Background Of all blood stream infections (BSI), candidaemia poses the greatest threat with a high fatality rate among children. There has been an increase in the number of reports of non- C. albicans species and antifungal resistance has progressively emerge. Aim The present study aimed to demonstrate the prevalence of candidaemia among children and to characterize the involved species and their susceptibility to antifungal agents. Methodology Microbes were isolated from blood samples and identified via standard microbiological procedures. Chromogenic media was used to characterize the Candida species. The susceptibility of the isolates to the antifungal agents; caspofungin, amphotericin, itraconazole, and fluconazole was determined with the E-test. Statistical methods The data were analysed with Statistical Package for the Social Science SPSS; SPSS Inc., Chicago, IL, USA) version 15 for Microsoft Windows. Comparisons between the study groups were performed using the Chi square (χ 2 ) test. p -values less than 0.05 were considered significant. Results Candidaemia accounted for 17.3% of all BSIs. C. albicans and non- C. albicans species accounted for 36% and 64% of the cases of candidaemia, respectively. Caspofungin, amphotericin, itraconazole, and fluconazole antifungals had activities of 99%, 97%, 73% and 64%, respectively. In total, 64% of patients with candiaemia died. Conclusion The prevalence of candidaemia was high, the fatality rate was alarming and non- C. albicans species were predominant. Fluconazole was the least effective of the tested antifungal agents owing to the high level of resistance.

BACKGROUND: Candida is considered the most common cause of opportunistic infections in the world. Increased use of antifungal agents may have led to increasing resistance of Candida for antifungals and may be related to therapeutic failures. Recently, a multidrug-resistant Candida auris has immerged causing outbreaks in several countries all over the world. This discovered superbug is widely spread causing a broad range of health care-associated infections. AIM: This study aims to set a protocol for the identification and detection of the prevalence of C. auris in tertiary Egyptian hospitals following the center of disease and control (CDC) methodology. METHODOS: Over almost 2 years, 400 Candida isolates were collected from different wards of Cairo University Hospitals. Identification of species of all isolates was done by germ tube test followed by sub-culturing on chromogenic agar media for confirmation. Candida non-albicans isolates were further subjected to thermotolerance. Isolates that grew in 42°C were further identified by matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry for definite species identification. Antifungal susceptibility using E-test was done for isolates identified by MALDI to detect resistance patterns. RESULTS: Among the 400 isolates, 227 (56.75%) were Candida albicans while 180 (43.25%) were non-albicans Candida. Candida non-albicans was classified by Chromagar as following; 25 (13.8%) were Candida tropicalis, 43 (23.8%) were Candida krusei, and 112 (62.2%) were other Candida spp. (Candida glabrata, Candida kefyr, Candida parapsilosis, and Candida lusitaniae). Using thermotolerance, 10 isolates grew at 42°C suspecting C. auris. MALDI-TOF was used for definite and final identification; five isolates were identified as C. glabrata, four as C. krusei, and one C. kefyr. Antifungal susceptibility testing of the 10 identified isolates revealed total resistance to fluconazole. CONCLUSION: Following the set protocol for identification based on CDC guidelines, C. auris is not prevalent in Egyptian hospitals. Fluconazole resistance is on the surge among candida isolates. Further studies on a bigger scale including larger number of hospitals are recommended.

Nucleic acid and antibody detection assays have been utilized in COVID-19 laboratory diagnosis. However, the use of viral antigenic proteins for diagnosis has not been successfully developed. Using viral antigen allows rapid direct viral detection earlier than production of antibodies. The present study was aimed at evaluating the performance of two COVID-19 rapid antigen detection tests, which are BIOCREDIT COVID-19 Ag (RapiGEN Inc., Korea) and Standard Q COVID-19 Ag (SD Biosensor, Korea), in comparison with RT-PCR. These tests were performed on 80 COVID-19 RT-PCR positive respiratory samples and 20 RT-PCR negative control samples. BIOCREDIT COVID-19 Ag and SD Biosensor RAD kits recorded total sensitivities of 52.5% and 68.7% and specificities of 46% and 96%, respectively. In high viral load samples, BIOCREDIT COVID-19 Ag and SD Biosensor RAD kits recorded higher sensitivities of 60% and 77%, compared to 45% and 60% in normal viral load samples, respectively. Sensitivity and specificity of the 2 antigen kits varied significantly with P values of <0.000001 and 0.0135, respectively. The evaluated RAD tests presented promising performance which was relatively better for SD-Biosensor than BIOCREDIT RAD tests, especially in high viral load samples. However, antigen tests are still considered substandard in comparison with RT-PCR in detecting SARS-CoV-2.

Background:The emergence and spread of antimicrobial-resistant bacterial isolates is of great concern, especially to commonly used antimicrobials as Quinolones. Aim of the Study: Estimation of the prevalence of quinolone-resistant P. aeruginosa and A. baumannii in various clinical specimens, detection and characterization of the pattern of plasmidmediated quinolone resistance genes present. Materials and Methods: Bacterial identification of P. aeruginosa (92) and A. baumannii (69) strains was performed using standard laboratory methods. Antimicrobial susceptibility to other antibiotic Original Research Article

Background: Rapid antigen detection tests for SARS-CoV-2 infection could promote the clinical and public health policies to handle the COVID-19 pandemic. Rapid antigen detection and molecular approaches could expand entry to checking and initial evidence of issues and playing an essential role in public health managing choices that may decrease the transmission. Objectives: We evaluated the diagnostic accurateness of couple of rapid antigen recognition tests equated with the molecular-based assays for verdict of SARS-CoV-2 infection. Methods: The 100 nasopharyngeal swabs were verified by the SARS-CoV-2 RT-PCR kit as a gold standard for COVID-19 recognition. SARS-CoV-2 antigen (Ag) was evaluated in the nasopharyngeal swabs using iFlash and UNICELL-2019-nCoV antigen methods. The iFlash-2019-nCoV antigen assay, which is a chemiluminescent immunoassay (CLIA), was used to qualitatively determine the nucleocapsid protein antigen, where the other one was used to identify the nucleocapsid protein antigen by lateral flow immunofluorescent test. Results: Out of the 100 samples, 62% were positive by RT-PCR. Amongst 62 confirmed COVID-19 cases, 43 (69.4%) were positive by iFlash and 40 samples (64.5%) were positive by the UNICELL-2019-nCoV antigen assay. The specificity of both I Flash-2019-nCoV antigen assay & UNICELL-2019-nCoV antigen assay with RT-PCR were 100% and sensitivity were 69.35 and 64.52%, respectively. This sensitivity was augmented to 100% compared with the PCR with Ct-value of ≤25 and specificity of 80.28 and 84.51%, respectively. Conclusion: Antigen detection rapid diagnostic tests may be motivating in the initial stage of the infection when the viral load is elevated, and the risk of SARS-CoV-2 transmission be high.

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Background: COVID-19 is a pandemic of serious global threat that forced test developers to flood the market with various diagnostic assays that have been independently validated. Objectives: This study aims at assessing the performance of four SARS-CoV-2 chemiluminescence immunoassays. Methodology: The present study included sera from 96 Polymerase Chain Reaction (PCR)–confirmed COVID-19 cases collected at 2 time periods (5-9 days and 9-14 days post symptom onset) during patient follow-up, and 30 control sera from COVID-19 PCR–negative individuals. All sera were tested for SARS-CoV-2 antibodies using four high-throughput commercially available chemiluminescence immunoassays: YHLO Biotech Co, Ltd China (IgM and IgG); Abbott, Abbott USA (IgG); Roche, Roche US (total: IgM, IgG, and IgA), and Ortho, Ortho Clinical Diagnostics, USA (total and individual IgG). Results: For the detection of total antibodies (IgM, IgG, and IgA), the highest sensitivities were for Ortho followed by Roche assays (91.6% and 84.3% in 5-9 days period, respectively) raised to 96.8% and 92.7% in 9-14 days respectively with significant difference P-value <0.00001. Ortho, Roche, and YHLO iFlash (IgM) assays had specificities of 100%, 100%, and 90.3% respectively. Roche (Total) and Ortho (Total) assays showed perfect categorical agreement (94.4% in 5-9 days, and 96.4% in 9-14 days). As for the detection of individual IgG antibodies, the Abbott assay had the highest sensitivity (91.6% in 5-9 days, and 93.7% in 9-14 days), followed by Ortho and YHLO iFlash assays (84.3%, and 83.3% in 5-9 days respectively) that increased to 89.5% and 88.5% in 9-14 days respectively. Ortho assay was the best in specificity (100%), followed by Abbott (98.8%) and YHLO iFlash (96.3%). YHLO iflash (IgG) and Ortho (IgG) showed perfect agreement (96.8%) in the 2 time frames. Conclusion: Ortho assay showed the best performance in detecting total antibodies with perfect match to Roche assay, while Abott assay was the best performing in detecting individual IgG with perfect match to Ortho assay rendering them to be efficient diagnostic tools

Background Surgical site infection (SSI) is a post-operative complication of high concern with adverse impact on patient prognosis and public health systems. Recently, SSI pathogens have experienced a change in microbial profile with increasing reports of non-tuberculous mycobacteria (NTM) as important pathogens. Aim of the study The study aimed to detect the prevalence of NTM among cases with SSIs and describe their species using matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS) and PCR-based microarray. Methods The study was conducted with 192 pus samples collected from patients with SSI. Mycobacterial investigations were done in the form of Ziehl–Neelsen (ZN) smears for acid-fast bacilli, automated mycobacterial culture to isolate mycobacteria, followed by immunochromatography test to predict NTM. NTM-positive cultures were tested by MALDI -TOF MS and PCR-based microarray to reach species-level identification. Results Mycobacterial growth was found in 11/192 samples (5.7%) and identified as 4 NTM and 7 M. tuberculosis isolates with prevalence of 2.1% and 3.64%, respectively. The NTM species were described by MALDI-TOF as M. abscessus, M. porcinum, M. bacteremicum, and M. gordonae. Microarray agreed with MALDI-TOF in identifying one isolate (M. abscessus), while two isolates were classified as belonging to broad groups and one isolate failed to be identified. Conclusions The prevalence of NTM among SSI was found to be low, yet have to be considered in the diagnosis of mycobacteria. Employing advanced technologies in diagnosis is recommended to guide for appropriate treatment.