title: Bacterial and fungal keratitis in Upper Egypt: in vitro screening of enzymes, toxins and antifungal activity.
abstract: OBJECTIVE
  This work was conducted to study the ability of bacterial and fungal isolates from keratitis cases in Upper Egypt to produce enzymes, toxins, and to test the isolated fungal species sensitivity to some therapeutic agents.
  
  
  METHODS
  One hundred and fifteen patients clinically diagnosed to have microbial keratitis were investigated. From these cases, 37 bacterial isolates and 25 fungal isolates were screened for their ability to produce extra-cellular enzymes in solid media. In addition, the ability of fungal isolates to produce mycotoxins and their sensitivity to 4 antifungal agents were tested.
  
  
  RESULTS
  Protease, lipase, hemolysins, urease, phosphatase, and catalase were detected respectively in 48.65%, 37.84%, 59.46%, 43.24%, 67.57%, and 100% out of 37 bacterial isolates tested. Out of 25 fungal isolates tested during the present study, 80% were positive for protease, 84% for lipase and urease, 28% for blood hemolysis, and 100% for phosphatase and catalase enzymes. Thirteen fungal isolates were able to produce detectable amounts of 7 mycotoxins in culture medium (aflatoxins (B1, B2, G1, and G2), sterigmatocystin, fumagillin, diacetoxyscirpenol, zearalenone, T-2 toxin, and trichodermin). Among the antifungal agents tested in this study, terbinafine showed the highest effect against most isolates in vitro.
  
  
  CONCLUSIONS
  In conclusion, the ability of bacterial and fungal isolates to produce extracellular enzymes and toxins may be aid in the invasion and destruction of eye tissues, which, in turn, lead to vision loss.
authors.affiliation: School of Biological Sciences, Universiti Sains Malaysia, 11800 Minden, Pinang, Malaysia.
authors.forename: Abdullah A
authors.initials: AA
authors.lastname: Gharamah
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Moharram
authors.forename: Mady A
authors.initials: MA
authors.lastname: Ismail
authors.forename: Ashraf K
authors.initials: AK
authors.lastname: Al-Hussaini
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000627:therapeutic use*; D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification / Q000378:metabolism; D001427:Bacterial Toxins / Q000378:metabolism*; D003315:Cornea / Q000382:microbiology; D004534:Egypt / Q000453:epidemiology; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D015821:Eye Infections, Fungal / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D005658:Fungi / Q000187:drug effects / Q000302:isolation & purification / Q000378:metabolism; D006801:Humans; D015994:Incidence; D007634:Keratitis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D009183:Mycotoxins / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D001427:Bacterial Toxins; D009183:Mycotoxins