Introduction Otomycosis is a common problem in otolaryngology practice. However, we usually encounter some difficulties in its treatment because many patients show resistance to antifungal agents, and present high recurrence rate. Objectives To determine the fungal pathogens that cause otomycosis as well as their susceptibility to the commonly used antifungal agents. Additionally, to discover the main reasons for antifungal resistance. Methods We conducted an experimental descriptive study on 122 patients clinically diagnosed with otomycosis from April 2016 to April 2017. Aural discharge specimens were collected for direct microscopic examination and fungal culture. In vitro antifungal susceptibility testing was performed against the commonly used antifungal drugs. We tested the isolated fungi for their enzymatic activity. Results Positive fungal infection was found in 102 samples. The most common fungal pathogens were Aspergillus and Candida species, with Aspergillus niger being the predominant isolate (51%). The antifungal susceptibility testing showed that mold isolates had the highest sensitivity to voriconazole (93.48%), while the highest resistance was to fluconazole (100%). For yeast, the highest sensitivity was to nystatin (88.24%), followed by amphotericin B (82.35%), and the highest resistance was to terbinafine (100%), followed by Itraconazole (94.12%). Filamentous fungi expressed a high enzymatic ability, making them more virulent. Conclusion The Aspergillus and Candida species are the most common fungal isolates in otomycosis. Voriconazole and Nystatin are the medications of choice for the treatment of otomycosis in our community. The high virulence of fungal pathogens is owed to their high enzymatic activity. Empirical use of antifungals should be discouraged.
Biofilm is an important problem of great medical concern in which microorganisms are present in extracellular matrix protecting them from external environment, host immunity and antibiotic therapy. Multiple phenotypic methods are present to detect biofilm in vitro tube method, congo red and tissue culture plate methods. objectives: To determine the ability of bacteria that cause urinary tract infection to form biofilm , antibiotic susceptibility pattern in biofilm forming isolates and to detect some of genes responsible for biofilm formation. Methodology: four hundred urine samples were collected 240 samples from catheterized and160 from non catheterized patients who fulfill the inclusion criteria. Samples were cultured and colony forming unit was counted (colony forming unit > 10 5 were considered positive UTI. Identification of bacteria and their antibiotic sensitivity was done by automated system VITEK II. Multiple phynotypic biofilm detection methods were done and detection of biofilm genes was done by PCR. Results: Enterobacter spp. Were the most frequent isolated organism of Gram negative, Staph aureus was the most frequent isolated organism of Gram positive bacteria. Multiple Phenotypic methods for detection of biofilm production were done to Gram positive and Gram negative bacteria. Tube method detected 84 (68.9%) cases as positive biofilm producer in catheterised patients while 2 (5%) were positive in non catheterized patients. Congo red method detected 80 cases (65.6%) as positive in catheterized cases , 2 (5%) in non catheterized patients but tissue culture plate detected 88 cases(72%) as positive in catheterized patients. Non catheterized patients 18 (45%) were positive. PCR was done to detect biofilm genes ( IcaA, IcaD in staphylococci), (BssS gene in enterobacteriaceae), IcaA, D were detected in 8 (19%) isolates of staphylococci, BssS was detected in 66/104(63.5%) of enterobacteriaceae. Sensitivity of phenotypic methods for biofilm detection in relation to genotypic revealed that tissue culture plate showed more sensitivity in Gram positive and negative bacteria. Conclusion: Multiple phenotypic methods are known for biofilm detection in vitro but tissue culture plate is the most sensitive method; so we can recommend tissue culture plate as a screening method for biofilm detection
SEF14 fimbriae are only found in some strains of serogroup-D Salmonella such as S. enteritidis, suggesting that SEF14 fimbriae may affect serovar-specific virulence traits. In this study, we found that prevalence of sefA, sefD and sefR genes in S. dublin and S. enteritidis was 100%. In 18 isolates of S. pullorum, the prevalence of sefA gene was 100%, while the prevalence of sefD and sefR genes was 38.9% (7/18), and 11 strains isolated after 1980s did not contain any gene sefD or sefR. Interestingly, among the 7 strains of S. pullorum before 1980s, the sefD sequence has a missing base pair at position 196 and caused open reading frame (ORF) shift, resulting in a stop codon (TAG) at position 71 amino acid residual (Leu of TTA at position 214-216 shift into stop codon of TAG at position 215-217). Unlike S. pullorum, all S. enteritidis and S. dublin tested could express SEF14 fimbriae in vitro.
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