Mycological microscopic and culture examination of 400 bronchoalveolar lavage [BAL] samples

The frequency of invasive opportunistic mycoses has increased significantly over the past decades especially in immunocompromised patients. Invasive aspergillosis [IA] has become a major cause of morbidity and mortality among these patients. As bronchoalveolar lavage [BAL] fluid samples are generally useful specimens in the diagnosis of invasive pulmonary aspergillosis [IPA], this study was designed to evaluate the incidence of fungal elements in at-risk patients by direct microscopy and culture of BAL samples. In a 16-month period, 400 BAL samples were obtained from several groups of different patients with pulmonary and respiratory disorders and examined by using both direct microscopy and culture. Of the 400 samples, 16 [4%] were positive direct examination with branching septate hyphae and 46 [11.5%] were positive culture: 25 [54%] Aspergillus flavus, 6 [13%] A. fumigatus, 5 [10.9%] A. niger, 1 [2.2%] A. terreus, 3 [6.5%] Penicillium spp. and 6 [13%] mixed A. flavus/A. niger. A. flavus was the most common cause of Aspergillus infection or colonization. Bone marrow transplant [BMT] recipients were the most susceptible group to fungal infection and/or colonization. Among Aspergillus species, A. flavus was the most common isolate in both infections and colonization in Iran. More studies are needed to clarify the epidemiological aspect of aspergillosis in Iran

[Comparision of MICs of some Iranian herbal essences against azole resistance and azole susceptible of candida albicans]

Candida albicans is the most important species, cause candida infections. The common forms of candidiasis are cutaneous and mucosal candidiasis, include oral [thrush], Vaginal candidiasis and onychomycosis. Different studies showed the drug resistance between candida albicans isolates, so it seems necessary to find replacement treatment for prevention of this resistance, side effects and avoidance of recurrent infection. Aim of this study is to determine of MICs of three essences against candida albicans isolates. Also, we compared the effects of essences between azole resistance and azole susceptible isolates. In this study, 30 candida albicans isolates [16 azole resistance and 14 azole susceptible isolates] obtained from oral, vaginal and nails of patients with candidiasis were evaluated. In order to determine of susceptibility of Zataria multiflora, Geranium herbarum and Artemisia sieberi essences against candida albicans, Macrodilution broth Serial dilution of essences was prepared in sabouraud glucose broth tubes. Essences were solved in DMSO [0.12] as solvent. The same solvent at an appropriate concentration was used as a control [with and without organisms]. After inoculation, incubation and subculture, MICs, compared to control tubes were determined. The obtained results of MICs for Zataria multiflora, Geranium herbarum and Artemisia sieberi were between 0.11-0.25 micro l/ml [mean: 0.18 micro l/ml], 0.4-1.25 micro l/ml [mean: 0.83 micro l/mI] and 0.62-1.25 micro l/ml [mean: 1.4 micro l/ml], respectively. Also, there are not significant differences in MICs of these essences against azole resistance and azole susceptible isolates. We conclude that anti-candida activity of three herbal essences under study, against azole resistance and azole susceptible isolates were similar. With attention to resistance of different candida albicans to synthetic and chemical antifungals, these herbal essences are safe replacement treatments for cutaneous and mucosal candidia infections

Evaluation of the effects of incubation temperature and pH on the susceptibility of Candida albicans isolates to ketoconazole invitro

Candidiasis, as an opportunistic infection, is caused by the Candida species. Although Candida albicans is classified in the body as an endogenic flora, it plays an important role in creating Candida related diseases. Candida vulvovaginitis in pregnant women, diabetes mellitus patients and those using multiple antibiotics and contraceptive drugs demonstrates the high resistance of the organism against conventional medication. On the other hand, recurrent vaginitis disintegrates the long-term process of treatment in majority of the patients. The present research was done with the aim of determining the optimum conditions for susceptibility testing before retreatment of patients. 10 isolates of Candida albicans obtained from 31 suspected patients suffering from recurrent Candida vaginitis were incubated with ketoconazole at two pH of 7.2 and 5.5 and two temperatures of 35°C and 27°C. The Microdilution broth test technique was used. The RPMI 1640 medium within the 96 well microplates with range of 12 tests was used to determine the MIC50, MIC90 and MFC of the drug. The obtained MIC50, MIC90 and MFC for ketoconazole at these conditions [T=35°C and pH=7.2] were 0.25 to 1 micro g/ml, 1 to 4 micro g/ml and 64 to >/= 512 micro g/ml respectively, while these values at 27°C, pH 5.5 were 1 to 8 micro g/ml, 8 to 64 micro g/ml and 512 to >/= 512 micro g/ml, at 35°C and pH 5.5 the values were 1 to 8 micro g/ml, 4 to 32 micro g/ml, 256 to >/= 512 micro g/ml, while at 27°C and pH 7.2 the values were 1 to 2 micro g/ml, 8 to 32 micro g/ml, 128 to >/= 512 micro g/ml, respectively. The obtained results confirmed that conditions with temperature of 35°C and pH 7.2 resulted in better treatment outcomes than other conditions