CHROMagar Plates Research Articles

Study of the prevalence of Salmonella Arizonae infection in backyard and commercial turkey flocks in Golestan, Mazandaran, Gilan, and Tehran provinces

Arizona infection or avian arizonosis (AA) is an acute or chronic egg-transmitted disease of primarily young turkey poults characterized by septicemia, neurological signs, blindness, and increased mortality, caused by caused by the bacterium Salmonella enterica subsp. Arizonae (S. Arizonae ). This study investigated the infection rate of Salmonella Arizonae in backyard and commercial turkeys of Golestan, Mazandaran, Gilan, and Tehran provinces. Fecal samples taken from industrial and backyard turkeys were transferred to cysteine selenite enrichment medium, incubated at 37° C for 24 hours, and then cultured linearly in selected media of Chromagar, Salmonella-Shigela, XLD, and McConkey agar plates and exposed to 37° C for 24 hours. Suspected Salmonella colonies were cultured in differentiated TSI and urea medium for confirmation and incubated at 37° C for 24 h. In this study, the microbial culture method was used by pre-enrichment, specific, and differential media to determine the level of contamination of backyard and industrial turkey flocks in four provinces of Golestan, Mazandaran, Gilan, and Tehran. All samples were tested for Salmonella infection, but positive samples were not found for Salmonella. Only 22 specimens were infected with Proteus. Our information about the Iranian turkey industry is limited compared to worldwide studies. This may be due to Iran's less widespread use of turkey production. The non-isolation of Salmonella in this study is inconsistent with some of the few studies in the country, which may be due to differences in the type of sampling, geographical location, and materials and methods of work. Due to the growth of the turkey industry in the country, the importance of studying Salmonella and other pathogens is felt more than ever.

Irrigation Ponds as Sources of Antimicrobial-Resistant Bacteria in Agricultural Areas with Intensive Use of Poultry Litter.

Poultry litter is widely used worldwide as an organic fertilizer in agriculture. However, poultry litter may contain high concentrations of antibiotics and/or antimicrobial-resistant bacteria (ARB), which can be mobilized through soil erosion to water bodies, contributing to the spread of antimicrobial resistance genes (ARGs) in the environment. To better comprehend this kind of mobilization, the bacterial communities of four ponds used for irrigation in agricultural and poultry production areas were determined in two periods of the year: at the beginning (low volume of rainfall) and at the end of the rainy season (high volume of rainfall). 16S rRNA gene sequencing revealed not only significantly different bacterial community structures and compositions among the four ponds but also between the samplings. When the DNA obtained from the water samples was PCR amplified using primers for ARGs, those encoding integrases (intI1) and resistance to sulfonamides (sul1 and sul2) and β-lactams (blaGES, blaTEM and blaSHV) were detected in three ponds. Moreover, bacterial strains were isolated from CHROMagar plates supplemented with sulfamethoxazole, ceftriaxone or ciprofloxacin and identified as belonging to clinically important Enterobacteriaceae. The results presented here indicate a potential risk of spreading ARB through water resources in agricultural areas with extensive fertilization with poultry litter.

In vitro Azole antifungals susceptibility of Candida spp. isolates from HIV-infected patients with periodontitis.

The objective of the present study was to determine the in vitro Azole antifungals susceptibility of Candida spp. strains isolated from HIV-positive patients with periodontitis. Oral examination was performed in 500 HIV-positive patients, of which 228 were included in the study for having periodontitis which and separated in two groups based on their TCD4+ T-cells: (A) n=110 (≤200 CD4+); (B) n=118 (>200 CD4+). Candida spp. were isolated from the subgingival biofilm and crevicular fluid by seeding on CHROMagar plates and confirmed by endpoint PCR and MALDI-TOF. The susceptibility test in vitro for five antifungals was performed using the disc diffusion method. From the 228 HIV-positive patients with periodontitis, 174 were positive to Candida spp., and 204 isolations were obtained. 138 (67.64%) were C. albicans, and 66 (32.35%) were Candida non-albicans species. The most frequent Candida non-albicans species in order of frequency were C. glabrata with 48 (23.52%), C. tropicalis with 10 (4.9%), C. krusei with 7 (3.43%), and C. dubliniensis with 1 (0.49%). All species presented resistance to any antifungal: 149 to 5-fluorocytosine (73.0%), 149 to fluconazole (73.0%), and 144 to voriconazole (70.7%). Miconazole and econazole presented the highest susceptibility rates with 129 (63.2%) and 130 (63.7%) isolations, respectively. The Candida spp. involved in periodontitis of HIV-positive patients have a multi-resistant feature. It is necessary to implement recurrent research regarding the antifungal resistance of the Candida spp. that take part in periodontitis pathogenesis to promote an effective treatment in HIV patients.

Novel insights into pivotal risk factors for rectal carriage of extended-spectrum-β-lactamase-producing enterobacterales within the general population in Lower Saxony, Germany.

To estimate the prevalence of extended-spectrum-β-lactamase (ESBL)-producing enterobacterales (ESBL-E) carriage in the general population of Lower Saxony, Germany, and to identify risk factors for being colonized. Participants were recruited through local press and information events. Detection of ESBL-E by culture was conducted using ESBL-selective chromagar plates containing third-generation cephalosporins. Identification of pathogens was performed using matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF)_technology on Vitek mass spectrometry. Antibiotic susceptibility testing was conducted by microdilution (Vitek II) and an ESBL confirmation assay was carried out using a combination disk test. Of 527 randomly collected stool samples from healthy volunteers, 5.5% were tested positive for ESBL-E. Post-stratification for age and gender yielded a similar population estimate (5.9%). People traveling abroad and taking antibiotics had the greatest rectal ESBL-E carriage. Potential risk factors (eg, working in healthcare facilities, recent inpatient stay) did not attribute to rectal ESBL-E carriage as other factors (eg, travelling, taking antibiotics). Rectal ESBL-E carriage within the general population seems to be high. The known risk factors for carriage with MDRO might not be fully applicable to ESBL-E and require further examination in order to develop effective strategies for the prevention of ESBL-E dissemination within the general population.

Isolation and identification of Candida spp. from immunocompromised patients

BackgroundCandida species is considered one of the normal inhabitant commensal microbiota of the human body. However, it can also act as an opportunistic pathogen especially in hospitals (nosocomial infection) and among immunocompromised patients. The accurate, precise, rapid and reliable identification of Candida to the species level is of great importance for control and management of candidiasis.ResultsOne hundred and eighteen different samples were collected (59 urine samples, 39 oral swabs, 5 vaginal swabs and 15 skin swabs) from immunocompromised patients (diabetics—pregnant women—patients underwent organ transplantation—cancer patients—burned and wounded patients) for probable existence of Candida species. Eighty-six out of 118 (72.8%) samples were typed macroscopically and microscopically and found to be Candida species. Upon streaking 86 Candida isolates on CHROMagar plates separately, 48 isolates gave green colonies, 25 isolates gave rose colonies, 10 isolates gave white colonies, 2 isolates gave pale coloured colonies and 1 isolate gave blue colonies. Forty-eight out of 86 isolates showed positive Germ tube test. API 20C assay was performed on some isolates with different coloured colonies, the results were similar to those of CHROMagar. Upon performing PCR assay on 14 isolates using ITS1 and ITS4 primers, 8 out of 14 PCR product bands appeared between 510 and 535 bp and this was difficult to differentiate among them (C. albicans, C. tropicalis, C. krusei and C. parapsilosis). Five out of 14 PCR products were found at 871 bp (C. glabrata) and the last one is negative control with no band appeared. Further molecular studies should be recommended to fully differentiate among Candida species especially those with very close bands. Antifungal activity (expressed by inhibitory zone) of zinc oxide nanoparticles in comparison with some commercially available antifungals (nystatin and Voriconazole) was carried upon the obtained Candida isolates. Zinc oxide nanoparticles with 100 μg/disc showed 9, 26, 40, 42 mm inhibitory zones for C. tropicalis, C. glabrata, C. albicans and C. parapsilosis, respectively. However, zinc oxide only showed no antifungal activity against C. krusei.ConclusionsA sheet of identification profile for Candida should include morphotyping, biotyping and genotyping to reach a rapid, reliable and accurate diagnosis. Candida species causes a myriad of infections causing non-invasive, mucocutaneous infections and severe systemic and deep-seated disease. Repress of Candida growth by ZnONPs provides an insight towards their therapeutic application for the prevention of Candida-associated infections. Further studies on the antifungal effect of nanoparticles combined with commercially available antifungal medicines maybe recommended.

Transmission of Acinetobacter baumannii by Surgical Masks During the COVID-19 Pandemic

Background:Acinetobacter baumannii, one of the major causes of nosocomial infections in modern healthcare systems, is characterized by its great persistence in the environment and by its ability to rapidly develop resistance to many antimicrobials. Most A. baumannii infections occur in intubated critically ill patients, causing ventilator-associated pneumonia which is a leading cause of mortality. During the coronavirus disease 19 (COVID-19) pandemic an increase in hospital-acquired carbapenem-resistant A. baumannii (CRAB) infection and colonization in acute-care hospitals has been described. CRAB healthcare-associated infections are often linked to breaches of infection prevention and control (IPC). Beginning in April 2020, our hospital’s IPC unit ordered mandatory universal masking for all healthcare workers (HCWs). Shortages of personal protective equipment during the COVID-19 pandemic led to extended use of surgical face masks by HCWs in our hospital. We investigated whether the extended use of surgical face masks was linked to an increase of CRAB colonization in our intubated critically ill patients. Methods: Surgical masks were collected from doctors, nurses, and housekeeping staff working in 2 internal medicine departments, each including a 4-bed unit for intubated critically ill patients. All surgical masks were worn continuously for 4–5 hours before removal. “Cases“ were defined as HCWs who treated CRAB colonized critically ill patients. “Controls“ were defined as HCWs who did not enter the critically ill patient unit. Surgical masks were incubated with BHI enrichment broth (HyLabs Rehovot, Israel) for 48 hours at 35°C. BHI was seeded on multidrug-resistant (MDR)–selective CHROMagar plates (HyLabs) and incubated overnight at 35°C. Identification was performed using MALDI-ToF mass spectrophotometry (bioMérieux, France). Susceptibility was tested using Vitek 2 (bioMérieux). Results: In total, 55 HCWs participated in the study: 25 cases and 30 controls. Masks from 10 cases (40%) were colonized with Acinetobacter spp versus only 3 masks (10%) from controls (OR, 5.98; 95% CI, 1.42–25; P = .012). Of 13 masks contaminated with Acinetobacter spp, 8 of 10 contaminated masks among cases were colonized with CRAB, whereas only 1 of 3 masks of controls was colonized with CRAB. Conclusions: During the COVID-19 pandemic, extended surgical mask use while treating patients colonized with CRAB increased mask contamination with this bacterium. Surgical masks should be changed after treating a patient colonized with CRAB the same way gown and glove removal and hand hygiene are performed.Funding: NoDisclosures: None

A Comparison of the Prevalence Rate of Oral Candida Colonization between Opium Users and Cigarette Smokers in Kerman, Iran.

BackgroundCandidiasis is the most common opportunistic oral infection and smoking is considered as one of its well-known risk factors. However, it remains unknown whether opium users are susceptible to increased oral candida colonization. The aim of the present study is to compare the prevalence rate of oral candida colonization between opium users and cigarette smokers in Kerman, Iran.MethodsThis case-control study included 75 healthy male respondents divided into three groups (25 in each group): cigarette smokers, cigarette and opium users, and non-smokers as control group. The samples were obtained from oral mucosa by scraping the mucosa with a sterile cotton swab then inoculated into Sabouraud Dextrose Agar (SDA) and CHROMagar plates and also examined with the light microscope.FindingsCandida was identified in 38.70% of respondents. The most frequently isolated species was Candida albicans (90.66%). The highest prevalence of candida carriage was found in cigarette smokers (52.00%). The difference of candida carriage between the two groups of cigarette smokers and cigarette plus opium users and the control group was statistically significant (P = 0.007 and P = 0.015, respectively).ConclusionIn the present study, it was revealed that the prevalence of oral candida carriage was significantly higher among cigarette and opium users in comparison to the non-users.

Comparison of proteins expressed during urinary tract infection in young females

Introduction: Gram-negative bacteria are a major cause of urinary tract infections (UTIs) and particularly Klebsiella pneumoniae (K. pneumoniae), which is a causative agent of 60-70% of community-acquired infections, about 30% of nosocomial UTIs and 20% of recurrent infections. Materials and methods: Nine urine samples were collected from patients from various clinical departments in King Abdulaziz University Hospital from 2/3/2019 to 2/4/2019. The microbial contents in the urine samples was analysed by urine culture and VITEK analyses. Here, we compared K. pneumoniae proteins profiles to find possible proteins which could shed a light on host-pathogen interactions. The colonies were suspended in a lysing buffer, which then were sonicated, and the proteins contents were separated using 1D SDS-PAGE, analyzed using liquid chromatography-mass spectrometry LC/MS. Proteins showing different expressions in samples were identified by TripleTOF 5600 mass spectrometer. Results: All of the Klebsiella pneumoniae isolates were ESBL+ and KPC+ as shown on ChromAgar plates. There was no available data on resistance, ESBL or KPC from VITEK2. Hence, ESBL+ or KPC+ data were only obtained from ChromAgar. Additionally, proteomics analysis revealed the following, the total number of different proteins that are expressed from all of the isolates is 2958 proteins. Where in sample U-102, 328 different proteins expressed, 300 different proteins expressed from isolate U-871, 350 different proteins expressed from isolate U-713, in isolate U-755, 378 different proteins were expressed, 207 different proteins expressed from isolate U-754, 305 different proteins expressed from sample U-134, 290 different proteins expressed from isolate U-968, 600 different proteins expressed from isolate U-104, and 200 different proteins expressed from isolate U-659. Conclusion: The different proteins between the UTI patients indicated specific host pathogen interaction, each isolate expressed different proteins than the other isolate could be reasoned by host pathogen interaction. Host pathogen interaction are influenced by numbers of factor: age, gender, immunity, underling health conditions, antibiotic treatment, acute UTI or recurrent infection all of these factor could have an impact on the type of proteins that are expressed during infection. Even though the isolates are Klebsiella pneumoniae from young females with UTI, they expressed different proteins, these proteins could explain evolutionary development of pathogens and survival in urinary niche, as pathogens need to express certain type of proteins to enable them to live and survival in urinary niche.

Characterization of Fecal Shiga Toxin-Producing Escherichia coli from Post-Weaning Cattle

ObjectivesShiga toxin-producing E. coli (STEC), which are often found in the intestinal tract of cattle and in their fecal matter, are among the most common foodborne pathogens of concern in beef production. Contamination from the fecal matter, both directly and indirectly, during harvest may compromise the safety of the beef products, which can have devastating impact on consumers and producers alike. While the microbial load present in cattle fecal matter may change as the cow matures, previous research has generally focused on analysis of the pathogen load late in the life cycle of cattle. There is merit in the analysis of this load earlier in the life cycle of cattle, as this may serve to subsequently control the pathogen load during later stages of production. As such, this study aims to assess the prevalence and characteristics of STEC in beef cattle production at the early post-weaning stage.Materials and MethodsRectal fecal samples from post-weaning cattle (n = 68) were collected. Ten grams of each sample was mixed and manually homogenized with 90mL tryptic soy broth (TSB) with added phosphates. The homogenized samples were spread-plated on CHROMagar STEC plates and incubated at 35°C for 24h before enumeration. To determine STEC prevalence, the homogenized samples were incubated at 42°C for 6 h, and streaked onto a second set of CHROMagar STEC plates, which were incubated at 35°C for 24h. Colonies with a purple coloration were STEC-positive. Two random STEC-presumptive colonies from each sample were tested via subsequent PCR amplification and gel electrophoresis to confirm the presence of stx1, stx2, and/or eae genes.Acid-resistant strains of presumptive STEC colonies from the enriched samples were collected and inoculated into TSB for recovery. One hundred microliters of the inoculated sample were then transferred into TSB without dextrose and incubated at 35°C for 24h, and finally challenged in acidified TSB without dextrose (pH = 3.50) for 1h and 6h. One hundred microliters of each survival sample were plated onto tryptic soy agar (TSA), and incubated at 35°C for 48h.ResultsThe fecal samples had an average 4.79 ± 1.24 log CFU/g (ranging 2.30 to 6.83) of STEC colonies. All samples were STEC-positive, as all samples had at least one of the three genes tested for (stx1, stx2, eae). All sixty-eight samples were confirmed positive for gene stx1, 12% (8 of 68) samples were confirmed positive for stx2, 62% (42 of 68) of samples were confirmed positive for eae, and 12% (8 of 68) were positive for all three genes. Of 67 samples tested for acid resistance, 34% (23 of 67) survived after 6 h in acidified growth media (pH = 3.50).ConclusionThis study provided preliminary data on the pathogen load of early post-weaning cattle. The prevalence of acid resistance shown may be a possible cause of concern, as these surviving bacteria can survive high acidic conditions. This may expedite the spread of acid-resistant pathogens within the food supply chain as acidic antimicrobial chemicals become ineffective in reducing pathogen populations. These results may be used as a baseline for future research regarding STEC prevalence or acid resistance aimed at reducing pathogen load in beef cattle production. Given the prevalence of acid resistance, further development is recommended for non-acid post-harvest antimicrobial interventions to reduce the presence of acid resistant STEC.

2129. When Is Methicillin-resistant Staphylococcus aureus not Methicillin-resistant Staphylococcus aureus?

BackgroundAs part of active surveillance in our NICU for methicillin-resistant Staphylococcus aureus (MRSA), two isolates representing modified S. aureus (MODSA), which are Methicillin resistant but lacking mecA or C were identified. Our current microbiology laboratory workflow for screening for MRSA involves plating isolates on chromoID agar (bioMérieux, Marcy-l’Etoile, France) as well as on sheep blood agar (SBA). Β hemolytic colonies on SBA that are catalase and coagulase positive are set up for confirmation and antimicrobial susceptibility testing on the Vitek 2 (bioMérieux, Marcy-l’Etoile, France).MethodsThese 2 isolates (from Baby 1 and Baby 2) tested positive for green colonies on the chromoagar plates. The Vitek 2 subsequently identified both these isolates as MRSA. However, for research purposes, all positive NICU MRSA isolates are tested via whole-genome sequencing (WGS). Both isolates were identified by WGS as methicillin-susceptible Staphylococcus aureus (MSSA). We subsequently went back and performed additional workup on these isolates. Isolates were plated on SBA and chromagar again and incubated for 24 hours. 2 colonies of different morphologies from the chromagar plates and 3 from the SBA were randomly selected and subcultured to chromagar and SBA for a total of 5 subcultures. Each of the subcultures was tested using staphaurex, mannitol salt agar and the Cepheid Xpert MRSA assay and all were confirmed to be Staphylococcus aureus.ResultsAll 10 isolates tested negative by the Cepheid Xpert MRSA assay for MRSA. Phenotypic testing was set up again for all ten isolates using the vitek GP panel, as well as cefoxitin disk, and oxacillin E test using Mueller–Hinton agar supplemented with 2% NaCl as per CLSI methods. See table attached for results.ConclusionIn conclusion, these two cases highlight the difficulty in identifying non-MecA, non-MecC-mediated MRSA isolates in the clinical microbiology laboratory. This is particularly important as more laboratories rely on testing for MecA by PCR for surveillance testing. These 2 cases were further complicated by heterogeneous sub-populations of Staphylococcus aureus. Failure to recognize these variant forms of MRSA can lead to difficulties in implementing appropriate therapy and infection control measures. Improved methodologies are needed. Disclosures All authors: No reported disclosures.

A Vibrio owensii strain as the causative agent of AHPND in cultured shrimp, Litopenaeus vannamei

The causative agent of shrimp AHPND was identified as specific Vibrio parahaemolyticus strains, which harbor a virulent plasmid that contains the toxic genes pirA and B (pirAB). Herein, a Vibrio bacterium was isolated from shrimp in Shanghai. This bacterium was identified as Vibrio owensii using 16S rRNA gene phylogeny, whole genome sequencing and comparative analysis. The V. owensii cells are rod-shape (1.86 ± 0.15 µm) with a single polar flagellum (4 µm). In addition, V. owensii form mauve colonies with jagged edges on CHROMagar plates. The pirAB genes on the plasmid revealed 100% sequence similarity to that of AHPND V. parahaemolyticus, and the encoded proteins were detected in the culture media. Subculture of V. owensii showed that the pirAB genes are unstable, and their loss rate is approximately 22% and reaches a dynamic equilibrium after the fifth generation. Upon immersion bioassay, the cumulative mortality of V. owensii (pirAB+)-infected shrimp was up to 100% within 4 days, and typical AHPND clinical signs were observed. Approximately 105 CFU/hepatopancreas of V. owensii cells were observed in the pirAB+-infected shrimp based on both culture-dependent and -independent assay. Our results indicate that the expression of pirAB in the V. owensii strain is responsible for AHPND.

Occurrence and characteristics of extended-spectrum β-lactamase- and carbapenemase- producing bacteria from hospital effluents in Singapore

One of the most important resistance mechanisms in Gram-negative bacteria today is the production of enzymes causing resistance to cephalosporin and carbapenem antibiotics. The spread of extended-spectrum β-lactamases (ESBL)- and carbapenemase- producing Gram-negative bacteria is an emerging global public health problem. The aim of the present study was to (i) assess the prevalence of carbapenem-resistant bacteria (CRB) and ESBL-producing strains in sewage effluents from two major hospitals in Singapore, (ii) characterize the isolated strains and (iii) identify some of the ESBL and carbapenemase genes responsible for the resistance. CHROMagar ESBL and KPC plates were used to rapidly screen for ESBL-producing bacteria and those expressing reduced susceptibility to carbapenems, respectively. The abundance of ESBL-producers and CRB in hospital wastewater ranged between 103 and 106CFU/mL. Out of the 66 isolates picked from ESBL and KPC plates, 95%, 82%, 82% and 76% were resistant to ceftriaxone, ceftazidime (3rd generation cephalosporin family), ertapenem and meropenem (carbapenem family), respectively. Among the resistant isolates, the most predominant taxa identified were Pseudomonas spp. (28.2%), Klebsiella spp. (28.2%), Enterobacter spp. (18.3%) and Citrobacter spp. (11.3%). PCR and sequencing analysis showed that the predominant β-lactamase genes were blaSHV (41.1%) followed by blaNDM-1 (35.6%), blaCTX (35.6%) and blaKPC (28.8%). The results of this study show a high prevalence of bacteria resistant to modern extended-spectrum cephalosporins and carbapenems and the presence of ESBL- and carbapenemase producers in hospital effluents. These findings support the need to improve management of hospital wastewater in order to minimize the spread of antimicrobial resistant microorganisms from this source.

Isolation and Speciation of Candida in Type II Diabetic Patients using CHROM Agar: A Microbial Study.

Newer Candida species are now becoming increasingly predominant commensal in the oral cavity. Aim of the study was to identify and compare different Candida species in the oral cavity of Type II diabetic individuals. The present microbial study was carried out for the duration of three months. Sixty participants were included in the study and divided into two groups of 30 individual each. Group I consisted of patients with Type II diabetes while Group II consisted of healthy individuals without diabetes or any other systemic disease. A total of 3 ml of unstimulated whole saliva was collected from them and centrifuged at 5000 rpm for fives minutes. This pellet was plated onto CHROM agar medium plates and incubated at 37°C for at least 3-4 days. CHROM agar plates were visualized daily at 24 hours, 72 hours and followed up to seven days to check for growth. Candida speciation was done by counting the different coloured creamy colonies. Comparison of Candida spp. between two groups was done by applying the Student's t-test. A p-value<0.05 was considered as statistically significant. All the species of Candida, namely, Candida albicans, Candida glabrata, Candida dubliniensis, Candida krusei, Candida parapsilosis except for Candida tropicalis showed a significantly higher (p<0.001) occurrence in the diabetic group compared to the healthy group. The highest identified species is C. parapsilosis, second being C. albicans in both the groups. C. parapsilosis is now considered as one of the significant causes of Candida infection in the oral cavity. This increased virulence will affect the global burden of Candidiasis as few treatment options are available for this new pathogen.

The Epidemiology of Candida Species Isolated From Urinary Tract Infections

Background: Candida spp. are members of a genus, including closely related fungal species that cause a variety of infections. Objectives: The aim of this study was the isolation of various Candida species from vulvovaginitis and urethra of patients in Neyshabur, Northeast Iran from 2013 to 2015. Methods: This descriptive-analytical and cross-sectional study was performed to identify Candida spp. causing vulvovaginitis and Urinary Tract Infection (UTI) at a referral laboratory in Neyshabur district, Khorasan Razavi Province. A total of 451 vaginal and midstream urine samples were collected. Ten micro-liters of each specimen was cultured on CHROM agar plates and then incubated at 37°C for 24 to 48 hours, aerobically. Candida species were identified based on colony morphology, germ tube production and micro-morphology on corn meal agar including 1% Tween 80. Results: The mean age of the patients was 34.7 ± 16.3. Candida albicans was the predominant species isolated. Moreover, age groups of 21 to 30 and 0 to 1 years were the most and the least infected individuals. Moreover, Candida spp. were significantly more common in females compared to males (P value 103. Conclusions: In this study, C. albicans was the most common species isolated from patients with vulvovaginitis and UTI, and significantly more common amongst females compared to males. The prevalence of candida spp. had significantly declined from 2013 to 2015. Moreover, the candida spp. counts were mostly higher than 103cfu/mL.

Frequency of Candidiasis and Colonization of Candida albicans in Relation to Oral Contraceptive Pills.

BackgroundCandidiasis, the infection caused by Candida albicans, is one of the most common infections of the oral cavity in humans. Candidiasis causes irritation and is known for its carcinogenic effects. Thus, it is important to recognize the predisposing factors for this opportunistic infection. Several previous studies have demonstrated an increased frequency of vaginal candidiasis in relation to oral contraceptive consumption.ObjectivesOnly a few studies on the relation between oral contraceptives and oral candidiasis have been previously conducted. This study aims to evaluate the possible relation between oral contraceptive pills and oral candidiasis.MethodsThis analytic, case-control study included 40 non-pregnant women divided into two groups: 20 who used oral contraceptive pills and 20 who did not. The groups were matched according to age, oral health, and past and present medical history. Samples were collected from the tongue’s dorsum using a cotton swab and inoculated on CHROMagar culture plates. The frequency of positive cultures and the number of Candida colonies were compared between the two groups using independent t-tests and Mann-Whitney statistical tests with SPSS18 software.ResultsThe frequency of positive cultures of Candida albicans was higher (P value = 0.03) for the case group. Also, the number of C. albicans and C. krusei was significantly higher for the case group compared to the control group (P value = 0.04, P value = 0.03).ConclusionsThe results of the present study demonstrate that oral contraceptives containing estradiol can lead to Candida colonization in the oral cavity. It is recommended that further studies comparing the influence of oral contraceptives on Candida’s adherence to the epithelium is highly recommended.

Prevalence and risk factors for Staphylococcus aureus and methicillin-resistant Staphylococcus aureus nasal carriage inpatients in a tertiary care hospital's chest clinic in Turkey.

We aimed to determine the prevalence and associated risk factors for nasal methicillin-sensitive and methicillin-resistant Staphylococcus aureus (MSSA/MRSA) carriage among patients admitted to a chest clinic of a tertiary care hospital in this study. Nasal samples were taken from anterior nares were cultured in CHROMagar S. aureus plates, MRSA was determined by disc diffusion method (cefoxitin 30 μg) according to the Clinical and Laboratory Standards Institute guidelines and CHROMagar MRSA plates. A questionnaire was applied to determine the demographic characteristics of the participants and risk factors for carriage. Fisher's exact test, univariate and multivariate logistic regression analysis were used. A P < 0.05 indicated a statistically significant difference. This is a cross-sectional study covering all the patients (n = 431) admitted to Kayseri Training and Research Hospital's Chest Clinic from January 1st to 31st 2014. Of all these patients 55 (12.8%) were nasal S. aureus carriers. MRSA positivity was in five among these patients. In multivariate analysis, being under 65 years of age (odds ratio [OR], 1.9; 95% confidence interval [CI], 1.0-3.3), and having prosthesis (OR, 4.8; 95% CI, 1.6-13.9) were found as risk factors for MSSA colonization. The prevalence of nasal carriage of MSSA was low in our study population. The only risk factors playing role in carriage were found as being under the age of 65 and having prosthesis.

기포 발생형 타정제의 살균세정 효과

By using effective sanitizers, early block for transmission of pathogens is the effective way to prevent epidermic outbreaks. Here we developed a chlorine oxide bubbling type of sanitizing tablets and evaluated the disinfectant and sanitization effects. The sanitizers showed 99.999% of sanitization effect for Escherichia coli ATCC 10536 and Staphylococcus aureus ATCC 6538 strains for 5 min±10 sec on 20±1℃ in clean condition by dilution-neutralization method. It reduced more than 5 log10 cfu/ml of a legal permission standard of colony reduction. When a few used socks and underwear soaked for one hour in the 0.1% of the sanitizing tablets, no microorganisms were grown on CHROMagar plates. However, on CHROMagar plates of the no sanitizing tablets treated control, about 6.5×104 cfu/ml of Staphylococcus sp., Klebsiella sp. and Enterococus sp. were grown. Furthermore, the sanitizing tablets killed approximately 1.5x108 cfu/ml of E. coli BL21 in 5 minutes. Therefore, we concluded that the chlorine based bubbling type of sanitizing tablets satisfied the legal standard for the regulation of food and drug safety for disinfectants and sanitizers to pathogens and daily supplies.

Changing Trends of Vulvovaginal Candidiasis

Introduction:Vulvovaginal candidiasis is one of the most common infections seen in women.Materials and Methods:A total of 300 symptomatic women were studied. High vaginal swabs collected from each patient were processed by Gram stain, culture on Sabourauds dextrose agar and CHROM agar plates. Isolates were identified and speciated using conventional methods and by the color of the colonies on the CHROM agar. Antifungal susceptibility was performed by disc diffusion method for fluconazole (25 μg) and voriconazole (1 μg) discs as per Clinical and Laboratory Standards Institute (CLSI) guidelines.Results:Vulvovaginal candidiasis was found in 53 (17.7%) of cases. Gram stain was positive in 22 (41.41%) of culture positives. Speciation of isolates by conventional and CHROM agar methods showed similar results. C. albicans 35 (66.0%) was the most common species isolated followed by C. tropicalis 14 (26.4%), C. krusei 2 (3.8%), C. parapsilosis and C. glabrata in 1 (1.9%) case each. Sensitivity to fluconazole was found in 91.4% of C. albicans, 57.1% of C. tropicalis and 50.0% of C. krusei. Sensitivity to voriconazole was seen in 91.4% of C. albicans, 85.7% of C. tropicalis and 50.0% of C. krusei. C. parapsilosis and C. glabrata were found sensitive only to voriconazole.Conclusion:CHROM agar has the advantage of being rapid, simple and cost effective method as compared to conventional methods in speciation of Candida. Routine susceptibility testing of Candida isolates help in selecting the most appropriate antifungal agent for vulvovaginal candidiasis.

SALIVARY PROFILE AND IDENTIFICATION OF EXISTING CANDIDA sp OF AN INSTITUTIONALIZED ELDERLY POPULATION IN JAKARTA

Saliva plays an important role to protect oral and dental health, in maintenance oral microflora balance. In elderly, disease, and medications usually influence the saliva. The purpose of this preliminary study was to investigate salivary profile, oral symptoms of dryness, and existing of Candida sp of an institutionalized elderly in Jakarta, Twenty seven (27) elderly (17 men and 10 women) were examined in a cross sectional study. Unstimulated whole saliva was collected for 5 minutes, according to published protocol, and then salivary flow rate and pH were measured. Candida sp were cultured in CHROM agar. The yeasts were counted and identified. Oral symptom or complaints of oral dryness, and burning or itching were recorded with an interview. Data of systemic conditions and medication the used were obtained from the medical record. Eighteen (66.7%) CHROM agar plates were Candida sp positive cultured, and about 61.1% subjects’ salivary pH were below normal range. Twenty one (77.8%) subjects had oral symptom and complain about oral dryness, even thought the salivary flow rate were in normal range. In this study, C.albicans is not the most frequently found colonized. About 72% were identified not C.albicans. This study suggests that, in elderly which salivary pH was below normal range have greater opportunistic infected by Candida sp. It can be concluded that, the result did not confirm a significant difference between subjects’ data and salivary profile concentration. The mycological finding Candida albicans is not the most frequently found colonized in this elderly population. Further study which lagger elderly population and might give deeper insights of salivary profile in this population.

Frequent detection of 'azole' resistant Candida species among late presenting AIDS patients in northwest Ethiopia.

BackgroundThe chronic use of antifungal agents in the treatment of fungal infection in general and oropharyngeal candidiasis mainly in AIDS patient’s leads to the selection of strain resistant to these therapies and a shift in the spectrum of Candida species. This study determines the species diversity and in vitro susceptibility of Candida isolates from late presenting AIDS patients in northwest Ethiopia.MethodsTwo hundred and twenty one HIV/AIDS patients were assessed with a standardized evaluation form at enrolment. Oral rinses were cultured on CHROMagar plates at 37°C for 48 hours and Candida species identification were made following standard microbiological techniques. In vitro drug susceptibility tests were made using broth microdilution method.ResultsThe colonization rate of Candida species was found to be 82.3% (177/215). C. albicans was the predominant species isolated from 139 (81%) patients but there was a diversity of other species. C. glabrata was the most frequent non-albicans species isolated in 22.5% (40/177) of the patients followed by C. tropicalis 14.1% (27/177), C. krusei 5.6% (10) and other unidentifiable Candida species 4% (7/177). Recurrent episodes of oropharyngeal candidiasis and previous exposure to antifungal drugs were found to be predisposing factors for colonization by non-albicans species. Irrespective of the Candida species identified 12.2% (11/90), 7.7% (7/90) and 4.7% (4) of the isolates were resistant to fluconazole, ketoconazole and itraconazole, respectively. In contrast, resistance to micafungin, amphotericin B and 5-Fluorocytosine was infrequent.ConclusionHIV/AIDS patients are orally colonized by single or multiple albicans and non- albicans Candida species that are frequently resistant to azoles and occasionally to amphotericin B, 5-Fluorocytosine and micafungin. These highlight the need for national surveillance for examining Candida epidemiology and resistance to antifungal drugs.