Jundishapur Journal of Microbiology
Volume:13 Issue: 8, Aug 2020

 Oropharyngeal candidiasis is a fungal infection in the mouth caused by Candida species. Oropharyngeal candidiasis is a major problem among hematologic malignancy patients.

 The present study was designed to identify and evaluate antifungal susceptibility patterns of Candida spp. isolated from hematological malignancy patients with oral candidiasis.

 Samples were collected from the oral cavity of 138 patients and confirmed for oropharyngeal candidiasis by microscopic examination and fungal culture. Isolated Candida strains were identified by ITS-PCR. Hyphal wall protein 1 (HWP1) was amplified to differentiate the Candida albicans complex. In vitro antifungal susceptibility tests against fluconazole, amphotericin B, and caspofungin were performed according to CLSI M27-A3/S4.

 The study enrolled 120 patients, including 74 (61.66%) females and 46 (38.33%) males. The mean age of affliction by fungal infections was 42 ± 8 years. Patients with acute myeloid leukemia (44%) comprised the majority of cases. The most commonly isolated species among patients were C. albicans (n = 110; 91.6%), C. glabrata (n = 8; 6.6%), and C. africana (n = 2; 2.8%). The overall resistance of C. albicans was 2.7% to fluconazole, and 1.8% to amphotericin B. Candida glabrata showed 12.5% resistance to amphotericin B. All Candida spp. isolates from patients were susceptible to caspofungin.

 Local information about the increasing resistance to fluconazole in both C. albicans and non albicans Candida species and their antifungal susceptibility is useful for deciding on antifungal prophylaxis and selecting the empirical therapy of cancer patients.

 Much research has been done on reproductive tract infections (RTIs), but no study exists about RTIs among rheumatoid arthritis women.

 This study investigated the prevalence and risk factors of RTIs among reproductive-aged women with rheumatoid arthritis in Pune, India.

 This clinical-based, cross-sectional study enrolled a sample of 400 consenting Indian women aged 15 -49 years with a history of at least three months’ rheumatoid arthritis referring to a popular community center. Patients were interviewed comprehensively using previously validated relevant questionnaires. Women underwent gynecological examinations and vaginal smears (wet mount) by a microbiologist to diagnose candidiasis, bacterial vaginosis, and trichomoniasis. Syphilis serological testing was performed for the study population.

 The prevalence obtained was 39.3%. Infection with bacterial vaginosis was 32.0%, Candidiasis 6.5%, and trichomoniasis 0.8%. Syphilis seroconversion was not observed. Adjusting for confounding factors in logistic regression showed that four factors remained significant, including age under 30 years [AOR: 2.4, 95% CI: 1.2 - 4.9], living in a crowded and small one-room house [AOR: 2.5, 95% CI: 1.2 - 5.1] , improper linen for menstruation bleeding [AOR: 1.9, 95% CI: 1.1 - 3.3], and oral disease-modifying anti-rheumatic drugs [AOR: 3.96, 95% CI: 1.9 - 7.9].

 This study demonstrated a large burden of RTIs in women suffering from rheumatoid arthritis. Regular screening algorithms for RTIs are urgently required to prevent neglect and improve overall standard care in rheumatology practice. The presence of an oral disease-modifying anti-rheumatic drug as a risk factor shows that more investigation is necessary in this case.

 Vulvovaginal candidiasis (VVC) is an ordinary infection caused by Candida species. Meanwhile, a shift towards non-albicans Candida (NAC) species has been detected in VVC patients.

 This study aimed at molecular identification of Candida isolates, causing VVC.

 Vaginal secretion samples of 320 non-pregnant vaginitis patients at Shahid Akbar-Abadi Obstetrics and Gynecology Hospital in Tehran (Iran) were collected. Samples were evaluated using mycological and molecular approaches. Vaginitis isolates were analyzed with the PCR using NL1 and NL4 primers, and the D1/D2 region of the large-subunit rRNA gene was amplified and sequenced.

 In total, 100 Candida isolates were identified from VVC and recurrent vulvovaginal candidiasis (RVVC). Candida albicans was the most frequent (51%), followed by C. glabrata (36%), C. krusei (Pichia kudriavzevii) (8%), and C. kefyr (Kluyveromyces marxianus) (5%). 51 and 49% of isolates had C. albicans and NAC, respectively.

 Candida albicans and C. glabrata were the most common agents of vulvovaginal candidiasis. NAC spp. (49%) was found as an important agent associated with VVC.

 Catalase enzyme is a potential virulence factor for Aspergillus species.

 This study aimed to evaluate the catalase activity in conidium and mycelium of Aspergillus flavus and A. fumigatus isolated from environmental and clinical samples.

 Forty Aspergillus species (20 A. fumigatus and 20 A. flavus) were evaluated. Species were identified using the macroscopic and microscopic criteria of the isolates on culture media and the PCR-RFLP method, using the MwoI enzyme. The activity of the enzyme was evaluated using the Amplex red catalase assay kit. The Shapiro Wilk, Kolmogorov-Smirnov, Mann-Whitney, and Wilcoxon Signed Rank tests were used to analyze the data.

 The mean conidial and mycelial catalase activities in A. flavus clinical and environmental isolates were 58.10, 57.80 mU/mL, and 1328.30, 531.60 mU/mL, respectively. In A. fumigatus clinical and environmental isolates, the activities were 61.10 and 61.40 mU/mL, and 1248.90 and 722.90 mU/mL, respectively. A significant difference was found between conidial and mycelial catalase activity in Aspergillus species (P = 0.01). The mycelial catalase activity of Aspergillus species isolated from clinical samples was higher than the environmental ones (A. flavus P = 0.01 and A. fumigatus P = 0.04).

 The mycelial catalase activity was higher than conidia. Clinical isolates of A. flavus had similar mycelium activity to A. fumigatus. By using the information provided in the present study, the severity of aspergillosis can be predicted, which paves the way for identifying new antifungal agents.

There are studies on Helicobacter pylori infection in Khyber Pakhtunkhwa. However, district Buner is far away, and most people have the least access to more developed techniques for the diagnosis of different diseases, and no study has been conducted in this region. Therefore, this study was conducted to determine the frequency of H. pylori infection in patients presenting with upper gastrointestinal symptoms.

This study aimed to determine the frequency of H. pylori antigen in the stool of patients with upper gastrointestinal symptoms.

A cross-sectional study was conducted at Bilal Medical Trust Hospital from February 2018 to November 30, 2019. A total of 111 patients presenting with upper gastrointestinal symptoms were included in this study. A purposive (non-probability) sampling technique was used. All of the patients were screened for H. Pylori in stool specimens using a specific stool H. pylori device.

Out of 111 patients, 74 (66.66%) were reported positive for H. pylori infection, among whom, females had a higher ratio (54.05%) than had males (45.94%). The infection was more prevalent in patients aged 20 - 30 years (43.67%). Patients who consumed fresh milk had higher rates of infection than those who used powdered milk/packed milk (52.54% vs. 15.25%). Patients who consumed water from water wells had a higher infection rate (72.87%) than those who used water from tube wells (27.11%).

The present study revealed a higher prevalence of H. pylori in females than in males. The maximum prevalence was noticed in the age group of 20 - 30 years. The study indicated a significantly higher rate of H. pylori infection in patients who used uncooked milk and water from contaminated sources.

 Emerging non-albicans Candida (NAC) species are a major threat because of their intrinsic or acquired resistance to routinely applied antifungal agents.

 The purpose of our study was to reveal in vitro activity of nine antifungal agents against NAC isolates.

 A total of 67 NAC (27 Candida glabrata, 10 C. tropicalis, 6 C. krusei, 6 C. parapsilosis, 4 C. lusitaniae, 4 C. lipolytica, etc.) were identified and tested. The antifungal susceptibility was estimated on the basis of minimum inhibitory concentrations (MIC).

 Overall, 13 species were determined, of which C. glabrata was the most common (40.3%), followed by C. tropicalis (14.9%), C. krusei, and C. parapsilosis (8.9 % each). Forty-nine NAC isolates (73.13%) demonstrated decreased susceptibility to one or more antifungals, and 18 of them were resistant to all azoles. Out of 27 C. glabrata, 12 (44.4%) were resistant to fluconazole with MICs: 32 - >128 µg/mL and 15 (55.6%) were intermediate with MICs: 8 - 16 µg/mL Non-albicans Candida revealed a good susceptibility to echinocandins. Amphotericin B resistance was found in 5.97% of the isolates. Of particular interest was the detection of 6 (8.95%) multidrug-resistant NAC, which expressed resistance to azoles and echinocandins and/or amphotericin B.

 About one-fourth of the studied NAC were resistant to all azoles. These findings as well as the detection of several multidrug-resistant isolates determine the necessity of susceptibility testing of clinically important yeast isolates and control of the antifungal drugs in our hospital.
 

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by a newly discovered coronavirus. Understanding the spreading routes of SARS-CoV-2 is crucial for patient management and defining biosafety strategies for public and health care workers.

In the current study, the virus shedding in the upper respiratory as well as blood, stool, and urine specimens of infected patients, was examined using quantitative real-time PCR assay (qRT-PCR).

The samples of 50 positive patients with high, moderate, and low virus titers in their respiratory specimens were collected. All specimens were subjected to RNA extraction and RT-qPCR assay using two different internally-controlled test systems.

The results indicated that no positive results were observed in the urine samples of all patients. The viral genome was diagnosed in 5% of blood and 3.3% of rectal swab samples. The Cq (Cycle of quantification)-values of positive results on the stool and blood samples were always higher than the Cq-value of the respiratory specimen of the same patient.

SARS-CoV-2 is mainly detected in the respiratory samples, and the virus is not detectable in the urine. The importance of viremia and the existence of the virus in feces in virus spread in the human population needs further investigation.

Acute hematogenous osteomyelitis (AHO) usually occurs in the first two decades of life. Evidence shows that 50% of patients with AHO are younger than five years. This infection typically affects the metaphyseal region of long tubular bones, whereas the fibula is rarely involved. Staphylococcus aureus is the causative agent of AHO in the majority of cases, while Escherichia coli is isolated rather uncommonly beyond the neonatal period.

Herein, we describe the case of an adolescent girl who was treated medically and surgically for AHO with an unusual location in the proximal fibula, caused by E. coli. The source of the causative agent remained unknown after the patient had been evaluated for possible urinary tract infection and underlying immune system defect.

The fibula is a rare anatomic location for AHO, and such cases may pose a diagnostic challenge. Lack of response to empiric antibiotic treatment in patients with AHO may indicate the involvement of an uncommon pathogen, which is not susceptible to standard empiric antimicrobials aimed to target S. aureus as the most likely pathogen. In such instances, prompt surgical intervention can help determine the causative pathogen and optimize antimicrobial treatment.