Résumé
Background: Fungal infections play important role in pathogenesis of diabetic foot infections
Objective: to investigate the prevalence of fungi among patient with diabetic foot infections
Methodology: one hundred and twenty diabetic patients hospitalized due to foot infections were enlisted in this study. Deep tissue specimens from depth of the wound and nail samples were collected from the infected sites using the standard protocol. Laboratory identification of samples was done and pathogens were identified to the species level by morpho-physiological methods. Polymerase chain reaction was used to assess the presence of fungi in samples from infected sites
Results: Fungi were found in 51.7% of the patients. Candida albicans were the most predominant isolated organism [40.1%]. Amphotericin B had 100% sensitivity against all Candida isolates. The most susceptible Candida species to fluconazole were C. dubliniensis and C. albicans. The most susceptible Candida species to voriconazole were C. dubliniensis. The most susceptible Candida species to itraconazole were C. dubliniensis. Of the study population, 70.0% had bacterial infection. The predominant isolates were Klebsiella spp. [32.7%]. Mixed fungal and bacterial infections were seen in 20.3% of patients. Sensitivity of Pan fungal PCR was 97.4%, specificity was 92.4%
Conclusion: Fungal infections were more in patients with poor glycemic control.The role of antifungal agents in management of diabetic foot infections needs to be evaluated further
Résumé
Background: Systemic fungal infection remains a major cause of morbidity and death in patients undergoing treatment for cancer. Therefore sensitive, quick and inexpensive testes essential for diagnosing systemic fungal infecton. In our labs we commonly diagnose fungemia using convential blood culture. Convential blood culture is time-consuming and with poor sensitivity. Polymerase chain reaction [PCR] has the potential to provide a quick and inexpensive method for diagnosis of systemic fungal infection. We studied these two different methods in the diagnosis of systemic fungal infection. Aim : The aims of this study were to compare convential blood culture and PCR in the diagnosis of systemic fungal infection and to determine sensitivity, specificity of PCR
Methods: Blood samples were collected from patients in Oncology center clinically suspected of systemic fungal infection. Whole blood samples were collected. First part of the sample was inoculated into blood culture bottle and the other part of the sample was subjected to DNA extraction and PCR which was carried out using pan-fungal primers
Results: One hundred thirty three samples were collected. Seventy six positive samples were positive by conventional blood culture bottle and/or PCR. Nine samples were positive by conventional blood culture. They yielded Candida species, these samples were also positive by PCR. The other 67 samples were positive by PCR reaction only using panfungal primer. The most common isolated organisms by conventional blood culture bottle were Candida albicans six isolates [66.7%]. Three non albicans Candida isolates [C. tropicalis, C. krusi and C. dubliniensis] were isolated. Using blood culture as gold test, sensitivity of PCR was 100%, and specificity was 46%. The most common underlying malignancy was leukaemia [84.2%], followed by lymphoma [13.1%], and solid tumours [2.6%]
Conclusion: The application of PCR technology directly to the whole blood samples will allow early and accurate diagnosis of systemic fungal infection?
Résumé
Background and objectives: Fungal infections of the eye constitute a group of difficult clinical problems for both the ophthalmologist and infectious disease practitioner. Despite the uncommon occurrence of ocular fungal disease, the threat of blindness from conditions such as fungal keratitis or endophthalmitis makes it a serious problem. The incidence of ocular fungal infections has increased over the last few years. This study was conducted to estimate the rate of ocular fungal infections, identify the fungal species causing ocular mycoses, and find out the epidemiological features of mycotic eye infections in patients admitted to the Ophthalmic Center, Mansoura University, Egypt
Methods: Fifty four patients [50 with clinically suspected fungal keratitis and 4 with endophthalmitis] were included in this study. Samples were collected by ophthalmologist and subjected to direct examination with potassium hydroxide [KOH] 10% and culture on Sabouraud's dextrose agar [SDA] without actidion. Experimental fungal keratitis was induced in mice to compare different methods of diagnosis of fungal keratitis
Results: Out of 54 samples collected, four showed fungal growth on SDA from patients with keratitis, while no fungi were isolated from suspected cases of fungal endophthalmitis. Two isolates were Candida albicans and two isolates were Aspergillus fumigatus. Fungal keratitis was more common among female patients in the age group 21-50 years old from rural areas. Contact lens wear, corneal trauma, topical steroid use, and systemic disease [diabetes mellitus] were the most common risk factors for fungal keratitis in our patients. Comparison of different methods of diagnosis of fungal keratitis induced in mice revealed that polymerase chain reaction [PCR] and histopathological examination were the best methods [sensitivity, specificty, and accuracy 100%] followed by Calcofluor White stain [CFW], culture on SDA without actidion, and finally KOH 10% wet mount [86, 100, 93%], [74, 100, 87%], and [54, 100, 78%] respectively
Conclusion: It is important to know the exact aetiology of fungal eye infections to institute appropriate therapy in time. Laboratory confirmation should be undertaken and fungal infection should be ruled out before prescribing corticosteroids and antibiotics. PCR and histopathological examination are cosidered the most sensitive, specific, and accurate method for diagnosing fungal keratitis
Résumé
Backgrounds: Infections continue to be a major problem, representing one of the leading causes of morbidity and mortality among liver transplant recipients
Objective: To detect the frequency of different bacterial and fungal pathogen causing nosocomial infections in living donor liver transplant recipients in Gastroenterology Center in Mansoura University
Patients and Methods: The current study conducted on 45 living donor liver transplant recipients. Patients with suspected bacterial or fungal infection cultures were performed. Susceptibility of the strains to the antibiotic and antifungal agents was tested
Results: Nosocomial infections occurred in 42% of liver transplant recipients. Surgical site infection was the commonest type of infection which represents 58% of the total bacterial infections. Multiple drug resistant bacteria occured in [67%] of isolates. Gram negative infections were predominant. Incidence of invasive fungal infection in early period after transplantation was 11.1%. Pretransplant ascites, low serum albumin, postoperative hospital stay and steroid intake were significantly associated with nosocomial infections among liver transplant recipients
Conclusions: Nosocomial bacterial infection is common in early period after liver transplantation. The commonest bacterial pathogens were Klebsiella pneumoniae and Staphylococcus aureus which represents 23.8% for each
Résumé
Bloodstream infections [BSI] due to Candida species are important complications in immunocompromised patients. This study presents data on species distribution and antifungal susceptibility profiles of Candida bloodstream isolates obtained from Mansoura University Hospitals [MUH] over a 2-year period. All the bloodstream isolates were identified to species level by CHROMagar Candida cornmeal-Tween 80 agar, and API 20C [bioMerieux, France]. Susceptibility to triazole antifungal drugs were determined by M 27A2 [broth microdilution method] of the Clinical and Laboratory Standards Institute [CLSI]. C. albicans was the predominant species, followed by C. parapsilosis, C. tropicalis, C. glabrata, C. krusei and C. dubliensis . All C. dubliensis, C. tropicalis and C. glabrata isolates were susceptible to triazoles. Resistance to fluconazole was observed in 3.8% [1/13] of C. albicans isolates, 50% [2/4] of C. glabrata isolates and 100% [4/4] of C. krusei isolates. Resistance to voriconazole was observed in 4 isolates [12.1%]. Our findings show that C. albicans is the most common cause of Candida-related BSI, followed by C. parapsilosis, and that the rates of resistance to triazole antifungals are low among bloodstream Candida isolates in MUH