Impact of Dermatophytosis on the Quality of Life in Patients Attending a Tertiary Care Hospital, Karachi

Abstract Objectives: To determine the impact of dermatophytosis on quality of life (QoL) of patients at tertiary care hospital, Karachi. Methods: The cross-sectional descriptive research was piloted in the Departments of Dermatology and Microbiology, Jinnah Postgraduate Medical Centre (JPMC) Karachi, a leading public tertiary care hospital during the July 2019 to December 2019. The patients <16 years aged were excluded from this study. The KOH (10%) wet mount was performed for fungal hyphae and spore observation in specimens. Quality of life was determined by dermatology life quality index (DLQI) scores and their association with different variables was evaluated by using t-test and Fisher test. Results: A total of 300 dermatophytosis patients were analyzed. The majority of the patients were of no education category. The active age group (16-30 years) showing higher frequency (138; 46.0%) and followed by age group of 31-50 years (126; 42.0%)).  In present study DLQI score mean was 13.4 ± 7.3. Unexposed area was the main site 249 (83.0%). Dermatophytosis has effect on the quality of life (QoL) in majority (98.7%) of the patients. The DLQI score was significantly higher in unexposed and both sites involvement (P < 0.001). DLQI score was not affected by the age, sex, literacy, addiction and other demographic variables. Conclusion: This study revealed that dermatophytosis has a significant impact on the quality of life (QoL) in these patients. &nbsp

Verona integron encoded metallo Beta lactamase (VIM) and Vietnam extended spectrum Beta lactamase (VEB) producing Pseudomonas balearica from a clinical specimen

Pseudomonas balearica, a saprophyte found in marshy and marine habitats, is not routinely differentiated from P. aeruginosa and P. stutzeri using automated systems and hence has not been reported from clinical samples. This study describes the identification of P. balearica using MALDI-TOF-MS and 16S rDNA sequence from a patient admitted to an intensive care unit (I.C.U.). The isolate was found to be Verona integron-mediated Metallo-blactamase (V.I.M.), and Vietnam extended-spectrum blactamase (V.E.B.) producer and resistant to Ceftriaxone, Imipenem, and Tobramycin. P. balearica can be a source for horizontal transfer of blaVEB and blaVIM. Its pathogenesis has yet to be understood

A clinico-mycological spectrum of superficial mycoses of scalp in pediatric population: A clinico-mycological spectrum of superficial mycoses of scalp

Objective: A clinico-mycological study was conducted to assess the profile of dermatophytes and non-dermatophytes in patients with superficial mycoses of scalp. Methods:  This Descriptive cross sectional study was conducted at Department of Microbiology, Basic Medical Sciences Institute, in collaboration with Department of Dermatology, Jinnah Postgraduate Medical Centre, Karachi. The study was carried out from May 2019 to September 2019. A total of 114 children were enrolled in the study having a clinical diagnosis of superficial mycoses of scalp. The hair specimens and scales from the scalp were collected. The specimens were processed for wet mounts (KOH and CFW staining) and mycological culture.  . Results: The most common clinical presentation was found to be dermatophytoses (28%). Non-dermatophytoses was seen in 16.1% cases, while 55.2% cases were culture negative. The most common isolated dermatophyte was Trichophyton violaceum (35.4%), while among non-dermatophyte molds, Aspergillus spp accounted for 45% of cases. Conclusion: The unambiguous diagnosis of scalp mycoses can be made by mycological culture and conventional techniques like KOH mounts and CFW staining. Keywords: Calcoflour white stain, Dermatophytes, KOH mount, Tinea capiti

The Underemphasized Epidemiology of Non- Dermatophytes in Tinea Capitis: A Study from Tertiary Care Hospital, Karachi

Background: Tinea capitis (TC) is a fungal infection that victimizes every age group. The fundamental culprits of TC are dermatophytes and the role of non-dermatophytes (NDM) in pathogenesis is overshadowed. Therefore, the current study was designed to evaluate the epidemiology of non-dermatophytes as the etiologic agent of tinea capitis among local population. Methods: It was a cross sectional descriptive study, which was conducted at the Department of Microbiology, Jinnah Post Graduate Medical Centre Karachi Pakistan, from January 2019 to September 2019. A total of 207 patients diagnosed with tinea capitis were enrolled in the study. The scalp scrapings and hair were collected and processed for Potassium Hydroxide (KOH), Lactophenol Cotton Blue (LPCB) and Calcofluor White (CFW) staining. The specimens were cultured on Dermatophyte Test Medium (DTM) and Sabouraud Dextrose Agar (SDA). The species were identified by slide culture, LPCB staining and biochemical tests. The Chi squared test was used for determining the association between variables. The kappa index was utilized for determining the correlation between the efficacies of tests, provided that p-value lesser than 0.05 was considered statistically significant.   Results: Among isolated species, 61(29.5%) were dermatophytes and 45(21.7%) were non-dermatophytes. The most common isolated non-dermatophytes were Aspergillus spp. (n=16, 35.5%), followed by Penicillium spp. (n=7, 15.55%). A significant association was observed between the non-inflammatory type of lesions of TC and non-dermatophytes (p-value=0.000). CFW staining was found to be a better tool in detecting fungal components in the specimen compared to KOH mounts (p-value=0.000). Conclusion: The non-dermatophytes carry substantial importance in causing tinea capitis and related superficial scalp mycoses. Keywords: Aspergillus; Dermatophytes; Tinea Capitis; Epidemiology

Verona integron encoded metallo Beta lactamase (VIM) and Vietnam extended spectrum Beta lactamase (VEB) producing Pseudomonas balearica from a clinical specimen

Pseudomonas balearica, a saprophyte found in marshy and marine habitats, is not routinely differentiated from P. aeruginosa and P. stutzeri using automated systems and hence has not been reported from clinical samples. This study describes the identification of P. balearica using MALDI-TOF-MS and 16S rDNA sequence from a patient admitted to an intensive care unit (I.C.U.). The isolate was found to be Verona integron-mediated Metallo-Beta-lactamase (V.I.M.), and Vietnam extended-spectrum Beta-lactamase (V.E.B.) producer and resistant to Ceftriaxone, Imipenem, and Tobramycin. P. balearica can be a source for horizontal transfer of blaVEB and blaVIM. Its pathogenesis has yet to be understood. Continue..