Antifungal susceptibility of molecularly confirmed Aspergillus species from clinical samples.

Invasive aspergillosis is the second most common invasive human mycosis but susceptibility data of Aspergillus species is limited. Antifungal treatment of aspergillosis is often done empirically without knowing the true susceptibility. Therefore, we aimed to determine antifungal susceptibility of Aspergillus species isolated from various clinical specimens over a 1-year period. We identified 28 Aspergillus isolates by sequencing the internal transcribed spacer (ITS) and ß-tubulin genes and performed antifungal susceptibility testing on these isolates using Sensititre YeastOne. The isolates were identified as Aspergillus niger (60.7%), A. fumigatus (21.4%), A. flavus (10.7%), A. chevalieri (3.6%) and A. tubingensis (3.6%). Based on the European Committee on Antimicrobial Susceptibility Testing (EUCAST) Antifungal Clinical Breakpoint for Aspergillus spp., 16/17 (94.1%) A. niger isolates were susceptible to amphotericin B, all six isolates (100%) of A. fumigatus were susceptible to amphotericin B, itraconazole and voriconazole, but only 5/6 (83.3%) A. fumigatus were susceptible to posaconazole. Meanwhile, all three (100%) A. flavus isolates were susceptible to itraconazole. There are no other breakpoints established by the EUCAST for other antifungal-species combinations. In conclusions, Aspergillus niger remains the most commonly isolated species from clinical specimens and Aspergillus isolates at our centre are still largely susceptible to amphotericin B, echinocandins and most azoles. This information is valuable in guiding antifungal therapy in the treatment of aspergillosis.

Non-Adherence to recommended Pap smear screening guidelines and its associated factors among women attending health clinic in Malaysia.

INTRODUCTION: Cervical cancer ranks as the second most frequent cancer among women in Malaysia. Although a cervical screening program has been introduced since 1960s and is provided free of charge in all government health facilities, the coverage and adherence rate to recommendation among Malaysian women remains low. OBJECTIVES: To determine the proportion of non-adherence to Pap smear screening guidelines and its associated factors among women attending a health clinic in Malaysia. METHOD: A cross sectional study involving 316 women aged 20 to 65 years who had undergone a Pap smear. Universal sampling method was applied to select participants among women who attended the selected health clinic from January 2013 to May 2013. A self-administered questionnaire was used to obtain the socio-demographic characteristics, socio-health data and perceptions about cervical cancer and Pap smear screening. The data was analysed using descriptive statistics and multiple logistic regression. RESULT: The proportion of non-adherence to Pap smear screening was 90.5%. Age, marital status, duration of marriage, education level, employment, household income and number of children were not significantly associated with non-adherence. Perceived severity, perceived susceptibility, perceived benefit, perceived barrier and cues to action did not show significant association with non-adherence to Pap smear screening. CONCLUSION: Non-adherence to Pap smear screening was high among Malaysian women. Measures should be taken to increase Pap smear screening coverage in our country. Other factors beyond Health Belief Model that influence Pap smear screening practice among Malaysian women should be explored.

The crucial role of molecular testing to facilitate the diagnosis of pneumocystis pneumonia during pregnancy.

Pneumocystis pneumonia is an important human immunodeficiency virus (HIV)-associated opportunistic infection, and especially so in pregnant HIV-positive patients. We report a case of a 40-year-old woman in her first trimester of pregnancy who initially presented with acute gastroenteritis symptoms but due to a history of high-risk behaviour and the observation of oral thrush, she was worked up for HIV infection. Her retroviral status was positive and her CD4+ T cell count was only 8 cells/µL. She was also worked up for pneumocystis pneumonia due to the presence of mild resting tachypnoea and a notable drop in oxygen saturation (from 100% to 88%) following brief ambulation. Her chest radiograph revealed bilaterally symmetrical lower zone reticular opacities and Giemsa staining of her bronchoalveolar lavage (BAL) was negative for Pneumocystis jirovecii cysts. However, real-time P. jirovecii polymerase chain reaction (PCR) testing on the same BAL specimen revealed the presence of the organism. A course of oral co-trimoxazole plus prednisolone was commenced and her clinical condition improved.

Non-Adherence to recommended Pap smear screening guidelines and its associated factors among women attending health clinic in Malaysia

Introduction: Cervical cancer ranks as the second most frequent cancer among women inMalaysia. Although a cervical screening program has been introduced since 1960s and isprovided free of charge in all government health facilities, the coverage and adherence rate torecommendation among Malaysian women remains low.Objectives: To determine the proportion of non-adherence to Pap smear screening guidelines andits associated factors among women attending a health clinic in Malaysia.Method: A cross sectional study involving 316 women aged 20 to 65 years who had undergonea Pap smear. Universal sampling method was applied to select participants among womenwho attended the selected health clinic from January 2013 to May 2013. A self-administeredquestionnaire was used to obtain the socio-demographic characteristics, socio-health data andperceptions about cervical cancer and Pap smear screening. The data was analysed using descriptivestatistics and multiple logistic regression.Result: The proportion of non-adherence to Pap smear screening was 90.5%. Age, marital status,duration of marriage, education level, employment, household income and number of children were notsignificantly associated with non-adherence. Perceived severity, perceived susceptibility, perceived benefit,perceived barrier and cues to action did not show significant association with non-adherence to Papsmear screening.Conclusion: Non-adherence to Pap smear screening was high among Malaysian women. Measuresshould be taken to increase Pap smear screening coverage in our country. Other factors beyondHealth Belief Model that influence Pap smear screening practice among Malaysian women shouldbe explored.

The use of an in-house biotin-avidin linked immunosorbent assay to detect Aspergillus antigens in sera of immunocompromised patients.

A biotin-avidin-linked immunosorbent assay was developed to detect Aspergillus antigens in sera of immunocompromised patients. The assay was based on a double antibody sandwich ELISA using polyclonal antibodies raised against water-soluble antigens of Aspergillus fumigatus. Aspergillus antigens were positive in sera of 9 of 16 (56%) patients who were studied prospectively and in 13 of 73 (19%) patients studied retrospectively. The 9 prospectively studied patients who were antigen positive were febrile neutropenic hematological malignancy patients who exhibited a high risk of acquiring invasive aspergillosis.

Cathodic stripping voltammetry of copper-complexed reactive dyes at a hanging mercury drop electrode: Reactive violet 5.

Reactive Violet 5 and its hydrolysis product, which is produced as a side product in the dyeing process, can be determined in an admixture at sub-ppb levels by cathodic stripping voltammetry because the potentials of their azo reduction peaks are separated sufficiently. For both dyes, at intermediate pH values the azo peak is preceded by a complexed -copper reduction peak at a less negative potential, which aids the identification of the dyes. The use of pH 6 EDTA buffer removes the complexed-copper peak, as does the use of an acidic buffer (pH < 3). This unusual use of EDTA as a pH buffer facilitates the determination of mixtures of the dye and its hydrolysis product.