Fungal contamination of indoor public swimming pools and their dominant physical and chemical properties

Introduction: Considering to the existence of both parasitic and fungal pathogens in the indoor public swimming pools and non-utilization of suitable filtration and disinfection systems in these places, this research aimed to determine the relationship between the indoor public swimming pools and possible pollution with parasitic and fungal agents, as well as physical and chemical characteristics of these pools and compare the results with national standards. Methods: In this study, 11 active indoor swimming pools of Zahedan city were sampled, using plastic pumps techniques, at the middle of winter to the late summer season. A total of 88 water samples (eight water samples from each pool) were examined to determine the residual chlorine, contamination with parasitic and fungal agents, using culture media and slide culture techniques. Results were analyzed with SPSS software (V16) and, Microsoft Excel (V2010). Results: The findings revealed parasitic fungal contamination with Cladosporium, Penicillium, Aspergillus flavus and Aspergillus fumigatus, etc. and the physicochemical factors comply with the minimum standards had which indicates the need for continuous monitoring and control of water filtration and disinfection of water is swimming. Conclusion: The results show reasonable derangement of physicochemical and microbial factors of the evaluated pools. Efforts shall be made by the concerned authorities to provide health education to users, quality water at the pools and to maintain the safety and quality of the water through proper and adequate chlorination

Antifungal agents: Polyene, azole, antimetabolite, other and future agents

Antifungals have always been considered as one of the astonishing discoveries of the 20th century. This is correct, but the real marvel is the development of antifungal resistance in hospitals, communities, and the environment concomitant with their use. Fungal infections have emerged as an important clinical threat, with significant associated morbidity and mortality.  This study is designed to provide a comprehensive view of antifungal agents and related agents. Information was based on the expertise of some literatures. Over the past decades, the incidence and diversity of fungal infection has grown in association with an increasing number of immunocompromised patients. An understanding of the pharmacokinetic and pharmacodynamics properties of the classes of antifungal compounds is vital for the effective management of invasive fungal infections. This review provides a summary of the pharmacologic principles involved in treatment of fungal diseases.  Clinical needs for novel antifungal agents have altered steadily with the rise and fall of AIDS-related mycoses, and the change in spectrum of fatal disseminated fungal infections that has accompanied change in therapeutic immunosuppressive therapies

Fungal infection in foot diabetic patients

Diabetic patients are more susceptible to cutaneous fungal infections. Cutaneous lesions and Foot infections are a frequent complication of patients with diabetes mellitus, accounting for up to 20% of diabetes-related hospital admissions. Foot ulcers and other foot problems are a major cause of morbidity and mortality in people with Diabetes mellitus. The higher blood sugar levels cause increasing the cutaneous fungal infections in these patients. More than 75% of diabetes mellitus (DM) patients are at risk for diabetic ulcers. About 15% of foot ulcers in diabetic patients lead to amputations. Although every 30 seconds one leg is amputated in the world due to DM, 80% of these cases are preventable. Poor controlled had significantly higher fungal infection in diabetic foot ulcers and require careful attention and management. The findings of various studies indicate that the prevalence of fungal infections in patients with diabetic foot ulcers is increasing and there are many drug resistance issues reported in this area, therefore more attention is important in diabetic centers about this neglected issue

Frequency of Cutaneous Fungal Infections and Azole Resistance of the Isolates in Patients with Diabetes Mellitus

Background: Diabetic patients are more susceptible to cutaneous fungal infections. The higher blood sugar levels cause increasing the cutaneous fungal infections in these patients. The main objective of this study was to find the frequency of fungal infections among cutaneous lesions of diabetic patients and to investigate azole antifungal agent susceptibility of the isolates. Materials and Methods: In this study, type 1diabetes (n = 78) and type 2 diabetes (n = 44) comprised 47 cases (38.5%) with diabetic foot ulcers and 75 cases (61.5%) with skin and nail lesions were studied. Fungal infection was confirmed by direct examination and culture methods. Antifungal susceptibility testing by broth microdilution method was performed according to the CLSI M27-A and M38-A references. Results: Out of 122 diabetic patients, thirty (24.5%) were affected with fungal infections. Frequency of fungal infection was 19.1% in patients with diabetic foot ulcer and 28% of patients with skin and nail lesions. Candida albicans and Aspergillus flavus were the most common species isolated from thirty patients with fungal infection, respectively. Susceptibility testing carried out on 18 representative isolates (13 C. albicans, five C. glabrata) revealed that 12 isolates (10 C. albicans and two C. glabrata isolates) (66.6%) were resistant (minimum inhibitory concentration [MIC] ≥64 mg/ml) to fluconazole (FCZ). Likewise, eight isolates (80%) of Aspergillus spp. were resistant (MIC ≥4 mg/ml), to itraconazole. Conclusion: Our finding expands current knowledge about the frequency of fungal infections in diabetic patients. We noted the high prevalence of FCZ-resistant Candida spp., particularly in diabetic foot ulcers. More attention is important in diabetic centers about this neglected issue

New foci of zoonotic cutaneous leishmaniosis due to Leishmania major in the northeastern Iran cities of Sabzevar and Neghaab

Cutaneous leishmaniosis (CL) is a major public health challenge in Iran. Overall, 18 provinces out of 31 of the country's provinces are in the endemic areas. The objective of the present study was to determine the presence of CL species in Sabzevar and Neghaab cities, Khorasan Razavi province, northeastern Iran. Overall, 280 samples were taken from suspected individuals referred to Sabzevar's and Neghaab's health centers during 2014-2016. Smear preparation, case detection and further identification by partial amplification of 7SL RNA and high-resolution melting curve analysis were done for all samples, followed by randomly polymerase chain reaction (PCR)-sequencing confirmation. Based on findings, the most infection rate was found in males with the age groups of 20-30 in both districts. All samples were characterized as Leishmania major, except one isolate in Neghaab closely related to Leishmania tropica. Various risk factors play roles in creating new foci of zoonotic CL (ZCL) caused by L. major in Sabzevar and Neghaab in northeastern Iran. Reports of the prevalence of CL in new foci make serious concerns about the incidence of cases and expansion of disease to the neighboring areas. Further measures are essential to control the disease in the regions