الفهرس 
Introduction and Aim of the work
AIM OF THE WORKOnly 14 pages are availabe for public view
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Abstract
This was a hospital based descriptive study that was conducted over a period of 12 months from January 2014 to January 2015 to include 137 patients admitted to different ICUs at Assiut University Hospitals.
This work was designed to study the prevalence of fungal urinary tract infections in catheterized patient in ICUs. Sensitivity of these fungi to antifungal agents was evaluated to discriminate resistant isolates. Enzymatic activities (production of protease, lipases and ureases) were also tested.
Eligible participants in the study were those with urinary tract infection and had one or more of the following criteria; suppressed general body immunity, suppressed local body immunity as a result of urinary catheters insertion, resistant to antibiotic therapy, negative samples for bacterial examination and culture and patients with critical life threatening infections.
Patients excluded from the study were those who received antifungal therapy within 3 days prior to sample collection and patients refused to participate in the study.
In this study, we determined the local epidemiology of fungal infection among catheterized patients admitted to ICUs at Assiut University Hospitals and found that 52.6 % of samples included in the study were positive for fungal infection with marked change in the causative fungal pathogens.
Invasive fungal infections among these patients were mainly in correlation to urinary catheters insertion that lowers local mucosal resistance in addition to critical patient condition that lowers general body resistance.
For identification of isolated fungal pathogens, traditional phenotypic methods (including macroscopic morphologic features on different culture media, microscopic features, biochemical reactions …etc.) and sequencing of rRNA gene were used.
Determination of in vitro antifungal susceptibility pattern showed that these emerging fungal pathogens are markedly resistant to conventional antifungal except amphotericin B that showed a broad spectrum of activity that accounts for its continued use despite of toxicity concerns.
This marked resistance of emerging fungal pathogens led to very difficult management of infections caused by them and poor patient outcome.
In the this study, we determined the enzymatic ability of isolated fungal pathogens and concluded that fungi show a high enzymatic ability making them more virulent and infections caused by them more aggressive.
During all the course of the study, feedback communication with the physicians at different ICUs at Assiut University Hospitals was serious to emphasize on prescription of antifungal drugs on basis of in vitro antifungal susceptibility testing results to decrease the possibility of emerging drug resistant fungal pathogens.
Also this communication with the physicians included recommendations to follow infection control measures carefully to prevent nosocomial dissemination of fungal pathogens among patients admitted to ICUs at Assiut University Hospitals.