Candida dubliniensis: An Appraisal of Its Clinical Significance as a Bloodstream Pathogen

A nine-year prospective study (2002–2010) on the prevalence of Candida dubliniensis among Candida bloodstream isolates is presented. The germ tube positive isolates were provisionally identified as C. dubliniensis by presence of fringed and rough colonies on sunflower seed agar. Subsequently, their identity was confirmed by Vitek2 Yeast identification system and/or by amplification and sequencing of the ITS region of rDNA. In all, 368 isolates were identified as C. dubliniensis; 67.1% came from respiratory specimens, 11.7% from oral swabs, 9.2% from urine, 3.8% from blood, 2.7% from vaginal swabs and 5.4% from other sources. All C. dubliniensis isolates tested by Etest were susceptible to voriconazole and amphotericin B. Resistance to fluconazole (≥8 µg/ml) was observed in 2.5% of C. dubliniensis isolates, 7 of which occurred between 2008–2010. Of note was the diagnosis of C. dubliniensis candidemia in 14 patients, 11 of them occurring between 2008–2010. None of the bloodstream isolate was resistant to fluconazole, while a solitary isolate showed increased MIC to 5-flucytosine (>32 µg/ml) and belonged to genotype 4. A review of literature since 1999 revealed 28 additional cases of C. dubliniensis candidemia, and 167 isolates identified from blood cultures since 1982. In conclusion, this study highlights a greater role of C. dubliniensis in bloodstream infections than hitherto recognized

High School Science Teaching Methods and Practices in Saudi Arabia and the USA

The purpose of this study was to determine the teaching methods. strategies, and techniques that are being practiced by high school science teachers , H.S.S.T., in Saudi Arabia and in the U.S.A. To achieve this purpose, a questionnaire of 22 items , methods, was developed. After assuring its validity and reliability, it was administered to 79 U.S.A. H.S.S.T. , in its English version, , and to 103 Saudi Arabian H.S.S.T. , in its Arabic version, . The results revealed that: 1, There are significant differences , at the 0.01 level, between the U.S.A. li.S.S.T. and the Saudi H.S.S.T. in their use of the methods investigated. 2, The predominant methods of teaching were discussion and lecturing in both countries. Televised science instruction and role playing were never used among the two groups in their teaching. 3, There were seven more methods used in the U.S. schools on a daily and/or weekly basis. They are: student homework, inquiry and discovery, problem solving, laboratory and hands-on methods, demonstrations, tests and quizzes, and individual assignments. 4, Four methods were found to be practiced in Saudi Arabian schools on a monthly basis. They are: problem solving. demonstration, tests and quizzes, and inquiry/discovery techniques. However, there were two methods practiced in the U.S. schools on a monthly basis. They are: student reports and projects, and practical lab tests and quizzes. 5, From the 22 science teaching methods investigated, 16 teaching methods were not practiced except ocassionally, in the Saudi high schools, while 11 teaching methods were not practiced in the Ui S. high schools. Finally, the study provided some recommendations to improve science teaching practices

High School Science Teaching Methods and Practices in Saudi Arabia and the USA

The purpose of this study was to determine the teaching methods. strategies, and techniques that are being practiced by high school science teachers (H.S.S.T.) in Saudi Arabia and in the U.S.A. To achieve this purpose, a questionnaire of 22 items (methods) was developed. After assuring its validity and reliability, it was administered to 79 U.S.A. H.S.S.T. (in its English version), and to 103 Saudi Arabian H.S.S.T. (in its Arabic version). The results revealed that: 1) There are significant differences (at the 0.01 level) between the U.S.A. H.S.S.T. and the Saudi H.S.S.T. in their use of the methods investigated. 2) The predominant methods of teaching were discussion and lecturing in both countries. Televised science instruction and role playing were never used among the two groups in their teaching. 3) There were seven more methods used in the U.S. schools on a daily and/or weekly basis. They are: student homework, inquiry and discovery, problem solving, laboratory and hands-on methods, demonstrations, tests and quizzes, and individual assignments. 4) Four methods were found to be practiced in Saudi Arabian schools on a monthly basis. They are: problem solving. demonstration, tests and quizzes, and inquiry/discovery techniques. However, there were two methods practiced in the U.S. schools on a monthly basis. They are: student reports and projects, and practical lab tests and quizzes. 5) From the 22 science teaching methods investigated, 16 teaching methods were not practiced except ocassionally, in the Saudi high schools, while 11 teaching methods were not practiced in the U.S. high schools. Finally, the study provided some recommendations to improve science teaching practices

First Report of Human Infection Due to the Fungus Triadelphia pulvinata

Triadelphia pulvinata, a soil hyphomycete, was found to be the cause of eczematoid, scaly, grey lesions on the skin of both eyelids of a 30-year-old Indian male living in Saudi Arabia. Repeated KOH preparations of the skin scrapings showed presence of sclerotic, branched, septate hyphae. When cultured, skin scrapings from the lesion grew the dematiaceous fungus T. pulvinata. Treatment with topical clotrimazole cured the infection, and no recurrence of the infection was noted in a 5-year follow-up

Candida dubliniensis at a University Hospital in Saudi Arabia

Candida dubliniensis is a newly described yeast species that is a close phylogenetic relative of C. albicans. Although it has been reported from different parts of the world, no detailed investigation of this species has been done in Saudi Arabia. The purpose of the present study was to identify C. dubliniensis isolates recovered from clinical specimens at a tertiary-care hospital in Riyadh, Saudi Arabia, and to determine the drug susceptibility profiles of those isolates. Over a period of 8 months, 823 germ tube- and chlamydospore-positive yeasts identified as C. albicans and recovered from different clinical specimens were screened for their ability to grow at 45°C on Sabouraud dextrose agar. Isolates which failed to grow at 45°C were presumptively identified as C. dubliniensis. The species identities were further confirmed by the production of pseudohyphae and chlamydospores on Staib agar and their inability to assimilate d-xylose and α-methyl-d-glucoside by using the API 20C AUX system. A total of 27 (3.3%) isolates were identified as C. dubliniensis. They were all recovered from 23 human immunodeficiency virus-negative patients. The prevalence of C. dublinensis in bronchoalveolar lavage (33.3%), oral (16.7%), and blood (16.7%) specimens was high. In addition, 33 isolates previously identified as C. albicans and preserved among our stock blood culture isolates were also recruited for the study. Of these, 5 isolates were found to be C. dubliniensis, thus making the total number of isolates identified as this species 32. Antifungal susceptibility testing of the C. dubliniensis isolates showed 100% sensitivity to amphotericin B, 97% sensitivity to each of fluconazole and ketoconazole, and 87.5% sensitivity to itraconazole. However, in contrast to other studies, the majority of the isolates (65.6%) showed high levels of resistance to flucytosine (MIC > 64 μg/ml). Further studies are warranted to investigate the cause of this unusually high rate of resistance to flucytosine of the C. dubliniensis isolates in this region