Objective:  The efficacy of fosfomycin against ESBL and/or carbapenem-resistant E. coli isolated from urine samples was determined. Methodology: Three hundred fifty (350) urine samples were collected from the patients having UTI visited to the department of Urology, JPMC, Karachi. The CLED agar was used for the primary isolation of uropathogens. Regular antimicrobial sensitivity testing was conducted in accordance with CLSI standards, and the minimum inhibitory concentration (MIC) of fosfomycin was assessed using E-strips. Results: Out of 350 urine samples 213 (60.85%) were E. coli.  Patients with E. coli had an average age of 38.75 15.01 years.  Females are more prone to have UTI 146(68.54%). E. coli was highest among uropathogens having frequency of 213(60.85%). E. coli manifest highest resistance to ampicillin 187(87.79%) and low resistance to meropenem 12(5.63%), imipenem 15(7.51%) and fosfomycin 21(9.85%). The overall carbapenem resistant E. coli was 9(6.4%) and majority of (61.5%) fosfomycin resistant E. coli, MIC value was >1024µg/ml. Isolates were categories in the non-MDR, MDR and XDR. Most of the isolates were MDR (53%), followed by the non-MDR (35%) and XDR (11%). Conclusion: In conclusion present study suggests that fosfomycin is still effective against E. coli. More than 50% E. coli isolates were MDR and it’s an alarming situation for urologist.

Objective: This study was designed to determine the frequency of Candida in clinically diagnosed cases of onychomycosis. Study Design: It was a cross-sectional study.Setting: It was conducted in the Department of Microbiology, BMSI, JPMC, Karachi, in a period of one year with the collaboration of the Department of Dermatology, JPMC, Karachi.Materials and Methods: A total of 328 clinical samples have been collected. The fungal isolates were identified according to standard microbiological procedures. Samples were processed for primary screening microscopic test by KOH 20% (potassium hydroxide solution) wet mount. Processing for mycological culture was done by using Sabouraud's dextrose agar (cycloheximide and chloramphenicol), without antibiotics and Dermatophytes test medium. Candida species identification will be achieved through the commercial test of the API ID 32C system.Results: Prevalence of fungal species that isolated from the 328 samples, 14.33% were dermatophytes, 6.40% were non-dermatophytes mould, 23.70% were Candida, 4.87% were mixed growth and 50.30% were negative for growth. Among the 16 mixed isolates, 15 were Candida species, accounting for a total of 28.4% Candida isolates. Out of 93, Candida albicans were 52.68%. Of the 47.32%, 26.88%, 11.82%, 4.30%, 2.15% and1.07%, Candida non albicans C. tropicalis C. parapsilosis, C. glabrata, C. krusei, C. guilliermondii, and Candida utilis respectively.Conclusion: A significant number of onychomycosis cases result from the Candida spp. and Candida albicans were the main species. However, Candida non-albicans species are emerging in onychomycosis. In this manner, legitimate conclusion of the pathogens of onychomycosis is vital for focused treatment.

Objective: To compare the diagnostic performance of direct microscopic techniques and culture media for detecting fungal isolates in hair specimens.Study Design:  Cross-sectional study.Place and Duration of Study: The study was conducted at the Department of Microbiology, Basic Medical Sciences Institute, Karachi, Pakistan, from January 2021 to June 2021.Materials and Methods:  A total of 207 hair specimens were collected from the patients with superficial mycoses of the scalp. The specimens were collected under aseptic techniques using clean glass slides and forceps which were processed for Potassium hydroxide mount and Calcofluor white staining. The mycological cultures were performed on a Dermatophyte test medium and Sabouraud Dextrose agar with and without antibiotics. The data was recorded and analyzed on SPSS version 21. The frequencies, percentages, means, and ratios were calculated using Descriptive statistics. The association between variables were analyzed by the Chi-square test and kappa index.Results: Potassium hydroxide mount revealed fungal spores and hyphae in 154(74.3%) specimens, while Calcofluor white staining showed fungal elements in 179(86.5%) specimens. Out of 207 specimens, 106(51.2%) were culture positive and 101(48.8%) were declared culture negative. Out of culture-positive specimens, dermatophytes were yielded in 61(57.5%) and non-dermatophytes in 45(42.5%) specimens. Among all culture media, the highest number of dermatophytes was yielded by plain Sabouraud dextrose agar (59; 96.5%), followed by dermatophyte test medium (55; 90%), and Sabouraud dextrose agar with antibiotics (54; 90.1%). On the contrary, the primary isolation of non-dermatophytes on the plain was Sabouraud dextrose agar s 32(71.1%), Sabouraud dextrose agar with antibiotics 31(68.2%), and dermatophyte test medium 13(28.8%).Conclusion: In our study, we found Calcofluor white staining technique as the most sensitive method to detect fungal elements from the given hair specimens. For mycological culture, all tested culture media were equally effective for the retrieval of dermatophytes. However, for non-dermatophytes, plain SDA and SDA with antibiotics were found to be better media for isolation.