], Aspergillus flavus in 12 [9.5%] of cases and Aspergillus niger plus Candida albicans in 8 [6.3%] of cases. In the remaining 26 cases [20.6%], the walls of the external ear canal were coated with white "cotton- wool" deposits, subsequently identified as Candida albicans. The study has shown that dry ear cleaning to be more effective than wet ear cleaning, in the opinion of both physician [P < 0.05] and patients [P < 0.02]