Molecular Characterization and Antifungal Susceptibility of Aspergillus spp. among Patients with Underlying Lung Diseases.

BACKGROUND: Pulmonary aspergillosis is a lung infection caused by Aspergillus spp., which can cause severe illnesses in immunocompromised patients with underlying lung disease or who have asthma and inhale their spores. This study aimed to screen the antifungal susceptibility of Aspergillus spp. isolated from patients with underlying pulmonary infections and characterize the isolates using PCR and sequencing. METHOD: Three hundred and eighty-four sputum or bronchoalveolar lavage samples were collected and processed for the isolation and identification, and characterization of Aspergillus species and molecular amplification of the ITS1-5.8S-ITS2 region by the PCR and Sanger sequencing method. Antifungal susceptibility tests for itraconazole and voriconazole were performed using the E-test. RESULT: The overall results revealed that out of 384 patients, 32 (8.3%) were positive for fungal growth, including 28 (87.5%) Aspergillus spp. The highest resistance rate (100 and 44.4%) was obtained from itraconazole against A. niger and A. fumigatus. In contrast, voriconazole revealed the best activities against all tested fungi compared to itraconazole. All A. flavus were sensitive to voriconazole, while only 54.5% were sensitive to itraconazole. The MICs of E-test for Aspergillus spp were 1.6 ± 1.8 and 0.6 ± 0.93 for itraconazole and voriconazole, respectively. CONCLUSIONS: The prevalence of aspergillosis was high, with a significant association with underlying lung diseases. Voriconazole was the drug of choice for isolated fungi.

Prevalence of rotavirus and adenovirus associated with diarrhea among displaced communities in Khartoum, Sudan.

BACKGROUND: Diarrheal diseases represent a major worldwide public health problem particularly in developing countries. Each year, at least four million children under five years of age die from diarrhea. Rotavirus, enteric adenovirus and some bacterial species are the most common identified infectious agents responsible for diarrhea in young children worldwide. This study was conducted to determine prevalence of rotavirus and adenovirus associated with diarrhea among displaced communities in Khartoum state, Sudan. METHODS: A total of seven hundred and ten patients, children and adults, suffering from diarrhea were examined. The clinical history, socio-demographic characteristics, physical examination findings and laboratory investigations were recorded. Stool samples or rectal swabs were collected and tested for rotavirus and adenovirus antigens using the immuno-chromatography test (ICT). Characterization of the identified Rotaviruses, as a major cause of diarrhea, was then made using real time-reverse transcription PCR. To make the study legal, an ethical clearance was obtained from Sudan Ministry of health- Research Ethical Committee. Written consent was taken from adult subjects, and also from children mothers.The participants were informed using simple language about the infection, aim of the research and the benefits of the study. RESULTS: Out of the 710 patients, viral pathogens were detected in only 99 cases (13.9%). Of the 99 cases of viral diarrhea, 83 (83.8%) were due to rotaviruses while 16 (16.2%) attributed to adenovirus. Of the 83 rotaviruses identified, 42 were characterized by RT-PCR, of these 40 (95.2%) were proved as type A (VP6), and 2 (4.8%) type C (VP7). Type C (VP7) rotavirus was detected in samples collected from children under 5 years only. CONCLUSIONS: In conclusion, most cases of viral diarrhea are found to be caused by rotavirus especially among children less than five years. Most of the identified rotavirus belonged to type A (VP6).It was also evident that most patients are those who drank untreated water obtained from donkey carts source and who had no access to latrines, and lived in poor environmental conditions would acquire diarrheal infection.

Bacteriological and parasitological assessment of food handlers in the Omdurman area of Sudan.

BACKGROUND/PURPOSE: Pathogenic organisms are thought to be widely distributed among food handlers. This study was designed to assess the prevalence of carriers of some pathogenic bacteria and intestinal parasites among food handlers in the city of Omdurman, Sudan. METHODS: A total of 518 nasal swabs and stool specimens were collected. Nasal swabs were cultured on bacteriological culture media. Stool specimens were examined microscopically for intestinal parasites. RESULTS: Of the total subjects examined, 30.1% were found to be carriers of pathogenic organisms. The pathogens isolated and identified were the bacteria Staphylococcus aureus, Salmonella typhi, and Shigella boydii, and the intestinal parasites, Giardia lamblia and Entamoeba histolytica/dispar. Bacteria and intestinal parasites were most prevalent among storekeepers (41%), followed by restaurant workers (24.4%), bakers (24.4%), butchers (5.1%), milk distributors (2.6%), and fruits/vegetables sellers (2.6%). S. aureus, the most abundant pathogen, was most prevalent in storekeepers (44.6%), followed by restaurant workers (25%), bakers (17.9%), butchers (5.4%), milk distributors (3.6%), and fruit/vegetable sellers (3.6%). CONCLUSION: The findings from this study indicate a key role for food handlers in the spread and transmission of food communicable diseases and reveal the need for protective measures.

Copper uptake by Pseudomonas aeruginosa isolated from infected burn patients.

Pseudomonas aeruginosa was isolated from infected burn patients and characterized by standard biochemical tests. The in vitro copper uptake was compared between this isolated pathogenic strain and two non-pathogenic control strains of gram positive bacteria Bacillus thuringiensis strain Israelis as well as gram negative bacteria Enterobacter aerogenes. Maximum copper uptake of 470 ppm/g biomass was obtained by P. aeruginosa strain, while the control strains B. thuringiensis and Enterobacter aerogenes had copper uptake of 350 and 383 ppm/g biomass, respectively. However, the lowest copper uptake (60 ppm/g biomass) was observed with another control the saprophytic strain Pseudomonas (Shewanella) putrefaciens. A further investigation regarding the effect of copper toxicity on bacterial growth, gave an MIC score of 600 ppm for P. aeruginosa strain compared to 460 and 300 ppm for the two gram positive and gram negative control strains, respectively. In tandem with these in vitro findings, blood analysis on burn patients infected with P. aeruginosa has indicated a selective decrease of copper (hypocupremia) and ceruloplasmin plasma levels. The iron metabolism was also affected by this copper deprivation leading to a similar decrease in plasma levels of PCV, iron, total iron binding capacity, and transferrin. All these hematological changes were significantly different (P < 0.05) from the matched group of non-infected burn patients. The observed hypocupremia in infected burn patients was attributed to demanding scavenger ability by P. aeruginosa strain for the copper of plasma.