Vulvovaginal candidiasis (VVC) remains one of the most common infections of the female genital tract. Correct identification of the isolated Candida species is essential to direct the empirical antifungal therapy. Objectives: This local study was conducted to identify the spectrum of Candida species associated with VVC using different phenotypic and genotypic methods and assess their antifungal susceptibility pattern. Materials and methods: High vaginal swabs were collected from 125 patients presenting with a clinical picture suggestive of VVC. Swabs were subjected to Gram-stain and culture on Sabouraud dextrose agar. Species identification of Candida isolates was done using phenotypic methods including germ tube test, Rice Tween-80 agar, Chrom ID (CAN2) agar and API 20C AUX, while PCR-RFLP was used as the gold standard method. Antifungal susceptibility testing was done using the disk diffusion method. Results: Vaginal swab cultures yielded Candida growth in 63 cases (50.4%). Candida albicans was the predominant isolated species (60.3%) while the most common non-albicans species was Candida glabrata (12.7%). Fortyfive (71.4%) and fifty-five (87.3%) Candida isolates were correctly speciated by Rice Tween-80 Agar and API 20C AUX, respectively, while fifty-seven isolates (90.5%) were correctly assigned into the 3 groups of yeasts identified by CAN2 agar. Amphotericin B was more effective than azoles against vaginal Candida isolates. Conclusion: C. albicans is the most common species associated with VVC. API 20C AUX was the most accurate phenotypic method for the proper identification of most Candida species whereas PCR-RFLP could properly confirm Candida species identification genotypically.
Background: Dermatophytes are major causative agents of cutaneous fungal infections worldwide. Identification of dermatophyte species is based on macroscopic and microscopic morphology on different culture media. Molecular methods such as PCR-RFLP are rapid, reliable and precise identification methods. This local study aimed to identify the spectrum of dermatophyte species among the studied patients population using different phenotypic and genotypic methods. Materials and methods: Hair, skin and nail specimens were collected from 135 patients with clinically suspected cases of dermatophytosis. All specimens were subjected to microscopic examination using KOH and culture on SDA and dermasel agar. Phenotypic identification was done by colony and microscopic morphology, and subculture on malt, PDA, lactrimel and urea agar plates. Molecular identification was done by PCR-RFLP using MvaI. Results: Out of 135 patients included in the study, 78 (57.8%) were positive by culture for dermatophytes. Five different species were identified, the most commonly isolated species was M. canis (51.3%) followed by T. violaceum (42.3%). PCR-RFLP correctly identified the isolated dermatophyte species, producing unique restriction patterns. Conclusion: Dermatophytosis is common in Egypt where humid hot climate and animal contact play important role in the spread of these fungi. The use of PCR-RFLP directly on clinical specimens rather than its use in the identification of dermatophytes from culture media is recommended.
Background: Asymptomatic bacteriuria (ASB) is defined as significant growth of pathogenic bacteria of more than 10 5 CFU/ ml in urine culture without any symptoms suggesting of urinary tract infection. It has many complications on the health of a pregnant woman, her pregnancy and the fetus. Objectives: The present study was conducted to determine the prevalence, risk factors, pathogenic organisms of ASB in pregnant women, to assess antimicrobial susceptibility pattern of uropathogens and to assess maternal and fetal complications. Methodology: Urine samples were collected from 256 asymptomatic pregnant women. All samples were subjected to microscopic examination and cultivation on CLED. Colonies were identified by Gram stain and biochemical reactions. In vitro susceptibility pattern was measured by disk diffusion method. Results: ASB prevalence rate was 7.8% among the studied group. E. coli was the most common uropathogen isolated (35%). This study revealed that nitrofurantoin (90%) sensitivity, imipenem (85%), norfloxacin (75%) and amikacin (75%) were very effective against most of the urinary isolates, while most of the urinary isolates were resistant to cephalexin, cefuroxime and cefotaxime. Conclusion: Early screening, detection and proper treatment were of considerable importance to reduce maternal and fetal complications. More systematic study covering larger population is recommended to give better insights about risk factors and complications.
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