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Dermatophytes are fungi that belong to three genera: Epidermophyton, Microsporum, and Trichophyton. Identification of dermatophyte species is essential for appropriate diagnosis and treatment of dermatophytosis. Routine identification depends on macroscopic and microscopic morphology, which is time-consuming and does not identify dermatophyte strains. In this study, two PCR-based methods were compared for their abilities to identify 21 dermatophyte isolates obtained from Egyptian patients to the species and strain levels. The first method employed a two-step method: PCR amplification, using ITS1 and ITS4 as primers, followed by restriction enzyme digestion using the endonuclease MvaI. The second method employed a one-step approach employing the repetitive oligonucleotide (GACA) 4 as a primer. Dermatophyte strains were also identified using a conventional culture method. Our results showed that the conventional culture method identified four species: Microsporum canis, Trichophyton mentagrophytes, Trichophyton rubrum, and Trichophyton violaceum. Moreover, both PCR methods agreed with the diagnosis made using the conventional approach. Furthermore, ITS1/ITS4-based PCR provided no strain differentiation, while (GACA) 4 -based PCR identified different varieties among the T. mentagrophytes isolates. Taken together, our results suggest that (GACA) 4 -based PCR has utility as a simple and rapid method for identification of dermatophyte species as well as utility for differentiation of T. mentagrophytes variants.Dermatophytes comprise a group of related fungi that belong to three genera, Epidermophyton, Microsporum, and Trichophyton, each of which includes several recognized species. These fungi are keratinophylic, as they infect the superficial keratinized tissues (skin, hair, and nails) of humans and animals (16), and can cause cutaneous mycoses which are called dermatophytoses, tinea, or ringworm infections. Health care costs associated with management of these mycoses are high (2, 14). Moreover, dermatophytoses are widespread and increasing in prevalence on a global scale and the recent increase in their incidence has been attributed to the increase of immunocompromised states, such as those associated with AIDS, diabetes mellitus, organ transplantation, and the use of corticosteroids and antineoplastic agents (3,5,11,17).The identification of dermatophyte species is essential for appropriate diagnosis and treatment of dermatophytosis. As the dermatophytes were reported to cause outbreaks of infection, especially in closed communities (15), their identification to the species as well as strain levels has a great epidemiological value in the investigations of such outbreaks with regard to identifying the sources of infections and establishing plans to manage and control them.Routine laboratory procedures for the identification of dermatophytes rely on culturing of these fungi on appropriate growth media, followed by examination of the gross morphological characters of their colonies (e.g., rate of growth, colony topo...

BackgroundThe aim of this study was to identify the common H. pylori virulence genes among dyspeptic Southwestern Saudi patients and their association with clinical outcomes and histopathological findings to help practitioners and researchers in the region for better management of infections caused by such bacteria.MethodsFour hundred two gastric biopsy specimens were analyzed using histopathological examination and real time-PCR. The positive 187 specimens by RT-PCR were genotyped using PCR targeting cagA, vacA and iceA genes.ResultsOne hundred twenty-eight gastric biopsy specimens were positive in genotyping PCRs. The cagA, vacA, iceA1 and iceA2 genes were detected in rates of 49.2% (63/128), 100%(128/128), 42.2% (54/128), 32.8% (42/128), respectively. The vacA s1as1bm2 subtype was the highest 23.4% (30/128), followed by m2 and s1a1b subtypes which were equally detected [16.4% (21/128) for each]. The iceA genes were significantly associated with gastritis and gastric ulcer. Overall, vacA genotypes were significantly associated with gastritis, gastric and duodenal ulcers. The vacA subtypes: s1as1bm2, s1a1b and s2 m2 showed chronic active gastritis in percentages of 90.0, 81, and 84.2%, respectively. All vacA mixed genotypes showed chronic active gastritis.ConclusionsH. pylori virulence genes are highly prevalent and diverse among patients with dyspepsia in Southwestern region of Saudi Arabia. The iceA genes and the different vacA subtypes are significantly associated with the clinical outcomes and histopathological changes especially chronic active gastritis.

BackgroundHelicobacter pylori (H. pylori) is a major cause of peptic ulcer disease (PUD) and chronic active gastritis that may progress to gastric cancer. Globally, it has been estimated that 50% or more of the world’s population is infected by H. pylori, making it the most widespread infection across the globe.ObjectivesTo determine the prevalence of H. pylori infection and to identify factors associated with H. pylori infection in Saudi patients presenting with dyspepsia.MethodsIn this prospective cross-sectional study, a total of 404 gastric biopsies were endoscopically obtained from 404 patients with dyspepsia from September 2014 to April 2016 (Jazan Province, Saudi Arabia). The specimens were analyzed using the real-time polymerase chain reaction (PCR). The data was examined using descriptive statistics as well as determining the prevalence, and employing Chi square and Fisher exact test. A p-value of ≤0.05 was considered statistically significant in examining the research hypotheses.ResultsThe overall prevalence of H. pylori in Jazan Province was 46.5% (95% CI: 41.7–51.4) and the prevalence was lower among those > 55 years old. Prevalence was higher among urban (50.0%; 95% CI: 43.1–56.8) versus rural (42.1%; 95% CI: 35.1–49.3), but with no significant difference. Prevalence did not show significant difference among different Body Mass Index (BMI) categories, ranging from 40.2% to 47.7%. The prevalence of H. pylori in females was 47.1% (95% CI: 40.4–53.9) versus 45.6% (95% CI: 38.7–52.6) in males. Histopathology findings were associated with H. pylori infection with prevalence of 58.1% among patients with chronic active gastritis, compared to 24.1% and 34.8% among mild and chronic gastritis, respectively.ConclusionOur results indicate that there is a high prevalence of H. pylori among Saudi patients with dyspepsia. Prevalence of H. pylori was high in ages below 55 years. Chronic active gastritis was significantly associated with H. pylori infection. In depth studies are needed to determine associated factors with of H pylori infection in the region

In this study, we determined the utility of a 2,3-bis(2-methoxy-4-nitro-5-[(sulfenylamino)carbonyl]-2H-tetrazolium hydroxide (XTT)-based assay for determining antifungal susceptibilities of dermatophytes to terbinafine, ciclopirox, and voriconazole in comparison to the Clinical and Laboratory Standards Institute (CLSI) M38-A2 method. Forty-eight dermatophyte isolates, including Trichophyton rubrum (n ‫؍‬ 15), Trichophyton mentagrophytes (n ‫؍‬ 7), Trichophyton tonsurans (n ‫؍‬ 11), and Epidermophyton floccosum (n ‫؍‬ 13), and two quality control strains, were tested. In the XTT-based method, MICs were determined spectrophotometrically at 490 nm after addition of XTT and menadione. For the CLSI method, the MICs were determined visually. With T. rubrum, the XTT assay revealed MIC ranges of 0.004 to >64 g/ml, 0.125 to 0.25 g/ml, and 0.008 to 0.025 g/ml for terbinafine, ciclopirox, and voriconazole, respectively. Similar MIC ranges were obtained against T. rubrum by using the CLSI method. Additionally, when tested with T. mentagrophytes, T. tonsurans, and E. floccosum isolates, the XTT and CLSI methods resulted in comparable MIC ranges. Both methods revealed similar lowest drug concentrations that inhibited 90% of the isolates for the majority of tested drug-dermatophyte combinations. The levels of agreement within 1 dilution between both methods were as follows: 100% with terbinafine, 97.8% with ciclopirox, and 89.1% with voriconazole. However, the agreement within 2 dilutions between these two methods was 100% for all tested drugs. Our results revealed that the XTT assay can be a useful tool for antifungal susceptibility testing of dermatophytes.Dermatophytes are a group of related keratinophilic fungi that infect the superficial keratinized tissues (skin, hair, and nails) of humans and animals. They belong to three genera: Epidermophyton, Microsporum, and Trichophyton, each of which includes several recognized species (17). Infections caused by these fungi are among the most prevalent cutaneous infections globally, and the recent increase in the number of patients with immunocompromised states, such as AIDS, diabetes mellitus, cancer, and organ transplantation, has given these infections more prominence (4, 14, 16). Dermatophyte infections can be disfiguring, recurrent, and chronic (especially nail infections) and generally need long-term treatment with antifungal agents. Recurrent dermatophyte infections may result from poor compliance of the patient, infection with a new strain, or development of resistance to the antifungal agent used in treatment. Therefore, antifungal susceptibility testing of dermatophytes may be helpful for managing patients, especially since a number of new antifungal agents are now clinically available.The standard broth microdilution M38-A2 method has been developed and adopted by the Clinical and Laboratory Standards Institute (CLSI) for testing of antifungal susceptibility of filamentous fungi, including the dermatophytes (6). Alternative colorimetry-based approaches for antifungal su...

Introduction:Occult hepatitis B infection (OBI) is considered to be one of the major risks for patients suffering from end-stage renal disease (ESRD) on regular hemodialysis (HD) and patients with chronic hepatitis C virus (HCV) infection. This study compared the prevalence of OBI among these two high-risk groups in the Suez Canal region, Northeastern Egypt, to obtain a better national overview of the magnitude of OBI in this region. Methods: Serum samples were collected from 165 HD patients and 210 chronic HCV-infected patients. Anti-HCV antibody, hepatitis B surface antigen (HBsAg), total hepatitis B core (anti-HBc) antibody, and hepatitis B surface antibody (anti-HBs) were detected by enzyme-linked immunosorbent assay (ELISA). HCV RNA was detected using a quantitative real-time RT-PCR assay, and HBV was detected using a nested PCR. Results: All patients were negative for HBsAg. A total of 49.1% and 25.2% of the patients in the HD and HCV groups, respectively, were anti-HBc-positive. In addition, more anti-HBs-positive patients were detected in the HD group compared to the HCV group (52.1% and 11.4%, respectively). Three cases were positive for HBV DNA in the HD group, while eighteen positive cases were detected in the HCV group. Both study groups showed signifi cant differences in serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) level as well as anti-HBc, anti-HBs and HBV-DNA positivity. Conclusions: OBI was more prevalent among chronic HCV patients than HD patients in the Suez Canal region, Egypt, with rates of 8.5% and 1.8%, respectively. However, more precise assessment of this infection requires regular patient follow-up using HBV DNA detection methods.

Summary and subsurface (25 50 cm) soil samples were collected from a loamy sand area (classified as Lithic Quartzipsamments) where sewage effluents of Cairo City have been used in irrigation for 23 and 47 years and were tested for their levels of organic matter, P, N, B, Cd, Co~ Cr, Cu, and Pb.The use of sewage effluents in irrigation, year after year, markedly increased available phosphorus and both total and soluble nitrogen in soil. The increase was also observed with respect to water soluble boron and total and DTPA-extractable heavy metals. The surface layers contained higher amounts of elements than the subsurface ones.We conclude that use of Cairo sewage effluents in irrigating the loamy sand soil has markedly increased the levels of heavy metals in soil and attention should be focused on their accumulation in fruit of citrus.