A diagnostically challenging case of pyelonephritis caused by Lactobacillus

Lactobacillus can lead to serious infection in individuals with multiple predisposing factors. Therefore, individuals with risk factors, including steroid use, and those harboring immunocompromised conditions such as hypothyroidism and cancer, should be promptly evaluated and appropriate treatment should be initiated without delay if the culture test is positive for Lactobacillus.

Evaluation of Trichoderma asperellum B1902 in Controlling Fusarium Wilt of Cavendish Banana Cultivar

Trichoderma species is one of the microorganisms with antagonistic properties as biological control agents. In the banana industry, Fusarium wilt disease caused by Fusarium oxysporum f. sp. cubense (Foc) has been practically managed using chemical pesticides that led to environmental disruptions, ineffective conditions and disease resistance. In preliminary study, T. asperellum gave better result compared to other species in inhibiting the growth of Foc in in vitro condition. Therefore, the aim of this study was to examine the effects of T. asperellum as a biological control of Fusarium wilt disease of banana. A total of 326 fungal isolates were isolated from soil samples obtained around Malaysia and identified as Trichoderma species based on phenotype characteristics. The species identity for the best candidates from dual culture test was confirmed based on internal transcribed spacers (ITS) and translation elongation factor 1 alpha (TEF-1α) sequence identity. In dual culture test, findings showed that three isolates with a high percentage inhibition of radial growth (PIRG) were observed in plates of T. asperellum isolates B1902 (84.85%), T2007 (77.78%) and C1667 (75.76%), which successfully inhibited the growth of F. oxysporum f. sp. cubense isolate 9888. Based on in vivo test, the best candidate was T. asperellum B1902 with lower disease severity index (DSI) value of 0.2 compared to the inoculated control with DSI of 3.6. As a conclusion, T. asperellum B1902 can be used as an alternative treatment in managing Fusarium wilt disease. Hence, future study should be focused on applying T. asperellum as a biocontrol agent in the field and controlling other plant diseases in the agricultural plantation.

Performance of acid fast techniques and genexpert in diagnosing pulmonary tuberculosis in Uasin Gishu county health facilities, Kenya

Tuberculosis is one of the major causes of death worldwide, millions of people have been infected with pulmonary tuberculosis and over 95% of tuberculosis deaths occur in low and middle income countries as per World Health Organization report. The study assessed the performance of Ziehl Neelsen technique and GeneXpert used for diagnosis of Pulmonary tuberculosis in Uasin Gishu county health facilities, Kenya, between November 2019 and February 2020. A cross-sectional study was conducted in three selected health facilities and a total of 104 participants were enrolled into the study. Sputum samples from suspected tuberculosis patients were tested using Ziehl Neelsen technique, GeneXpert and culture method was used as gold standard. Performance of the tests was done by considering their sensitivity, specificity, predictive values. The results indicated that among the 104 sputum samples tested Ziehl Neelseen technique used detected 23(22.1%) bacilli from spot samples and 33(31.7%) bacilli from morning sputum samples. GeneXpert test detected 49 (47.1%) bacilli. The results also revealed that there was significant difference between Ziehl Neelsen technique using spot samples and GeneXpert and culture test (p-value< 0.05) and Ziehl Neelsen technique using morning test done with culture test had no significant difference (p-value>0.05). Performance of tests should be done accurately for proper diagnosis of TB, GeneXpert should always be used since its sensitivity is high and also detects Rifampicin resistance. Also, Performance of tests should be done using standard procedures to avoid errors in the test results.

Dermatomycosis from the Perspective of Dermatopathology (Version 1.1)

Dermatomycosis is a skin disease caused by fungi, including dermatophytes and yeasts. Its diagnostic methods include KOH smear, fungal culture test, Wood's lamp test, biopsy, and molecular biology test. Superficial dermatomycosis can already be diagnosed using only KOH smear and culture test, so biopsy has not yet received attention from many clinicians. Nonetheless, biopsy is one of the most basic tests in the field of dermatology, with high diagnostic value for deep and superficial dermatomycoses, which often shows negative findings on KOH smear or fungal culture test. In this study, the histopathologic findings and special chemical staining methods in dermatomycosis are described. This review article is an upgraded English version of the review paper "Dermatomycosis from the perspective of dermatopathology (Korean Version 1.0)" published in 2016.

Validity and reliability of eight-grade digital culture test in light of item response theory

The purpose of this study is to construct a digital culture test in light of the Item Response Theory and to investigate its psychometric properties. The study sample consisted of six hundred fifty (650) male and female students in the eighth grade from the Directorate of Education and Teaching of Salt District. To obtain the results, the descriptive approach was used. The results showed that the items have acceptable indicators of discrimination and extend on the continuum of difficulty adequately. The validity and reliability of the test were verified by using several methods, including content validity and internal consistency. The study findings showed that most of the test items fit the assumptions of the two-parameter logistic model. The results also displayed statistically significant differences in the arithmetic means of the digital culture test due to gender in favor of female students. Moreover, the outcomes presented statistically significant differences attributed to the education sector variable favoring the private sector. Keywords: Digital Culture Test, IRT, Psychometric Properties, Teaching.

Hidróxido de cálcio como medicação intracanal em casos de necrose pulpar com lesão periapical

The purpose of this study is to evaluate calcium hydroxide as a root canal dressing in presence of apical lesion due to pulpal necrosis, after chemomechanical preparation. Culture test were done in 19 patients in wich 80% of all teeth treated with calcium hydroxide remained negative and 100% treated with PMCC. Under the present experimental conditions, PMCC as well as calcium hydroxide mantained the desinfection status pursued during chemomechanical preparation and therefore is indicated as an intracanal medicament in such cases.

Frequency of Bacteriological Organism in Patients with Thoracic Empyema

Objective: To examine the frequency of bacteriological organism present in pleural fluid, in patients positive with thoracic empyema, assessed on the basis of pus culture test. Study Design: Cross-sectional study Place and Duration: Inpatient Department, Chest Medicine Ward 12, JPMC, Karachi, Pakistan for six months duration from 11 February 2019 to 10 August 2019. Methodology: One hundred and thirty nine patients diagnosed with Thoracic Empyema were included in this study. All patients included in the study shall undergo Pus Culture Test prior to identify the presence or absence of bacterial organism. Those with positive bacterial findings (mainly Staph Aureus and gram negative organisms) were further assessed for stratification with reference to their possible variable affecters. Results: There were 107 males and 32 females (%M: F ratio 77:23), with Empyema Thoracic, aged between 25-55 years and having a mean age of 36.28 year (± SD 8.206), were studied. The Pus Culture Test rate was 100% whereas duration of empyema was of average 18.38 days (± S.D 11.16). One hundred and four patients (74.82%) were carrying investigated bacteria which were staph. Aureus in 17 (12.50%) patients. GRAM NEGATIVE ORGANISMS in 87 (62.58%) patients. Echerea Coli in 12 (8.3%) patients, Pseudomonas. Aeruginosa in 46 (33.33%) patients, Klebseilla in 17(12.50%) patients, Enterococcus Species in 12 (8.3%) patients. While remaining thirty five patients (25.17%) were found to have other bacteria, including Streptococcus, Proteus Mirabillis and Acinobacter, responsible for Empyema. Conclusion: It is concluded that 74.82% patients had bacteria and among them 62.58% patients had gram negative organism. Pseudomonas Aeruginosa was the most common organism followed by Klebseilla and staph. Aureus. Keywords: Empyema, Thoracic, Pleural Effusion, Thoracentesis, Thoracostomy

Fish Tank Granuloma Presenting as a Nasal Cavity Mass

Mycobacterium marinum is a free-living nontuberculous mycobacterium that is widely distributed in freshwater and seawater around the world. Granulomatous skin infection from M. marinum in people who are exposed to fish or aquatic environments is a rare condition known as fish tank granuloma. The granuloma mainly occurs on the skin of the upper limb, in a few cases on the face, and rarely in the nasal cavity. We describe a case of M. marinum infection that presented as a nasal cavity mass. A 57-year-old woman who was receiving infliximab for psoriatic arthritis visited our hospital with a complaint of right nasal obstruction. A granulomatous mass with an irregular surface was found in the anterior part of the right nasal cavity. Tissue biopsy revealed granulation tissue. Since the application of steroid ointment did not reduce the size of the mass, the tumor was resected under local anesthesia, and the base was cauterized. The pathological finding was an inflammatory granuloma with negative Ziehl–Neelsen staining. The granuloma recurred 3 months after resection. The interferon-gamma release assay (IGRA) test was positive, and therefore, a mycobacterial tissue culture test was performed because of suspected nasal tuberculosis, which identified M. marinum. The nasal cavity mass disappeared 2 months after the administration of minocycline, followed by clarithromycin, and subsequent discontinuation of infliximab. M. marinum infection can cause an intranasal mass. IGRA and the mycobacterial tissue culture test are useful for diagnosis. As in this case, the nasal lesion may be excised as an inflammatory nasal granuloma, and therefore, there may be many more “hidden” cases of M. marinum infection. If nasal granulation is present, the possibility of M. marinum infection should be considered.

Reducing the Contamination Rate and the Unnecessary Requesting of Blood Culture Test through Quality Improvement Project

Background: Blood stream infections are major leading causes of morbidity and mortality in hospitalized patients. Increasing the awareness of the clinicians and nurses about the proper protocol of blood culture test is very important in reducing the contamination rate and the unnecessary requesting of blood culture. Objectives: to reduce the contamination rate and the unnecessary requesting of blood culture from different departments through implementation of hospital wide Quality Improvement Project (QIP). Methodology: Blood cultures were tested in the Microbiology Laboratory of Najran Armed Forces hospital, Saudi Arabia, in the period from June 2019 to July 2020 and their results were compared before and after the implementation of the QIP. Results: The comparison between the blood cultures results before and after QIP implementation showed statistically significant (19.6%) reduction in the contamination rate, (14%) reduction in the total number of blood culture requests and (11.6%) reduction in the negative results rate. Conclusion: The reduction in the total number, negative results and contamination rate of blood culture test after QIP implementation were considered as performance indicators that the recommendations of QIP were effective and implemented strictly.