The prevalence of Candida infections of the urinary tract (candiduria)has increased significantly over the past few years due to various predisposing factors especially in hospitalized patients. The predisposing factors frequently associated with candiduria are urinary tract instrumentation, prior antibiotic use, prolonged hospital stay, extremes of age, diabetes mellitus, female sex and use of immunosuppressive therapy. The purpose of this study was to apply different diagnostic techniques for characterization of Candida species in urine samples from renal failure patients using urinary catheters. Results showed that 20 % of renal failure patients were suffering from candiduria. Females were more affected than males (64% versus 36% of culture positive cases). Diabetes mellitus and catheterization were the obvious risk factors. Different Candida isolates showed variations in their phenotypic (macroscopic and microscopic) characteristics when cultured on CHROMagar Candida, corn meal agar and bovine serum. Candida albicans was the most common species being isolated from 54% of positive cases. C.krusei (Teleomorph: Pichia kudriavzevii), C. glabrata and C.tropicalis were respectively identified in 24%, 16% and 6% of samples. Positive germ tube test (in serum) and production of chlamydospores (on corn meal agar) were only confined to C. albicans. Sequencing of rRNA gene (18S covering ITS1 and ITS2) confirmed the identification of the four Candida species. In vitro antifungal sensitivity test (disc diffusion method) revealed that all Candida strains were inhibited by Amphotericin-B and Nystatin. Other compounds as Clotrimazole, Itraconazole, Ketoconazole, Tioconazole, Fluconazole and Sertaconazole were effective against 50%-67% of Candida strains. All isolates of C. glabrata were resistant to Clotrimazole and Sertaconazole.It is highly recommended to follow standard hygienic precautions to avoid cross contamination by Candida during hemodialysis. Complications following candiduria can be avoided by early diagnosis and proper treatment with effective antifungal agents.
BACKGROUND The intensive care unit (ICU) is a special department of the hospital and health care setting that provides intensive nursing care and care to patients with the most severe and life-threatening illnesses and injuries that require accurate, continuous monitoring and support from specialist, medication, and equipment in order to maintain normal bodily functions. Nosocomial infections are one of the leading causes of mortality in hospitalised patients especially the critically ill patients in the intensive care unit. The purpose of the present study was isolation, identification, and detection of the antibiotic sensitivity pattern of pathogenic bacteria isolated from different clinical specimens of ICU patients under the effect of infection control in Sajer General Hospital in Saudi Arabia. METHODS In this cross-sectional study conducted from January 2020 to April 2020, 200 clinical samples, 40 blood, 45 urine, 50 tracheal aspirate, 30 post-surgical Caesarean section wound swabs, 20 central venous catheters and 15 pus swabs were collected from patients hospitalised in ICUs of Sajer General Hospital. Antibiotic sensitivity testing was performed with the diffusion-disk method for several antibiotics. RESULTS The rate of nosocomial infection among ICU patients due to Gram-negative bacteria is significantly higher than that recorded by Gram-positive bacteria (78.75 %, 21.25 %, respectively). The majority of frequent bacteria isolated from all clinical specimens were Klebsielleae pneumoniae 20 (25 %) followed by Pseudomonas aeruginosa 18 (22.5 %), Acinetobacter baumannii 15 (18.75 %), Escherichia coli 10 (12.50 %), Staphylococcus aureus 9 (11.25 %), Streptococcus pyogenes 6 (7.50 %) and enterococcus spp. 2 (2.50 %). K. pneumoniae, P. aeruginosa and E. coli achieved high sensitivity to imipenem and meropenem (100 %). A. baumannii showed high sensitivity to meropenem (100 %) and imipenem (93.33 %). Staph. aureus, Streptococcus pyogenes and enterococcus species showed high sensitivity to vancomycin (100 %). CONCLUSIONS The nosocomial infection is a major cause of mortality and morbidity in hospitals. The role of nursing care in the prevention of nosocomial infection has proven vital due to the emergence and spreading of different pathogenic bacteria. Close interactions between health care providers can save many more lives. KEY WORDS Intensive Care Units, Antibiotics Sensitivity Pattern, Nursing Infection Control
Abstract:Corneal blindness is a major health problem worldwide and infectious keratitis is one of the predominant causes.The incidence of fungal keratitis has increased over the last few years. Keeping this in mind, this study was conducted to evaluate the frequency of positive fungal cultures in infectious keratitis and of the various fungal species identified as etiologic agents in patients with corneal ulcer attending the ophthalmic departments of 3 hospitals in Riyadh. Corneal scrapings from 100 patients of corneal ulcer with suspected fungal etiology were subjected to direct examination by 10% KOH and lactophenol cotton blue mount. Also swabs of diseased eyes were taken with sterilized swabs. The specimens were also inoculated directly on to Sabouraud's dextrose agar in C-shaped streaks. From 100 patients of corneal ulcer investigated, only 52% of patients were positive. Males were more commonly affected than females (69.23% and 30.76%), respectively. The age of patients was ranged from 28-55 years. 18 (34.61%) patients with fungal keratitis were laborers, 15 (28.84%) teachers, 7 (13.46%) housewives, 6 (11.53%) shepherds and 6 (11.53%) were civil engineers. Corneal trauma with stone chips and metal splinters appeared to be the most common predisposing factors of fungal keratitis (30.76%) followed by ocular surgery and corneal disease (26.92%). Of 52 positive patients with corneal ulcer surveyed the most important causative agents of fungal keratitis were Aspergillus spp. (44.23%), followed by Candida spp. (17.30%) and Fusarium spp. (17.30%). Because of serious consequences of infectious keratitis, it is important to know the exact etiology of fungal keratitis to institute appropriate therapy in time. Laboratory confirmation should be before pre scribing corticosteroids and antifungal.
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