We present a description of a rare but dangerous case of fungal meningitis caused by Aspergillus terreus in an immunocompetent patient with a history of sinus disease.

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Objective: To detect the prevalence of carbapenem resistance among Gram negative bacilli at the Al-Noor Specialist Hospital in the western part of Saudi Arabia. Materials and Methods: This study was conducted in the Microbiology department, Al-Noor Specialist Hospital, Makah city, Saudi Arabia. The clinical samples were collected from admitted patients in the wards, Intensive Care Units (ICUs), urology unit and surgery unit, these samples included blood, urine, sputum, pus and wound. The identification and antibiotic susceptibility testing of all bacterial isolates were performed via the Vitek 2 Compact System. Results: Out of 4803 Gram negative bacterial bacilli were isolated, the prevalence rate of carbapenem resistance among these isolates was 2797/4803 (58.23%), and sensitivity rate was 2006/4803 (41.77%) of the total isolates. The rate of resistance to carbapenem was among Acinetobacter baumannii 1710 (99.13%), followed by Pseudomonas aeruginosa 575 (62.4%), Klebsiella pneumoniae 459 (38%) and Escherichia coli 56 (5.59%). The trend of carbapenem resistance among Gram negative bacterial isolates from 2013-2015 was 53.99%, 59.88% and 61.43% respectively. Conclusion: A. baumannii recorded, the highest rate of carbapenem resistance through three year, 98.19%, 99.48% and 99.81% respectively and the lowest rate of resistance recorded with E. coli, 4.63%, 5.79% and 6.31% respectively.

Most coronavirus disease 2019 (COVID-19) patients present with mild or moderate severity of the disease. However, disease comorbidities may require mechanical ventilation and intensive care (IC), which predispose COVID-19 patients to secondary opportunistic fungal infections. Objective: An observational retrospective cohort study was conducted to investigate the relationship between fungal coinfections and morbidity and mortality rates in patients with severe COVID-19 admitted to a tertiary hospital in Makkah, Saudi Arabia. Methodology: This work was conducted on 1,220 patients with COVID-19 admitted to a Saudi Tertiary Care Hospital in Makkah city from June 1, 2020, to May 30, 2021, to evaluate the existence of fungal infections. COVID-19 cases were confirmed by real-time reverse transcription-polymerase chain reaction (RT-PCR). Statistical analysis was performed via SPSS version 22.0 (IBM, USA). Results:Of the 1,220 included samples, fungal coinfections were detected in 57 (4.7%) patients. Candida albicans was the major isolated strain in 39 (68.4%) patients, and the primary source of infection was sputum (40 patients: 70.2%). Most samples were isolated from the ICU (41 patients; 71.9%); bacteria coinfection was detected in 12 (21%) severely ill patients. Conclusion: Mindfulness of the plausibility of fungal coinfection is important to control infection and ultimately reduces the risk and the delay in diagnostic and treatment process. It will also guide the diagnostic tools in identifying high-risk patients and quickly determine the most appropriate interventions for reducing the possibility of infection besides morbidity and mortality rates.