Common Fungal Isolates Research Articles

MICROBIOLOGICAL ASPECT OF FUNGAL RHINOSINUSITIS: STUDY CONDUCTED IN TERTIARY CARE HOSPITAL OF NORTH INDIA.

Introduction: Fungal rhinosinusitis is the emerging disease of current era, so isolation of fungus is important aspect to plan the treatment modalities accordingly.
 Methods: 50 samples of suspected patients of fungal rhinosinusitis were studied. Various samples like nasal secretion, nasal lavage and tissue were examined on direct microscopy using KOH and processed by standard protocols for fungal culture.
 Result: Out of 50 suspected cases fungal rhinosinusitis was seen in 23 (46%) cases. The 40% of cases were positive by direct microscopy using 20%KOH and 46% were positive by fungal culture. The most common fungal isolates was Aspergillus flavus (65.5%) followed by Aspergillus niger (13%).
 Conclusion: Aspergillus spp. was the most common isolated species among all the cases of fungal rhinosinusitis.
 Keywords: Aspergillus spp., Fungal, Rhinosinusitis.

Colletotrichum species associated with mango in southern China

Mango (Mangifera indica L.) is an economically significant fruit crop in provinces of southern China including Hainan, Yunnan, Sichuan, Guizhou, Guangdong and Fujian. The objective of this study was to examine the diversity of Colletotrichum species infecting mango cultivars in major growing areas in China, using morphological and molecular techniques together with pathogenicity tests on detached leaves and fruits. Over 200 Colletotrichum isolates were obtained across all mango orchards investigated, and 128 of them were selected for sequencing and analyses of actin (ACT), chitin synthase (CHS-1), glyceraldehyde-3-phosphate dehydrogenase (GAPDH), the internal transcribed spacer (ITS) region, β-tubulin (TUB2) genomic regions. Our results showed that the most common fungal isolates associated with mango in southern China involved 13 species: Colletotrichum asianum, C. cliviicola, C. cordylinicola, C. endophytica, C. fructicola, C. gigasporum, C. gloeosporioides, C. karstii, C. liaoningense, C. musae, C. scovillei, C. siamense and C. tropicale. The dominant species were C. asianum and C. siamense each accounting for 30%, and C. fructicola for 25%. Only C. asianum, C. fructicola, C. scovillei and C. siamense have previously been reported on mango, while the other nine Colletotrichum species listed above were first reports associated with mango in China. From this study, five Colletotrichum species, namely C. cordylinicola, C. endophytica, C. gigasporum, C. liaoningense and C. musae were the first report on mango worldwide. Pathogenicity tests revealed that all 13 species caused symptoms on artificially wounded mango fruit and leaves (cv. Tainong). There was no obvious relationship between aggressiveness and the geographic origin of the isolates. These findings will help in mango disease management and future disease resistance breeding.

Microbial profile of ear discharge in children with chronic suppurative otitis media and the antibiotic susceptibility pattern of bacterial isolates

Microbial profile of ear discharge in children with chronic suppurative otitis media and the antibiotic susceptibility pattern of bacterial isolates - IJMR- Print ISSN No: - 2394-546X Online ISSN No:- 2394-5478 Article DOI No:- 10.18231/j.ijmr.2019.038, Indian Journal of Microbiology Research-Indian J Microbiol Res

Cumulative antimicrobial susceptibility data for a tertiary-level paediatric oncology unit in Johannesburg, South Africa

Background: There is global concern regarding the spread of antimicrobial resistance in bacteria and fungi. Oncology patients are at particular risk of infections with multidrug resistant organisms. These patients require urgent initiation of empiric antimicrobial therapy when presenting with neutropenic fever. Currently, piperacillin-tazobactam and amikacin with or without vancomycin is the treatment of choice in the unit.Aim: The purpose of this study was to develop a cumulative antibiogram for the paediatric oncology unit at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) to guide empiric treatment recommendations for patients presenting with suspected bacterial or fungal infection.Setting: Tertiary-level paediatric oncology unit.Methods: A retrospective observational analysis was performed of bacterial and fungal antimicrobial susceptibility data extracted from the microbiology laboratory information system for clinical specimens submitted from the paediatric oncology unit at CMJAH. Data was analysed for the period January 2015 to May 2018. In addition, analysis and comparison of two 17-month time periods was performed in order to elicit any changes over time.Results: Klebsiella pneumoniae and Escherichia coli were the most common gram-negative organisms isolated. Twenty-one percent of Enterobacteriaceae showed resistance to third generation cephalosporins and 9% to carbapenems. Rates of carbapenem-resistant isolates decreased significantly over time. Adding amikacin to piperacillin-tazobactam significantly increased bacterial coverage. Coagulase-negative staphylococci and Candida parapsilosis were the most common gram-positive and fungal isolates recovered during the study.Conclusion: The results support the continued use of piperacillin-tazobactam and amikacin for paediatric oncology patients presenting with neutropenic fever in this unit. Antibiograms are an important component of antimicrobial stewardship in conjunction with efficient infection prevention and control measures.

Pantoea spp. Associated with Smooth Crabgrass (Digitaria ischaemum) Seed Inhibit Competitor Plant Species.

Digitaria ischaemum (Schreb.) Schreb. ex Muhl. and Poa annua L. are competitive, early successional species which are usually considered weeds in agricultural and turfgrass systems. Bacteria and fungi associated with D. ischaemum and P. annua seed may contribute to their competitiveness by antagonizing competitor forbs, and were studied in axenic culture. Pantoea spp. were the most common bacterial isolate of D. ischaemum seed, while Epicoccum and Curvularia spp. were common fungal isolates. A variety of species were collected from non-surface sterilized P. annua. Certain Pantoea spp. isolates were antagonistic to competitor forbs Taraxacum officinale, Trifolium repens. All bacterial isolates that affected T. officinale mortality were isolated from D. ischaemum seed while none of the P. annua isolates affected mortality. Two selected bacterial isolates identified as Pantoea ananatis were evaluated further on D. ischaemum, T. repens (a competitor forb) and P. annua (a competitor grass) alone and in combination with a Curvularia sp. fungus. These bacteria alone caused >65% T. repens seedling mortality but did not affect P. annua seedling mortality. These experiments demonstrate that Pantoea ananatis associated with D. ischaemum seeds is antagonistic to competitor forbs in axenic culture. The weedy character of D. ischaemum could at least in part stem from the possession of bacteria that are antagonistic to competitor species.

New Remedy to Control Human Skin Fungal Infections by Silver Nanoparticles Biosynthesized by Two Marine Macro Algae.

FROM Dermatology Department of Tanta University Hospitals during 2016, it was observed that cutaneous fungal infections were more common in patients dealing with indoor closed pipe networks as a water source (recorded in 73 cases), sewage disposal by outdoor conservancy (68 cases), of 2-20 years old (38 cases) and house wives (23 cases). The most common fungal isolates among the studied cutaneous infections were Microsporum canis (21 cases), Malassezia furfur (16 cases), Trichophyton rubrum (11 cases), Candida albicans (9 cases), Epidermophyton floccosum (8 cases) and Candida tropicalis (7 cases); that caused Tinea capitis (29 cases), Tinea unguium (23 cases), Tinea versicolor (16 cases) and Tinea corporis (13 cases). The present study reported an eco-friendly biosynthesis of stable silver nano-particles (AgNPs) by two selected marine algal extracts; which gave a great antifungal activity against the most commonly isolated fungi; that was confirmed by their low MIC values, namely MIC for AgNPs of Corallina mediterranea was 0.25mg/ml against Epidermophyton floccosum, while MIC for AgNPs of C. officinalis was 0.5mg/ml against Candida tropicalis and further elucidated by their destructive effects, as observable thinning of cell wall (as low as 89.1nm in C. tropicalis and 54.9nm in E. floccosum), agglutination of cellular proteins, rupture of cell membrane and leakage of intracellular components, revealed through TEM examinations.

Bacterial and Fungal Keratitis: A Retrospective Analysis at a University Hospital in Switzerland.

Infectious keratitis is a serious corneal disease and may lead to permanent visual deterioration if not treated rapidly and effectively. In order to determine possible changes in the spectrum of pathogens over time, we evaluated the pathogenic organisms of keratitis at a university hospital in Switzerland, comparing two time periods within a decade. In this retrospective study, 417 patients with the clinical diagnosis of bacterial or fungal keratitis in 2006/07 and 2015/16 were enrolled. In an additional analysis, all cases of fungal keratitis between 2006 and 2016 were evaluated. Collected parameters were age, gender, side, use of contact lenses, systemic, neurological and ocular diseases, trauma, previous surgery, and systemic and topical therapy before presentation. In each patient, microbiological results of corneal smears such as growth and antibiotic resistance were analysed. A total of 163 and 254 eyes were included in 2006/07 and 2015/16, respectively. In 2006/07, a culture of smears revealed a bacterial cause in 70 eyes (42.9%) and a fungal cause in 4 eyes (2.5%), whereas in 2015/16, bacterial growth was found in 115 eyes (45.3%) and fungal growth in 6 eyes (2.4%). The most common bacteria in 2006/07 and 2015/16 were coagulase-negative Staphylococci (44.3 vs. 49.6%), Pseudomonas aeruginosa (18.6 vs. 13.9%), Staphylococcus aureus (10 vs. 16.5%), Corynebacterium spp. (8.6 vs. 5.2%), and Moraxella spp. (7.1 vs. 9.6%). Candida parapsilosis was the most common fungal isolate in both groups (25 vs. 33.3%). Between 2006 and 2016, fungal keratitis was found in 37 eyes (Candida spp. n = 11, Fusarium spp. n = 11, Aspergillus spp. n = 5, others n = 10). All patients with Fusarium spp. keratitis had a history of wearing contact lenses. The most commonly isolated bacterial organisms were Staphylococci and Pseudomonas spp., whereas fungal keratitis was mainly due to Candida spp. or Fusarium spp. No relevant variation in causative pathogens was observed between the two time periods.

Types of organisms and in-vitro susceptibility of bacterial isolates from patients with microbial keratitis: A trend analysis of 8 years.

Purpose:To report the distribution and trends of types of organisms and antibiotic susceptibility of the bacterial isolates obtained from patients with microbial keratitis.Methods:Microbiology records of culture-positive microbial keratitis that underwent a diagnostic corneal scraping and cultures were reviewed. Fungal, bacterial, and parasitic culture results and antibiotic susceptibility profile of bacteria were analyzed and comparisons were made between two halves of the study period (2007–2010 vs. 2011–2014).Results:A total of 3981 corneal scrapings were processed during the 8-year study period. Pathogen was recovered in culture in 1914 (48.1%) samples. Fungi, bacteria, and parasites constituted 38.7%, 60%, and 1.3% of the total isolates, respectively. The common fungal isolates were Aspergillus spp. (224/868, 25.8%) and Fusarium spp. (200/868, 23.0%), while common Gram-positive bacteria were Streptococcus pneumoniae (217/1125, 19.3%) and Staphylococcus aureus (185/1125, 16.4%), and common Gram-negative bacteria was Pseudomonas spp. (99/219, 45.2%). There was no significant difference in proportion of bacterial (P = 0.225) and fungal (P = 0.421) keratitis between the first half and second half of the study period. There was a significant increase in proportion of Gram-positive isolates (P = 0.015) [353/758 (46.6%) vs. 772/1482 (52.1%)] and decrease in proportion of Gram-negative organisms (P = 0.044) [88/758 (11.6%) vs. 131/1482 (8.8%)] in the recent years. In-vitro antibiotic susceptibility testing showed decrease in susceptibility to moxifloxacin for Pseudomonas spp. (P = 0.016) in recent years.Conclusion:Prevalence of fungal and bacterial keratitis has remained unchanged over the years. This study shows a significant increase in Gram-positive bacterial infection and decrease in Gram-negative bacterial infection of the cornea in the recent years.

Clinicomycological and Histopathological Profile of Onychomycosis: A Cross-sectional Study from South India.

Background:Onychomycosis (OM) is a fungal infection of the finger or toenails caused by dermatophytes, yeasts, or nondermatophyte molds (NDMs) and can involve any component of the nail unit. OM, apart from being asymptomatic, is a chronic disease and warrants long-term treatment.Aims:The aim was to study the clinicoepidemiological features of OM and to evaluate the mycological and histopathological features among patients attending the dermatology outpatient department.Subjects and Methods:A cross-sectional hospital-based study was performed in 500 patients with symptoms related to the nails and nail folds. OM was confirmed in 284 patients by potassium hydroxide (KOH) mount, fungal culture, or biopsy. Descriptive analysis of the data was undertaken.Results:The study included 284 confirmed cases of OM of which 117 (41.1%) were positive for fungal elements by KOH mount, 168 (59.1%) samples showed positivity in fungal culture, and 62 (21.8%) samples had positive nail biopsy results. Distolateral subungual OM was the most common clinical type (47.6%). Among the fungal isolates, a predominance of dermatophytes was observed followed by yeasts and NDMs. The most common dermatophytic fungal isolate in the culture was Trichophyton rubrum (45%).Conclusion:Our study implies the importance of laboratory diagnosis of OM as it can mimic diverse nail disorders. As the role of NDMs and yeasts is on the rise for etiology of OM, investigations such as KOH examination, culture, or nail biopsy becomes essential for correct diagnosis and management.

Identification of Fungal Pathogens in Otomycosis and Their Drug Sensitivity: Our Experience.

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.

Transplant tourism and invasive fungal infection

BackgroundDeceased and live-related renal transplants (RTXs) are approved procedures that are performed widely throughout the world. In certain regions, commercial RTX has become popular, driven by financial greed. MethodsThis retrospective, descriptive study was performed at the Royal Hospital from 2013 to 2015. Data were collected from the national kidney transplant registry of Oman. All transplant cases retrieved were divided into two groups: live-related RTX performed in Oman and commercial-unrelated RTX performed abroad. These groups were then divided again into those with and without evidence of fungal infection, either in the wound or renal graft. ResultsA total of 198 RTX patients were identified, of whom 162 (81.8%) had undergone a commercial RTX that was done abroad. Invasive fungal infections (IFIs) were diagnosed in 8% of patients who had undergone a commercial RTX; of these patients, 76.9% underwent a nephrectomy and 23.1% continued with a functioning graft. None of the patients with RTXs performed at the Royal Hospital contracted an IFI. The most common fungal isolates were Aspergillus species (including Aspergillus flavus, Aspergillus fumigatus, Aspergillus nidulans, and Aspergillus nigricans), followed by Zygomycetes. However, there was no evidence of fungal infection including Aspergillus outside the graft site. Computed tomography (CT) findings showed infarction of the graft, renal artery thrombosis, aneurysmal dilatation of the external iliac artery, fungal ball, or just the presence of a perigraft collection. Of the total patients with IFIs, 23.1% died due to septic shock and 53.8% were alive and on hemodialysis. The remaining 23.1% who did not undergo nephrectomy demonstrated acceptable graft function. ConclusionsThis is the largest single-center study on commercial RTX reporting the highest number of patients with IFI acquired over a relatively short period of time. Aspergillus spp were the main culprit fungi, with no Candida spp being isolated. A high index of suspicion might be the most reasonable means to reduce the possible very poor outcomes. Improving legal transplant programs and strengthening the associated laws could prevent commercial transplant tourism.

Identification and Characterization of Colletotrichum Species Associated with Mango Anthracnose in Guangxi, China.

Mango (Mangifera indica) is widely grown across southern China, especially in the provinces of Guangxi, Hainan, Yunnan, Sichuan, and Taiwan. Guangxi itself has over 86,667 ha of mango production. The purpose of this study was to identify Colletotrichum species associated with mango in different parts of Guangxi and examine their pathogenicity on leaves and fruits of mango in vitro. Diseased leaves were collected from 25 mango orchards in different areas of Guangxi province. Sixty-five isolates were obtained from mango leaves with anthracnose symptoms, and these were further characterized based on morphology and DNA sequencing. Twenty-nine isolates from different areas were selected for sequencing and analyses of the internal transcribed spacer region, glyceraldehyde-3-phosphate dehydrogenase, partial actin, β-tubulin, and chitin synthase genomic regions. The most common fungal isolates were these three species: Colletotrichum asianum, C. fructicola, and C. siamense. C. asianum was the most common and widely distributed in Guangxi (51.7%), followed by C. fructicola (37.9%) and C. siamense (10.2%), both found in Tiandong, Tianyang, and Wuming counties. There was no evidence of geographical specialization of the different species. Pathogenicity assays showed that all isolates were pathogenic to mango leaves and fruit (cultivar Tainong). No relationship was found between origin of isolates and their virulence. This is the first description of C. asianum, C. fructicola, and C. siamense as causal agents of mango leaf anthracnose from Guangxi province, China.

MYCOLOGICAL PROFILE AND ANTIFUNGAL SENSITIVITY OF INFECTIVE KERATITIS IN A TERTIARY CARE HOSPITAL OF SOUTHERN ODISHA

Background: Infective keratitis is the second major cause of blindness next to cataract. Mycotic keratitis is an important ophthalmologic problem especially in developing countries including India. Fungal infection involving cornea is a fatal condition which needs early diagnosis and treatment to save the patient’s eye. Though studies on mycotic keratitis have been reported from different part of India, to the best of our knowledge this study showing antifungal susceptibility is the first to be reported from Southern Odisha. Objective: The purpose of this study was to study epidemiological characteristics, predisposing factors, fungal etiology and antifungal susceptibility of common fungal isolates in infective keratitis cases. Materials and Methods: A prospective study was conducted from November 2015 to October2017 in the Department of Microbiology and Ophthalmology M.K.C.G Medical College and Hospital .Relevant information was recorded using standard proforma of keratitis cases. Corneal scrapings were collected under strict aseptic conditions and subjected to10% KOH mount, Gram stain and culture. Identification of fungal agents were done as per standard microbiological procedures. An antifungal sensitivity test was done by microbroth dilutions as per CLSI reference method. Results: Over a period of two years 149 patients of infective keratitis were evaluated. Microbiological diagnosis of mycotic keratitis was established in 39 (26.17%) cases. Filamentous fungi were isolated more often than yeasts. The most frequently encountered filamentous fungi and yeasts were Aspergillus spp. 14(35.89%) and Candida albicans 7 (17.94%) respectively. Males were more commonly affected and were mostly in the age group of 46-60 years. Ocular trauma due to vegetative matter was the most common predisposing factor. Natamycin was the most effective antifungal against filamentous fungi and amphotericin B was most effective for Candida albicans . Conclusion: Because of serious consequences of mycotic keratitis, it is very important to know the exact etiological agents and effective antifungals to save the eye of the patients. So laboratory confirmation should be undertaken and fungal infection should be ruled out before prescribing antimicrobial agents.

A Study of Tinea Capitis in Children

Background: Tinea capitis is a superficial fungal infection that predominantly affects the pediatric population. The etiological factors vary from area to area, and the exact occurrence remains obscure. The clinicoepidemiological and mycological aspects of this dermatophytosis were studied in King Abdulaziz Hospital. Purpose: To determine the clinicoepidemiological aspects and mycological findings of dermatophytes involved in tinea capitis cases. Subjects and Methods: KOH examination, Wood's lamp examination, and fungal culture were performed in 50 clinically diagnosed cases of tinea capitis with patients’ age up to 13 years over a period of 8 months. The epidemiological factors associated with the disease were also evaluated. Results: Tinea capitis was predominant in the 3–6 and 6–9 years age groups with a male preponderance. Grey patch tinea capitis was the most common variant. KOH positivity was 74%, and Trichophyton tonsurans was the most common fungal isolate. Conclusion: Tinea capitis is a very common fungal infection in our setting. Early detection and diagnosis is mandatory to prevent its spread in the community as well as the development of scarring alopecia in the affected individual.

Otomycosis associated with active chronic otitis media

Seventy samples from out patients seeking medical care in Al- Diwanyia teaching hospital were screened for identification of fungi associated with active chronic otitis media during June to December 2011 There were 45 (64.28%) had positive culture for fungal growth while 25 (35.71%) patients had negative culture for fungal growth. The patients from 61-70 and 71-80 years were more susceptible to fungal otitis externa than other age groups .the most common causal fungal isolates were Aspergillus niger (26.92%) followed by Candia albicans (19.24%) ,A.flavus (15.38%),A.fumigatus (11.53%),Penicillum digitatum and Cephalosporium sp (7.69%) for each one while Alternaria alternata and Rhizopus sp (5.7%) for each one .

Common fungal isolates from routine clinical specimens: a two years’ studyfrom a tertiary care hospital in South India

Common fungal isolates from routine clinical specimens: a two years’ studyfrom a tertiary care hospital in South India

A clinicomycologic study of onychomycosis at a tertiary health-care center in Chennai

Background: Onychomycosis poses to be an important public health problem. There has been a worldwide increase in the prevalence of onychomycosis with factors such as diabetes mellitus, poor peripheral circulation, indulgence in sporting activities, and prolonged antibiotic usage playing major contributory roles. Further, management of fungal infections of nails usually requires a prolonged course with a tendency for relapse. Aim: To study the clinical, epidemiologic, and demographic profile of onychomycosis and determine various organisms responsible for the same. Methods: A cross-sectional study was done over a 1-year period, wherein after patient enrollment, a thorough clinical evaluation was performed, followed by microscopically examining the infected nail specimen under 40% potassium hydroxide, which was succeeded by cultivating the organisms on fungal culture media and identifying the pathogen both by closely studying colony morphology in culture and also microscopically utilizing lactophenol cotton blue staining. Results: Females (67.3%) were more commonly affected than males (32.7%). The most common age group affected was 20-40 years(47%). Majority of patients demonstrated both finger and toe nail involvement (43.6%). Distal and lateral subungual onychomycosis (55.4%) was the most common clinical variant of onychomycosis identified in our study. Out of the 101 patients in our study, 86 demonstrated a positive fungal growth on culture. Non-dermatophyte moulds (NDM) (58.1%) were the most common fungal isolate followed by Candida species (36%) and dermatophytes (5.8%). Conclusion: Unlike most studies, NDM constituted the major pathogen among our participants.

Persistently Vitreous Culture–Positive Exogenous Fungal Endophthalmitis

To report the clinical settings, microbiological isolates, and best-corrected visual acuities (BCVA) of patients with persistently culture-positive exogenous fungal endophthlamitis. Retrospective consecutive case series. Setting: Tertiary referral center. Sixteen eyes of 16 patients with at least 2 consecutive positive vitreous cultures between 1981 and 2015. Intravitreal antifungal injection, pars plana vitrectomy (PPV). Clinical settings, microbiologic isolates, BCVA. The most common clinical settings were after cataract surgery (9/16, 56%), glaucoma surgery (4/16, 25%), and trauma (2/16, 13%). The most common single fungal isolate was Candida (4/16, 25%), but 75% of all isolates were molds. Treatment for presumed bacterial endophthalmitis was given initially in 14 patients (88%). All patients underwent a vitrectomy during the course of their treatment, and all received intravitreal or systemic antifungal therapy. The mean initial BCVA was 1.76 ± 0.9 logMAR (Snellen equivalent ≈20/1200), and the mean final BCVA was 1.84 ± 1.2 logMAR (≈20/1400, P=.83). The 9 patients (56%) who had intraocular lens (IOL) and capsular bag removals had better final BCVAs than those who did not (P= .011). The BCVAs were similar in eyes with yeast and mold (P= .37). The visual acuity at the last follow-up was ≥20/40 in 13% (2/16), ≥20/400 in 50% (8/16), and no light perception in 25%(4/16). Candida was the single most common isolate, but the majority of isolates were molds. Eyes managed with PPV and removal of the IOL and capsular bag had better visual outcomes. Persistently culture-positive fungal endophthalmitis was associated with poor final visual acuities.

Fungal Profile of Occular Infection in Patients Attending In a Tertiary Care Hospital

Aim and objective: To identify the fungal etiology of Ocular infections in patients attending Ophthalmology department from the period Nov 2010 to Sep 2011 at Navodaya Medical College Hospital and Research Centre, Raichur. Methods: 102 patients attending Ophthalmology OPD/IPD in Navodaya Medical College Hospital and Research Centre were analysed from Nov 2010 to Sep 2011. Using predefined inclusion and exclusion criteria, samples were collected according to the standard protocol. These were cultured for microorganisms (fungal) and were identified. Results: Out of 102 samples studied, 75 samples had growth and the isolation rate. only 23(26%) was fungal growth. KOH wet mount examination showed high specificity of 98.73% and PPV of 90.91% with very significant p value of < 0.0001. The most common fungal isolate were Fusarium spp (30.43%) followed by Aspergillus spp (26.04%). Conclusion: Fungal etiology was mostly associated with corneal infections. Direct microscopic examination is an essential tool in the diagnosis of fungal infections. A simple and rapid KOH wet mount examination early during the disease result in significant progress of the disease in initiating early and specific therapy.

Evaluation of Conventional and Molecular Techniques in the Diagnosis of Fungal Rhinosinusitis

Introduction: Fungal infection of the nose and paranasal sinuses is increasing in both immunocompetent and immunocompromised patients. Limited studies on spectrum of fungi causing fungal rhinosinusitis (FRS) and the types of FRS are scarce from this region of India. We therefore analyzed the suspected cases of FRS by clinical, radiological, histopathological, mycological and molecular methods and categorized them in to non-invasive and invasive forms. Objective: To evaluate laboratory methods in the diagnosis of fungal rhinosinusitis and to find out the spectrum of fungi causing various forms of FRS Methods: 44 patients of chronic rhinosinusitis were enrolled on the basis of history, clinical examination, and radiological findings from the E.N.T. department after obtaining their consent. Functional endoscopic sinus surgery was performed and tissues were examined histopathologically, by fungal culture and PCR. Antimicrobial susceptibility testing of the fungal isolates were done by disk diffusion (M51-A) & broth micro dilution (M38-A2) methods of CLSI. Result: Out of 44 clinically and radiologically suspected patients of chronic rhinosinusits, 23 (52%) were positive for fungal rhinosinuistis. In 44 cases, 18 (40.9%) cases were PCR positive, 12 (27%) were culture positive, 8(18%) were positive by KOH microscopy and 4 (9%) were positive on histopathology. Aspergillus flavus was found to be the most common fungal isolate causing fungal rhinosinusitis Conclusion: We found laboratory methods are essential in confirming the diagnosis of FRS. Among all the laboratory methods, though culture is an important diagnostic tool, PCR were found to be more significant than other methods.