Introduction: The number of fungal infections caused by uncommon fungi has increased in recent years. Cyberlindnera fabianii is a yeast species that is a rare cause of human infections. In previous cases, isolation of Cyberlindnera fabianii has been reported only from blood specimens and only infrequently. This report describes what we believe is the first case of isolation of Cyberlindnera fabianii from a urine specimen of an immunocompromised 5-year-old child who had a history of prolonged hospitalization and exposure to multiple antibacterial agents and who was neutropenic. Case presentation: A 5-year-old male child presented in paediatric emergency in a febrile (103 °F), conscious but confused and irritable state. A number of risk factors were present in the child including an immunocompromised state, prolonged prior hospitalization, exposure to multiple antibiotics, indwelling catheters and neutropenia. A urine culture showed pure and significant growth of Candida sp., which was identified as Candida utilis (resistant to amphotericin B) by Vitek 2 Compact (bioMérieux). Subsequent 26S rRNA gene sequencing identified it as Cyberlindnera fabianii. Conclusion: Molecular assays have a major role in confirming the identity of uncommon fungal isolates, as correct identification is important for epidemiological purposes. It is imperative that antifungal susceptibility should be performed along with identification of the Candida sp.

Abstract:Recently, an increase in the incidence of infections caused by fungi especially non-albicans Candida species has been reported. Several virulence factors like biofilm formation, toxin production and presence of adhesins contribute to its pathogenesis. This study was undertaken to determine species distribution, biofilm formation and in-vitro antifungal susceptibility of Candida isolated in our tertiary care hospital. One hundred and forty-two clinical isolates obtained from various clinical specimens were subjected to KOH smear and cultured on Sabouraud's Dextrose agar medium. Conventional methods and automated identification system (Vitek 2 Compact) for yeast identification were done. Biofilm forming ability of each isolate was detected using microtitre plate method. Antifungal susceptibility against fluconazole, voriconazole, flucytosine, amphotericin B and caspofungin was tested using Vitek 2 Compact. Out of 142 Candida isolates, 90 (63.4%) were C. albicans and 52 (36.6%) were non-albicans Candida species. Among 52 nonalbicans Candida, C. parapsilosis was found in 20 (38.5%) cases followed by C. tropicalis 16 (30.8%). Among all isolates, 52 (36.6%) were biofilm producers and biofilm positivity was more among non-albicans Candida 28 (53.8%) as compared to C. albicans 24 (26.7%) (p-value <0.002). The maximum positivity was observed with isolates from plastic devices (60%). The minimum inhibitory concentrations of all isolates against antifungal drugs were within susceptible range. Although C. albicans remains the major isolate from various clinical specimens, infections caused by non-albicans. Candida is on the rise and biofilm formation as a virulence factor might have a higher significance for non-albicans Candida species than for C. albicans. The changing epidemiology of Candida infections highlights the need for close monitoring on the distribution, biofilm production and susceptibility to optimize therapy and outcome.

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Introduction: Real time Reverse Transcription-Polymerase Chain Reaction (RT-PCR) test, the gold standard test for Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) detection, is a tedious process and requires proficient workforce. Accurate and fast test results may permit more efficient use of protective and isolation resources and allow rapid therapeutic interventions. Aim: To evaluate the analytical performance characteristics of the Cepheid Xpert Xpress SARS-CoV-2 test, a rapid, automated molecular test for SARS-CoV-2 with gold standard RT-PCR test. Materials and Methods: This retrospective cohort study was conducted in Virus Research and Diagnostic Laboratory (VRDL) in Department of Microbiology at GGS Medical College, Faridkot from January 2021-June 2021. A total of 100 nasopharyngeal samples, collected from clinically suspected Coronavirus Diseae2019 (COVID-19) cases admitted at GGSMC during 1st January30th June 2021 were tested both by Xpert assay and RT-PCR test simultaneously, taking RT-PCR as the gold standard test. The data was analysed by MedCalc® statistical software version 19.6.4., and sensitivity, specificity, predictive values, likelihood ratios and the agreement between the two tests were calculated. Results: The mean age of the study participants was 46 years. Of these, 55 were males and 45 were females. The overall sample sensitivity and specificity of the Xpert assay were both 100% and there was perfect agreement across specimens, if authors, set a cut-off Cycle threshold-value (Ct-value) at 40 cycles for Xpert. Of 100 samples, 32 were positive for SARSCoV-2 by either of the tests and 68 were negative. Xpert assay could detect 100% positive cases and RT-PCR test could detect 84.37% positive cases. Out of the 32 samples which were positive by Xpert assay, 5 (15.62%) samples had a Ctvalue greater than 40. Conclusion: The Xpert assay found to be useful as a point-ofcare test in acute scenario, where rapid and authentic diagnosis is essential, but do not have expertise and infrastructure to perform RT-PCR.