Vancomycin resistant Enterococcus faecium (VREF) ia an emerging and challenging nosocomial pathogen. This study aimed to determine the prevalence, risk factors and clonal relationships between different VREF isolates in the intensive care units (ICUs) of the university hospitals in our geographic location. This prospective study was conducted from July, 2012 until September, 2013 on 781 patients who were admitted to the ICUs of the Mansoura University Hospitals (MUHs), and fulfilled the healthcare-associated infection (HAI) criteria. Susceptibility testing was determined using the disk diffusion method. The clonal relationships were evaluated with pulsed field gel electrophoresis (PFGE). Out of 52 E. faecium isolates, 12 (23.1%) were vancomycin resistant. The significant risk factors for the VREF infections were: transfer to the ICU from a ward, renal failure, an extended ICU stay and use of third-generation cephalosporins, gentamicin, or ciprofloxacin. PFGE with the 12 isolates showed 9 different patterns; 3 belonged to the same pulsotype and another 2 carried a second pulsotypes. The similar pulsotypes isolates were isolated from ICUs of one hospital (EICUs); however, all of the isolates from the other ICUs had different patterns. Infection control policy, in conjunction with antibiotic stewardship, is important to combat VREF transmission in these high-risk patients.

Dermatophyte test media (DTM) and Sabouraud's dextrose agar (SDA) are well established media for recovery of dermatophytes from clinical samples of dermatophytosis. Skin, hair and nail samples were mycologically examined from 112 patients attending Outpatient Clinic of Dermatology and Veneriology in Mansoura University Hospital in an attempt to compare dermatophyte identification media (DIM) with DTM and SDA for recovery and identification of dermatophytes. One hundred and sixteen fungi were recovered from 112 patients. The most common clinical lesions were onychomycosis 35.7% (40/112) and tinea capitis 17.86% (20/112). The most common recovered keratinophilic fungi were T. mentagrophytes (31/116), followed by T. rubrum (15/116). On comparing DIM with SDA and DTM sensitivity was 95.74% and 94.74% respectively while specificity of DIM with DTM was 86.67%.So DIM culture is an inexpensive, rapid, specific, and accurate method for the presumptive recovery of dermatophytes from clinical samples.

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