SlideShare une entreprise Scribd logo
1  sur  4
Télécharger pour lire hors ligne
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS)
e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 14, Issue 11 Ver. IV (Nov. 2015), PP 27-30
www.iosrjournals.org
DOI: 10.9790/0853-141142730 www.iosrjournals.org 27 | Page
Rapid identification of dermatophyte species by 28S rDNA
Polymerase Chain Reaction (PCR)
Dr. T. Santhi. MD¹, Dr. C. Subhashini. MD2
, Dr. S. Jhansi Lakshmi MD3
¹Assistant Professor, 2
Assistant Professor, 3
Assistant Professor,
Dept. of DVL, Andhra Medical College, Visakhapatnam – 530002.
Abstract: Dermatophytes are the main cause of onychomycoses, but various nondermatophyte filamentous
fungi are often isolated from abnormal nails. The correct identification of the aetiological agent of nail
infections is necessary in order to recommend appropriate treatment. To evaluate a rapid polymerase chain
reaction (PCR) assay based on 28S rDNA for fungal identification in nails on a large number of samples in
comparison with cultures. Infectious fungi were analyzed using PCR in 22 samples of swabs and nail samples
in which fungal elements were observed in situ by direct mycological examination (positive samples). The
results were compared with those previously obtained by culture of fungi on Sabouraud agar from the same
samples. PCR identification of fungi in nails allowed validation of the results obtained in culture when three
Trichophyton spp. and one Microsporum spp grew from infected samples. Improved sensitivity for the detection
of fungi in nails was obtained using the PCR assay. Rapid and reliable molecular identification of the infectious
fungus can be used routinely and presents several important advantages compared with culture in expediting
the choice of appropriate antifungal therapy.
Keywords: Dermatophytes, Trichophyton spp., Microsporum spp., PCR, 28S rDNA
I. Introduction
Molecular techniques are increasingly being employed in the clinical microbiological laboratory for
identification and direct detection of microbes in clinical specimens because of the high sensitivity, specificity
and speed (1). Classical diagnosis of dermatophytosis consists of direct microscopy and culture with a
subsequent species identification mainly based on macroscopic and microscopic features of the culture (2, 3, 4).
Dermatophytes commonly infect keratinaceous tissue such as hair, skin, and nails. This characteristic is
thought to be due to an inhibitory agent in blood or serum that precludes establishment of infections at other
body sites. While these organisms are pathogenic in man, they freely exist as soil saprophytes or zoopathogens.
Microsporum and Trichophyton are human and animal pathogens. Epidermophyton is a human
pathogen. The dermatophytes can be geophilic, zoophilic, or anthropophilic (5). The term geophilic is used for
fungi whose natural habitat is in soil. Zoophilic refers to fungi that infect humans as well as lower animals.
Anthropophilic means man-loving. Organisms in this category prefer to infect man (6). It is important to
underscore the distinction between molecular diagnostics, which relates to the direct detection of dermatophyte
DNA in the clinical specimen (nail, skin or hair), and molecular identification in the sense of application of
molecular tools for species identification of fungal isolates (7, 8). Numerous targets within the fungal genome
have been evaluated, with much of the current work using sequence areas within the ribosomal DNA (rDNA)
gene complex (9). This section of the genome includes the 18S, 5.8S and 28S genes which code for ribosomal
RNA (rRNA) and which have a relatively conserved nucleotide sequence among fungi (10).
II. Research Methodology
2.1. Samples collection
22 Samples were collected from Dept. of Dermatology, King George Hospital, Visakhapatnam in the
period of March 2011 to August 2013. Infected nail clippings and swabs were collected from patients.
2. 2. Culturing and lacto phenol blue staining
Samples were inoculated on sabourand dextrose agar and incubated for 7-10 days. Cultured specimens
were stained with cotton blue and observed under microscope. Cotton blue (China blue) stains chitin and
cellulose. Since cell walls of fungi are primarily chitin, this stain is an excellent choice for observing fungi in
clinical specimens (11). Placed a small drop of lactophenol cotton blue (LPCB) in the center of a clean glass
slide. Removed a fragment of fungus culture with a teasing needle and placed in the LPCB and gently tease
apart. Gently placed a cover slip onto the preparation. Examined the slide using the low power (10x) objective
of a microscope (12).
Rapid identification of dermatophyte species by 28S rDNA Polymerase Chain Reaction (PCR)
DOI: 10.9790/0853-141142730 www.iosrjournals.org 28 | Page
2.3 DNA Isolation
To evaluate a rapid polymerase chain reaction (PCR) assay based on 28S rDNA for fungal
identification in samples (nails and swabs) on a large number of samples in comparison with cultures (9, 10).
Infectious fungi were analyzed using PCR in 22 samples of swabs and nail samples in which fungal elements
were observed in situ by direct mycological examination (positive samples). Scrap the fungal 1-2 colonies into a
1.5mL tube which is containing phosphate buffer or distilled water. Centrifuge at 1100g for 3 min. Make the
pellet homogenous by hand flicking the tube. Added 5% Chelax (Resin) which is just vortexed and add 0.2µg
Proteinase K and mix well. Incubated the samples at 65˚C for 20 min followed by 100˚C for 10 min. Centrifuge
at 1100g for 3 min. Supernatant was used for subsequent PCR reactions.
2. 4. Amplification
A polymerase chain reaction (PCR) was then carried out to amplify the DNA sequences of interest by
denaturing the DNA molecule and replicating it by utilizing primers, free nucleotides, and a polymerase
designed to help the DNA withstand the high temperatures involved in PCR. Because PCR can only be applied
when the nucleotide sequence of at least one DNA segment is known, primers were used. 28S rDNA forward
primer was 5'- GGTTGGTTTCTTTTCCT -3' and its reverse primer was 5’- AAGTAAAAGTCGTAACAAGG
-3'. PCR conditions as follows, 5 minute denaturing at 95°C, denaturing at 95°C for 30 seconds, annealing at
53°C, and 30 seconds extension at 72°C for 40 cycles (13-15).
2.5. Electrophoresis and Analysis
Agarose gel electrophoresis was then performed to analyze the DNA samples using a 2% agarose gel at
100 V for 30 minutes. Ethedium bromide was used to colour each band under ultraviolet light. Band sizes were
subsequently compared to the molecular weight band markers for 100-1000 base pairs for confirmation.
III. Results
Figure-1 shows the mycological culture and microscopic images of T. metagrophytes and M. audouinii.
Rapid identification of dermatophyte species by 28S rDNA Polymerase Chain Reaction (PCR)
DOI: 10.9790/0853-141142730 www.iosrjournals.org 29 | Page
Figure-2 shows the mycological culture and microscopic images of T. rubrum and T.tonsurans.
Figure -3 shows the PCR bands for 28SrDNA
Rapid identification of dermatophyte species by 28S rDNA Polymerase Chain Reaction (PCR)
DOI: 10.9790/0853-141142730 www.iosrjournals.org 30 | Page
Among 22 samples, successfully we isolated 4 species, 3 belonged to Trichophyton, and one belonged
to the Microsporum. L1 - Trichophyton rubrum, L2- Trichophyton tonsurans gave band size 650bp. L3-
Trichophyton mentagrophytes and L4- Microsporum audouinii gave band at 900bp. L5- 100bp DNA ladder.
IV. Discussion
Dermatophytes are fungi that belong to three genera: Epidermophyton, Microsporum, and
Trichophyton. Identification of dermatophyte species is essential for appropriate diagnosis and treatment of
dermatophytosis (16). Routine identification depends on macroscopic and microscopic morphology, which is
time-consuming and does not identify dermatophyte strains (17, 18). In this study, PCR-based method used for
their abilities to identify 22 dermatophyte isolates obtained from KGH hospital patients to the species and strain
levels. Here in the present study we employed a method: PCR amplification, using 28S rDNA primers.
Dermatophyte strains were also identified using a conventional culture method (19). Out of 22 samples,
successfully we isolated 4 species, 3 belonged to Trichophyton, and one belonged to the Microsporum. Our
results showed that the conventional culture method identified four species: Microsporum audouinii,
Trichophyton mentagrophytes Trichophyton rubrum, and Trichophyton tonsurans. Trichophyton rubrum,
Trichophyton tonsurans gave band size 650bp. Trichophyton mentagrophytes and Microsporum audouinii gave
band at 900bp. Moreover, both PCR methods agreed with the diagnosis made using the conventional approach.
This report describes the application of PCR fingerprinting for the identification of species and
varieties of common dermatophytes and related fungi utilizing 28S rDNA primer (20). The primer was able to
amplify all the strains, producing species-specific profiles for Microsporum audouinii, Trichophyton rubrum,
Trichophyton mentagrophytes, and Trichophyton tonsurans.
V. Conclusion
Improved sensitivity for the detection of fungi in clinical samples were obtained using the PCR assay.
The spectrum of fungi detected depends on the test designs and requires careful evaluation with the local
epidemiology in mind. Challenges associated with DNA extraction from clinical specimens seem to be resolved.
Rapid and reliable molecular identification of the infectious fungus can be used routinely and presents several
important advantages compared with culture in expediting the choice of appropriate antifungal therapy.
However, very few assays have been externally evaluated, and thus future studies are needed for nonbiased
validations.
References
[1]. Ajello, L. 1962. Present day concepts in the dermatophytes. Mycopathol. Mycol. Appl. 17:315–324.
[2]. Ajello, L. 1968. A taxonomic review of the dermatophytes and related species. Sabouraudia 6:147–159.
[3]. Ajello, L. 1974. Natural history of the dermatophytes and related fungi. Mycopathol. Mycol. Appl. 53:93–110.
[4]. Ajello, L. 1977. Milestones in the history of medical mycology: the dermatophytes, p. 3–11. In K. Iwata (ed.), Recent advances in
medical and veterinary mycology. University of Tokyo Press, Tokyo.
[5]. Ajello, L. 1977. Taxonomy of the dermatophytes: a review of their imperfect and perfect states, p. 289–297. In K. Iwata (ed.),
Recent advances in medical and veterinary mycology. University of Tokyo Press, Tokyo.
[6]. Anonymous. 1990. Onychomycosis and terbinafine. Lancet i:636. (Editorial.)
[7]. Bowman, B. H., and J. W. Taylor. 1992. Molecular evolution of the fungi: human pathogens. J. Mol. Biol. Evol. 9:893–904.
[8]. Gra¨ ser Y, Scott J, Summerbell R. The new species concept in dermatophytes a polyphasic approach. Mycopathologia 2008;
166:239–256.
[9]. Berk, S. H., N. S. Penneys, and G. D. Weinstein. 1976. Epidermal activity in annular dermatophytosis. Arch. Dermatol. 112:485–
488.
[10]. Larone, DH: Medically Important Fungi, A Guide to Identification, 2nd Edition, New York, Elsevier Science Publishing Co., 1987.
[11]. Baron, EJ, Finegold, SM: Baily & Scott's Diagnostic Microbiology, 8th Edition, St. Louis, C.V. Mosby Company, 1990.
[12]. Koneman, EW, Roberts, GD: Practical Laboratory Mycology, Baltimore, The Williams and Wilkins Co., 1985.
[13]. Badillet, G. 1988. Dermatophytes et immigration. Ann. Biol. Clin. 46:37–43.
[14]. Chmel, L. 1980. Zoophilic dermatophytes and infections in man. Med. Mycol. 8(Suppl.):61–66.
[15]. Bentley, M. D., R. J. Anderegg, P. J. Szaniszlo, and R. F. Davenport. 1986. Isolation and identification of the principal siderophore
of the dermatophyte Microsporum gypseum. Biochemistry 25:1455–1457.
[16]. Bronson, D. M., D. R. Desai, S. Barskey, and S. McMillen Foley. 1983. An epidemic of infection with Trichophyton tonsurans
revealed in a 20 year survey of fungal infections in Chicago. J. Am. Acad. Dermatol. 8:322–330
[17]. Apodaca, G., and J. H. McKerrow. 1990. Expression of proteolytic activity by cultures of Trichophyton rubrum. J. Med. Vet.
Mycol. 28:159–171.
[18]. Baer, R. L., S. A. Rosenthal, J. L. Litt, and H. Rogachefsky. 1956. Experimental investigations on the mechanism producing acute
dermatophytosis of the feet. JAMA 160:184–190.
[19]. Babel, D. E., and S. A. Baughman. 1989. Evaluation of the adult carrier state in juvenile tinea capitis caused by Trichophyton
tonsurans. J. Am. Acad. Dermatol. 21:1209–1212.
[20]. Birnbaum, J. E. 1990. Pharmacology of the allylamines. J. Am. Acad. Dermatol. 23:782–785.

Contenu connexe

Tendances

Group 5 DNA Tech - Ecology & Envt
Group 5 DNA Tech - Ecology & EnvtGroup 5 DNA Tech - Ecology & Envt
Group 5 DNA Tech - Ecology & EnvtJessica Kabigting
 
TB presentation
TB presentationTB presentation
TB presentationGamal Agmy
 
Serological detection techniques of plant viruses
Serological detection techniques of plant virusesSerological detection techniques of plant viruses
Serological detection techniques of plant virusesN.H. Shankar Reddy
 
Paper id 21201499
Paper id 21201499Paper id 21201499
Paper id 21201499IJRAT
 
melissa Poster SGM 2013
melissa Poster SGM 2013melissa Poster SGM 2013
melissa Poster SGM 2013Melissa Choong
 
molecular microbiology
molecular microbiologymolecular microbiology
molecular microbiologyVEENA P KUMAR
 
quarantine by sahadeo kuwardadra
quarantine by sahadeo kuwardadraquarantine by sahadeo kuwardadra
quarantine by sahadeo kuwardadrasahadeo kuwardadra
 
2015 new phytol mazzoleni et al
2015 new phytol mazzoleni et al2015 new phytol mazzoleni et al
2015 new phytol mazzoleni et alClaudia Lanteri
 
Modern Techniques for Detection of Seed Born Fungi.
Modern Techniques for Detection of Seed Born Fungi.Modern Techniques for Detection of Seed Born Fungi.
Modern Techniques for Detection of Seed Born Fungi.ParanjayRohiwala
 
Moleecular mechanism of disease diagnosis
Moleecular mechanism of disease diagnosisMoleecular mechanism of disease diagnosis
Moleecular mechanism of disease diagnosisjeeva raj
 
Identification of micro organisms
Identification of micro organismsIdentification of micro organisms
Identification of micro organismsakash mahadev
 
Current methods for plant disease diagnosis
Current methods for plant disease diagnosisCurrent methods for plant disease diagnosis
Current methods for plant disease diagnosisSHIVANI PATHAK
 

Tendances (18)

Group 5 DNA Tech - Ecology & Envt
Group 5 DNA Tech - Ecology & EnvtGroup 5 DNA Tech - Ecology & Envt
Group 5 DNA Tech - Ecology & Envt
 
TB presentation
TB presentationTB presentation
TB presentation
 
Serological detection techniques of plant viruses
Serological detection techniques of plant virusesSerological detection techniques of plant viruses
Serological detection techniques of plant viruses
 
Paper id 21201499
Paper id 21201499Paper id 21201499
Paper id 21201499
 
melissa Poster SGM 2013
melissa Poster SGM 2013melissa Poster SGM 2013
melissa Poster SGM 2013
 
molecular microbiology
molecular microbiologymolecular microbiology
molecular microbiology
 
quarantine by sahadeo kuwardadra
quarantine by sahadeo kuwardadraquarantine by sahadeo kuwardadra
quarantine by sahadeo kuwardadra
 
Lab diagnosis
Lab diagnosisLab diagnosis
Lab diagnosis
 
Abbas Morovvati
Abbas MorovvatiAbbas Morovvati
Abbas Morovvati
 
Ppt for seminar
Ppt for seminarPpt for seminar
Ppt for seminar
 
final report
final reportfinal report
final report
 
2015 new phytol mazzoleni et al
2015 new phytol mazzoleni et al2015 new phytol mazzoleni et al
2015 new phytol mazzoleni et al
 
Modern Techniques for Detection of Seed Born Fungi.
Modern Techniques for Detection of Seed Born Fungi.Modern Techniques for Detection of Seed Born Fungi.
Modern Techniques for Detection of Seed Born Fungi.
 
Moleecular mechanism of disease diagnosis
Moleecular mechanism of disease diagnosisMoleecular mechanism of disease diagnosis
Moleecular mechanism of disease diagnosis
 
molecular approches
molecular approchesmolecular approches
molecular approches
 
Identification of micro organisms
Identification of micro organismsIdentification of micro organisms
Identification of micro organisms
 
viruses-08-00300 (1)
viruses-08-00300 (1)viruses-08-00300 (1)
viruses-08-00300 (1)
 
Current methods for plant disease diagnosis
Current methods for plant disease diagnosisCurrent methods for plant disease diagnosis
Current methods for plant disease diagnosis
 

Similaire à Rapid identification of dermatophyte species by 28S rDNA Polymerase Chain Reaction (PCR)

Molecular Environmental Microbiology.ppt
Molecular Environmental Microbiology.pptMolecular Environmental Microbiology.ppt
Molecular Environmental Microbiology.pptHuma Hameed
 
Diagnostic tool development using advanced techniques in biotechnology for mi...
Diagnostic tool development using advanced techniques in biotechnology for mi...Diagnostic tool development using advanced techniques in biotechnology for mi...
Diagnostic tool development using advanced techniques in biotechnology for mi...BioMedSciDirect Publications
 
Genomic markers for parasitic infections
Genomic markers for parasitic infectionsGenomic markers for parasitic infections
Genomic markers for parasitic infectionsRangineni Prada
 
Malaria treatment schedules and socio economic implications of
Malaria treatment schedules and socio  economic implications ofMalaria treatment schedules and socio  economic implications of
Malaria treatment schedules and socio economic implications ofAlexander Decker
 
PCR & NON PCR BASED MARUTHI.pptx
PCR  & NON PCR BASED MARUTHI.pptxPCR  & NON PCR BASED MARUTHI.pptx
PCR & NON PCR BASED MARUTHI.pptxMaruthiHpatil1
 
Prevalence of Moraxella ovis Infection in Goats under the Ladang Angkat Progr...
Prevalence of Moraxella ovis Infection in Goats under the Ladang Angkat Progr...Prevalence of Moraxella ovis Infection in Goats under the Ladang Angkat Progr...
Prevalence of Moraxella ovis Infection in Goats under the Ladang Angkat Progr...iosrjce
 
mego (M-1607) Master Seminar Presentation.pptx
mego (M-1607) Master Seminar Presentation.pptxmego (M-1607) Master Seminar Presentation.pptx
mego (M-1607) Master Seminar Presentation.pptxSurenderKumar488475
 
s12917-021-03064-9.pdf
s12917-021-03064-9.pdfs12917-021-03064-9.pdf
s12917-021-03064-9.pdfNisar Ahmad
 
Fungal Identification method by RDNA sequence analysis: Molecular approach to...
Fungal Identification method by RDNA sequence analysis: Molecular approach to...Fungal Identification method by RDNA sequence analysis: Molecular approach to...
Fungal Identification method by RDNA sequence analysis: Molecular approach to...IOSR Journals
 
Fungal Identification method by RDNA sequence analysis: Molecular approach to...
Fungal Identification method by RDNA sequence analysis: Molecular approach to...Fungal Identification method by RDNA sequence analysis: Molecular approach to...
Fungal Identification method by RDNA sequence analysis: Molecular approach to...IOSR Journals
 
The Sensitivity Of 99mTc-Ciprofloxacin (Infecton) Scintigraphy Imaging To Det...
The Sensitivity Of 99mTc-Ciprofloxacin (Infecton) Scintigraphy Imaging To Det...The Sensitivity Of 99mTc-Ciprofloxacin (Infecton) Scintigraphy Imaging To Det...
The Sensitivity Of 99mTc-Ciprofloxacin (Infecton) Scintigraphy Imaging To Det...iosrphr_editor
 
Customizable pcr microplate array for differential identification of multiple...
Customizable pcr microplate array for differential identification of multiple...Customizable pcr microplate array for differential identification of multiple...
Customizable pcr microplate array for differential identification of multiple...Tiensae Teshome
 
Molecular Dıagnostic Tests Used in the Dıagnosis of Tuberculosis_Crimson Publ...
Molecular Dıagnostic Tests Used in the Dıagnosis of Tuberculosis_Crimson Publ...Molecular Dıagnostic Tests Used in the Dıagnosis of Tuberculosis_Crimson Publ...
Molecular Dıagnostic Tests Used in the Dıagnosis of Tuberculosis_Crimson Publ...CrimsonpublishersCJMI
 

Similaire à Rapid identification of dermatophyte species by 28S rDNA Polymerase Chain Reaction (PCR) (20)

Molecular Environmental Microbiology.ppt
Molecular Environmental Microbiology.pptMolecular Environmental Microbiology.ppt
Molecular Environmental Microbiology.ppt
 
Diagnostic tool development using advanced techniques in biotechnology for mi...
Diagnostic tool development using advanced techniques in biotechnology for mi...Diagnostic tool development using advanced techniques in biotechnology for mi...
Diagnostic tool development using advanced techniques in biotechnology for mi...
 
Genomic markers for parasitic infections
Genomic markers for parasitic infectionsGenomic markers for parasitic infections
Genomic markers for parasitic infections
 
Detection of contaminants_in_human_cell_culture
Detection of contaminants_in_human_cell_cultureDetection of contaminants_in_human_cell_culture
Detection of contaminants_in_human_cell_culture
 
A Study of Fungal Isolates from Superficial Mycoses Cases Attending IIMS& R, ...
A Study of Fungal Isolates from Superficial Mycoses Cases Attending IIMS& R, ...A Study of Fungal Isolates from Superficial Mycoses Cases Attending IIMS& R, ...
A Study of Fungal Isolates from Superficial Mycoses Cases Attending IIMS& R, ...
 
Malaria treatment schedules and socio economic implications of
Malaria treatment schedules and socio  economic implications ofMalaria treatment schedules and socio  economic implications of
Malaria treatment schedules and socio economic implications of
 
PCR & NON PCR BASED MARUTHI.pptx
PCR  & NON PCR BASED MARUTHI.pptxPCR  & NON PCR BASED MARUTHI.pptx
PCR & NON PCR BASED MARUTHI.pptx
 
Prevalence of Moraxella ovis Infection in Goats under the Ladang Angkat Progr...
Prevalence of Moraxella ovis Infection in Goats under the Ladang Angkat Progr...Prevalence of Moraxella ovis Infection in Goats under the Ladang Angkat Progr...
Prevalence of Moraxella ovis Infection in Goats under the Ladang Angkat Progr...
 
ijep-03-22531-1
ijep-03-22531-1ijep-03-22531-1
ijep-03-22531-1
 
mego (M-1607) Master Seminar Presentation.pptx
mego (M-1607) Master Seminar Presentation.pptxmego (M-1607) Master Seminar Presentation.pptx
mego (M-1607) Master Seminar Presentation.pptx
 
s12917-021-03064-9.pdf
s12917-021-03064-9.pdfs12917-021-03064-9.pdf
s12917-021-03064-9.pdf
 
O01721103106
O01721103106O01721103106
O01721103106
 
Fungal Identification method by RDNA sequence analysis: Molecular approach to...
Fungal Identification method by RDNA sequence analysis: Molecular approach to...Fungal Identification method by RDNA sequence analysis: Molecular approach to...
Fungal Identification method by RDNA sequence analysis: Molecular approach to...
 
Fungal Identification method by RDNA sequence analysis: Molecular approach to...
Fungal Identification method by RDNA sequence analysis: Molecular approach to...Fungal Identification method by RDNA sequence analysis: Molecular approach to...
Fungal Identification method by RDNA sequence analysis: Molecular approach to...
 
ijep-03-01-21820-1
ijep-03-01-21820-1ijep-03-01-21820-1
ijep-03-01-21820-1
 
ajcmi-02-03-29691 edited by SC
ajcmi-02-03-29691 edited by SCajcmi-02-03-29691 edited by SC
ajcmi-02-03-29691 edited by SC
 
The Sensitivity Of 99mTc-Ciprofloxacin (Infecton) Scintigraphy Imaging To Det...
The Sensitivity Of 99mTc-Ciprofloxacin (Infecton) Scintigraphy Imaging To Det...The Sensitivity Of 99mTc-Ciprofloxacin (Infecton) Scintigraphy Imaging To Det...
The Sensitivity Of 99mTc-Ciprofloxacin (Infecton) Scintigraphy Imaging To Det...
 
Customizable pcr microplate array for differential identification of multiple...
Customizable pcr microplate array for differential identification of multiple...Customizable pcr microplate array for differential identification of multiple...
Customizable pcr microplate array for differential identification of multiple...
 
Seminario nisseria final
Seminario nisseria finalSeminario nisseria final
Seminario nisseria final
 
Molecular Dıagnostic Tests Used in the Dıagnosis of Tuberculosis_Crimson Publ...
Molecular Dıagnostic Tests Used in the Dıagnosis of Tuberculosis_Crimson Publ...Molecular Dıagnostic Tests Used in the Dıagnosis of Tuberculosis_Crimson Publ...
Molecular Dıagnostic Tests Used in the Dıagnosis of Tuberculosis_Crimson Publ...
 

Plus de iosrjce

An Examination of Effectuation Dimension as Financing Practice of Small and M...
An Examination of Effectuation Dimension as Financing Practice of Small and M...An Examination of Effectuation Dimension as Financing Practice of Small and M...
An Examination of Effectuation Dimension as Financing Practice of Small and M...iosrjce
 
Does Goods and Services Tax (GST) Leads to Indian Economic Development?
Does Goods and Services Tax (GST) Leads to Indian Economic Development?Does Goods and Services Tax (GST) Leads to Indian Economic Development?
Does Goods and Services Tax (GST) Leads to Indian Economic Development?iosrjce
 
Childhood Factors that influence success in later life
Childhood Factors that influence success in later lifeChildhood Factors that influence success in later life
Childhood Factors that influence success in later lifeiosrjce
 
Emotional Intelligence and Work Performance Relationship: A Study on Sales Pe...
Emotional Intelligence and Work Performance Relationship: A Study on Sales Pe...Emotional Intelligence and Work Performance Relationship: A Study on Sales Pe...
Emotional Intelligence and Work Performance Relationship: A Study on Sales Pe...iosrjce
 
Customer’s Acceptance of Internet Banking in Dubai
Customer’s Acceptance of Internet Banking in DubaiCustomer’s Acceptance of Internet Banking in Dubai
Customer’s Acceptance of Internet Banking in Dubaiiosrjce
 
A Study of Employee Satisfaction relating to Job Security & Working Hours amo...
A Study of Employee Satisfaction relating to Job Security & Working Hours amo...A Study of Employee Satisfaction relating to Job Security & Working Hours amo...
A Study of Employee Satisfaction relating to Job Security & Working Hours amo...iosrjce
 
Consumer Perspectives on Brand Preference: A Choice Based Model Approach
Consumer Perspectives on Brand Preference: A Choice Based Model ApproachConsumer Perspectives on Brand Preference: A Choice Based Model Approach
Consumer Perspectives on Brand Preference: A Choice Based Model Approachiosrjce
 
Student`S Approach towards Social Network Sites
Student`S Approach towards Social Network SitesStudent`S Approach towards Social Network Sites
Student`S Approach towards Social Network Sitesiosrjce
 
Broadcast Management in Nigeria: The systems approach as an imperative
Broadcast Management in Nigeria: The systems approach as an imperativeBroadcast Management in Nigeria: The systems approach as an imperative
Broadcast Management in Nigeria: The systems approach as an imperativeiosrjce
 
A Study on Retailer’s Perception on Soya Products with Special Reference to T...
A Study on Retailer’s Perception on Soya Products with Special Reference to T...A Study on Retailer’s Perception on Soya Products with Special Reference to T...
A Study on Retailer’s Perception on Soya Products with Special Reference to T...iosrjce
 
A Study Factors Influence on Organisation Citizenship Behaviour in Corporate ...
A Study Factors Influence on Organisation Citizenship Behaviour in Corporate ...A Study Factors Influence on Organisation Citizenship Behaviour in Corporate ...
A Study Factors Influence on Organisation Citizenship Behaviour in Corporate ...iosrjce
 
Consumers’ Behaviour on Sony Xperia: A Case Study on Bangladesh
Consumers’ Behaviour on Sony Xperia: A Case Study on BangladeshConsumers’ Behaviour on Sony Xperia: A Case Study on Bangladesh
Consumers’ Behaviour on Sony Xperia: A Case Study on Bangladeshiosrjce
 
Design of a Balanced Scorecard on Nonprofit Organizations (Study on Yayasan P...
Design of a Balanced Scorecard on Nonprofit Organizations (Study on Yayasan P...Design of a Balanced Scorecard on Nonprofit Organizations (Study on Yayasan P...
Design of a Balanced Scorecard on Nonprofit Organizations (Study on Yayasan P...iosrjce
 
Public Sector Reforms and Outsourcing Services in Nigeria: An Empirical Evalu...
Public Sector Reforms and Outsourcing Services in Nigeria: An Empirical Evalu...Public Sector Reforms and Outsourcing Services in Nigeria: An Empirical Evalu...
Public Sector Reforms and Outsourcing Services in Nigeria: An Empirical Evalu...iosrjce
 
Media Innovations and its Impact on Brand awareness & Consideration
Media Innovations and its Impact on Brand awareness & ConsiderationMedia Innovations and its Impact on Brand awareness & Consideration
Media Innovations and its Impact on Brand awareness & Considerationiosrjce
 
Customer experience in supermarkets and hypermarkets – A comparative study
Customer experience in supermarkets and hypermarkets – A comparative studyCustomer experience in supermarkets and hypermarkets – A comparative study
Customer experience in supermarkets and hypermarkets – A comparative studyiosrjce
 
Social Media and Small Businesses: A Combinational Strategic Approach under t...
Social Media and Small Businesses: A Combinational Strategic Approach under t...Social Media and Small Businesses: A Combinational Strategic Approach under t...
Social Media and Small Businesses: A Combinational Strategic Approach under t...iosrjce
 
Secretarial Performance and the Gender Question (A Study of Selected Tertiary...
Secretarial Performance and the Gender Question (A Study of Selected Tertiary...Secretarial Performance and the Gender Question (A Study of Selected Tertiary...
Secretarial Performance and the Gender Question (A Study of Selected Tertiary...iosrjce
 
Implementation of Quality Management principles at Zimbabwe Open University (...
Implementation of Quality Management principles at Zimbabwe Open University (...Implementation of Quality Management principles at Zimbabwe Open University (...
Implementation of Quality Management principles at Zimbabwe Open University (...iosrjce
 
Organizational Conflicts Management In Selected Organizaions In Lagos State, ...
Organizational Conflicts Management In Selected Organizaions In Lagos State, ...Organizational Conflicts Management In Selected Organizaions In Lagos State, ...
Organizational Conflicts Management In Selected Organizaions In Lagos State, ...iosrjce
 

Plus de iosrjce (20)

An Examination of Effectuation Dimension as Financing Practice of Small and M...
An Examination of Effectuation Dimension as Financing Practice of Small and M...An Examination of Effectuation Dimension as Financing Practice of Small and M...
An Examination of Effectuation Dimension as Financing Practice of Small and M...
 
Does Goods and Services Tax (GST) Leads to Indian Economic Development?
Does Goods and Services Tax (GST) Leads to Indian Economic Development?Does Goods and Services Tax (GST) Leads to Indian Economic Development?
Does Goods and Services Tax (GST) Leads to Indian Economic Development?
 
Childhood Factors that influence success in later life
Childhood Factors that influence success in later lifeChildhood Factors that influence success in later life
Childhood Factors that influence success in later life
 
Emotional Intelligence and Work Performance Relationship: A Study on Sales Pe...
Emotional Intelligence and Work Performance Relationship: A Study on Sales Pe...Emotional Intelligence and Work Performance Relationship: A Study on Sales Pe...
Emotional Intelligence and Work Performance Relationship: A Study on Sales Pe...
 
Customer’s Acceptance of Internet Banking in Dubai
Customer’s Acceptance of Internet Banking in DubaiCustomer’s Acceptance of Internet Banking in Dubai
Customer’s Acceptance of Internet Banking in Dubai
 
A Study of Employee Satisfaction relating to Job Security & Working Hours amo...
A Study of Employee Satisfaction relating to Job Security & Working Hours amo...A Study of Employee Satisfaction relating to Job Security & Working Hours amo...
A Study of Employee Satisfaction relating to Job Security & Working Hours amo...
 
Consumer Perspectives on Brand Preference: A Choice Based Model Approach
Consumer Perspectives on Brand Preference: A Choice Based Model ApproachConsumer Perspectives on Brand Preference: A Choice Based Model Approach
Consumer Perspectives on Brand Preference: A Choice Based Model Approach
 
Student`S Approach towards Social Network Sites
Student`S Approach towards Social Network SitesStudent`S Approach towards Social Network Sites
Student`S Approach towards Social Network Sites
 
Broadcast Management in Nigeria: The systems approach as an imperative
Broadcast Management in Nigeria: The systems approach as an imperativeBroadcast Management in Nigeria: The systems approach as an imperative
Broadcast Management in Nigeria: The systems approach as an imperative
 
A Study on Retailer’s Perception on Soya Products with Special Reference to T...
A Study on Retailer’s Perception on Soya Products with Special Reference to T...A Study on Retailer’s Perception on Soya Products with Special Reference to T...
A Study on Retailer’s Perception on Soya Products with Special Reference to T...
 
A Study Factors Influence on Organisation Citizenship Behaviour in Corporate ...
A Study Factors Influence on Organisation Citizenship Behaviour in Corporate ...A Study Factors Influence on Organisation Citizenship Behaviour in Corporate ...
A Study Factors Influence on Organisation Citizenship Behaviour in Corporate ...
 
Consumers’ Behaviour on Sony Xperia: A Case Study on Bangladesh
Consumers’ Behaviour on Sony Xperia: A Case Study on BangladeshConsumers’ Behaviour on Sony Xperia: A Case Study on Bangladesh
Consumers’ Behaviour on Sony Xperia: A Case Study on Bangladesh
 
Design of a Balanced Scorecard on Nonprofit Organizations (Study on Yayasan P...
Design of a Balanced Scorecard on Nonprofit Organizations (Study on Yayasan P...Design of a Balanced Scorecard on Nonprofit Organizations (Study on Yayasan P...
Design of a Balanced Scorecard on Nonprofit Organizations (Study on Yayasan P...
 
Public Sector Reforms and Outsourcing Services in Nigeria: An Empirical Evalu...
Public Sector Reforms and Outsourcing Services in Nigeria: An Empirical Evalu...Public Sector Reforms and Outsourcing Services in Nigeria: An Empirical Evalu...
Public Sector Reforms and Outsourcing Services in Nigeria: An Empirical Evalu...
 
Media Innovations and its Impact on Brand awareness & Consideration
Media Innovations and its Impact on Brand awareness & ConsiderationMedia Innovations and its Impact on Brand awareness & Consideration
Media Innovations and its Impact on Brand awareness & Consideration
 
Customer experience in supermarkets and hypermarkets – A comparative study
Customer experience in supermarkets and hypermarkets – A comparative studyCustomer experience in supermarkets and hypermarkets – A comparative study
Customer experience in supermarkets and hypermarkets – A comparative study
 
Social Media and Small Businesses: A Combinational Strategic Approach under t...
Social Media and Small Businesses: A Combinational Strategic Approach under t...Social Media and Small Businesses: A Combinational Strategic Approach under t...
Social Media and Small Businesses: A Combinational Strategic Approach under t...
 
Secretarial Performance and the Gender Question (A Study of Selected Tertiary...
Secretarial Performance and the Gender Question (A Study of Selected Tertiary...Secretarial Performance and the Gender Question (A Study of Selected Tertiary...
Secretarial Performance and the Gender Question (A Study of Selected Tertiary...
 
Implementation of Quality Management principles at Zimbabwe Open University (...
Implementation of Quality Management principles at Zimbabwe Open University (...Implementation of Quality Management principles at Zimbabwe Open University (...
Implementation of Quality Management principles at Zimbabwe Open University (...
 
Organizational Conflicts Management In Selected Organizaions In Lagos State, ...
Organizational Conflicts Management In Selected Organizaions In Lagos State, ...Organizational Conflicts Management In Selected Organizaions In Lagos State, ...
Organizational Conflicts Management In Selected Organizaions In Lagos State, ...
 

Dernier

Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...
Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...
Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...gragneelam30
 
Call Girl In Chandigarh 📞9809698092📞 Just📲 Call Inaaya Chandigarh Call Girls ...
Call Girl In Chandigarh 📞9809698092📞 Just📲 Call Inaaya Chandigarh Call Girls ...Call Girl In Chandigarh 📞9809698092📞 Just📲 Call Inaaya Chandigarh Call Girls ...
Call Girl In Chandigarh 📞9809698092📞 Just📲 Call Inaaya Chandigarh Call Girls ...Sheetaleventcompany
 
Pune Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Pune No💰Adva...
Pune Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Pune No💰Adva...Pune Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Pune No💰Adva...
Pune Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Pune No💰Adva...Sheetaleventcompany
 
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service AvailableCall Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Availableperfect solution
 
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...amritaverma53
 
Difference Between Skeletal Smooth and Cardiac Muscles
Difference Between Skeletal Smooth and Cardiac MusclesDifference Between Skeletal Smooth and Cardiac Muscles
Difference Between Skeletal Smooth and Cardiac MusclesMedicoseAcademics
 
Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...
Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...
Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...Sheetaleventcompany
 
tongue disease lecture Dr Assadawy legacy
tongue disease lecture Dr Assadawy legacytongue disease lecture Dr Assadawy legacy
tongue disease lecture Dr Assadawy legacyDrMohamed Assadawy
 
Cardiac Output, Venous Return, and Their Regulation
Cardiac Output, Venous Return, and Their RegulationCardiac Output, Venous Return, and Their Regulation
Cardiac Output, Venous Return, and Their RegulationMedicoseAcademics
 
Call Girls in Lucknow Just Call 👉👉8630512678 Top Class Call Girl Service Avai...
Call Girls in Lucknow Just Call 👉👉8630512678 Top Class Call Girl Service Avai...Call Girls in Lucknow Just Call 👉👉8630512678 Top Class Call Girl Service Avai...
Call Girls in Lucknow Just Call 👉👉8630512678 Top Class Call Girl Service Avai...soniyagrag336
 
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...dishamehta3332
 
Premium Call Girls Nagpur {9xx000xx09} ❤️VVIP POOJA Call Girls in Nagpur Maha...
Premium Call Girls Nagpur {9xx000xx09} ❤️VVIP POOJA Call Girls in Nagpur Maha...Premium Call Girls Nagpur {9xx000xx09} ❤️VVIP POOJA Call Girls in Nagpur Maha...
Premium Call Girls Nagpur {9xx000xx09} ❤️VVIP POOJA Call Girls in Nagpur Maha...Sheetaleventcompany
 
ANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptxANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptxSwetaba Besh
 
💰Call Girl In Bangalore☎️63788-78445💰 Call Girl service in Bangalore☎️Bangalo...
💰Call Girl In Bangalore☎️63788-78445💰 Call Girl service in Bangalore☎️Bangalo...💰Call Girl In Bangalore☎️63788-78445💰 Call Girl service in Bangalore☎️Bangalo...
💰Call Girl In Bangalore☎️63788-78445💰 Call Girl service in Bangalore☎️Bangalo...gragneelam30
 
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service AvailableCall Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service AvailableJanvi Singh
 
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...Sheetaleventcompany
 
💚Reliable Call Girls Chandigarh 💯Niamh 📲🔝8868886958🔝Call Girl In Chandigarh N...
💚Reliable Call Girls Chandigarh 💯Niamh 📲🔝8868886958🔝Call Girl In Chandigarh N...💚Reliable Call Girls Chandigarh 💯Niamh 📲🔝8868886958🔝Call Girl In Chandigarh N...
💚Reliable Call Girls Chandigarh 💯Niamh 📲🔝8868886958🔝Call Girl In Chandigarh N...Sheetaleventcompany
 
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...Sheetaleventcompany
 
❤️Call Girl Service In Chandigarh☎️9814379184☎️ Call Girl in Chandigarh☎️ Cha...
❤️Call Girl Service In Chandigarh☎️9814379184☎️ Call Girl in Chandigarh☎️ Cha...❤️Call Girl Service In Chandigarh☎️9814379184☎️ Call Girl in Chandigarh☎️ Cha...
❤️Call Girl Service In Chandigarh☎️9814379184☎️ Call Girl in Chandigarh☎️ Cha...Sheetaleventcompany
 
Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...
Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...
Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...Sheetaleventcompany
 

Dernier (20)

Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...
Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...
Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...
 
Call Girl In Chandigarh 📞9809698092📞 Just📲 Call Inaaya Chandigarh Call Girls ...
Call Girl In Chandigarh 📞9809698092📞 Just📲 Call Inaaya Chandigarh Call Girls ...Call Girl In Chandigarh 📞9809698092📞 Just📲 Call Inaaya Chandigarh Call Girls ...
Call Girl In Chandigarh 📞9809698092📞 Just📲 Call Inaaya Chandigarh Call Girls ...
 
Pune Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Pune No💰Adva...
Pune Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Pune No💰Adva...Pune Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Pune No💰Adva...
Pune Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Pune No💰Adva...
 
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service AvailableCall Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
 
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
 
Difference Between Skeletal Smooth and Cardiac Muscles
Difference Between Skeletal Smooth and Cardiac MusclesDifference Between Skeletal Smooth and Cardiac Muscles
Difference Between Skeletal Smooth and Cardiac Muscles
 
Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...
Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...
Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...
 
tongue disease lecture Dr Assadawy legacy
tongue disease lecture Dr Assadawy legacytongue disease lecture Dr Assadawy legacy
tongue disease lecture Dr Assadawy legacy
 
Cardiac Output, Venous Return, and Their Regulation
Cardiac Output, Venous Return, and Their RegulationCardiac Output, Venous Return, and Their Regulation
Cardiac Output, Venous Return, and Their Regulation
 
Call Girls in Lucknow Just Call 👉👉8630512678 Top Class Call Girl Service Avai...
Call Girls in Lucknow Just Call 👉👉8630512678 Top Class Call Girl Service Avai...Call Girls in Lucknow Just Call 👉👉8630512678 Top Class Call Girl Service Avai...
Call Girls in Lucknow Just Call 👉👉8630512678 Top Class Call Girl Service Avai...
 
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
 
Premium Call Girls Nagpur {9xx000xx09} ❤️VVIP POOJA Call Girls in Nagpur Maha...
Premium Call Girls Nagpur {9xx000xx09} ❤️VVIP POOJA Call Girls in Nagpur Maha...Premium Call Girls Nagpur {9xx000xx09} ❤️VVIP POOJA Call Girls in Nagpur Maha...
Premium Call Girls Nagpur {9xx000xx09} ❤️VVIP POOJA Call Girls in Nagpur Maha...
 
ANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptxANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptx
 
💰Call Girl In Bangalore☎️63788-78445💰 Call Girl service in Bangalore☎️Bangalo...
💰Call Girl In Bangalore☎️63788-78445💰 Call Girl service in Bangalore☎️Bangalo...💰Call Girl In Bangalore☎️63788-78445💰 Call Girl service in Bangalore☎️Bangalo...
💰Call Girl In Bangalore☎️63788-78445💰 Call Girl service in Bangalore☎️Bangalo...
 
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service AvailableCall Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
 
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
 
💚Reliable Call Girls Chandigarh 💯Niamh 📲🔝8868886958🔝Call Girl In Chandigarh N...
💚Reliable Call Girls Chandigarh 💯Niamh 📲🔝8868886958🔝Call Girl In Chandigarh N...💚Reliable Call Girls Chandigarh 💯Niamh 📲🔝8868886958🔝Call Girl In Chandigarh N...
💚Reliable Call Girls Chandigarh 💯Niamh 📲🔝8868886958🔝Call Girl In Chandigarh N...
 
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
 
❤️Call Girl Service In Chandigarh☎️9814379184☎️ Call Girl in Chandigarh☎️ Cha...
❤️Call Girl Service In Chandigarh☎️9814379184☎️ Call Girl in Chandigarh☎️ Cha...❤️Call Girl Service In Chandigarh☎️9814379184☎️ Call Girl in Chandigarh☎️ Cha...
❤️Call Girl Service In Chandigarh☎️9814379184☎️ Call Girl in Chandigarh☎️ Cha...
 
Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...
Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...
Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...
 

Rapid identification of dermatophyte species by 28S rDNA Polymerase Chain Reaction (PCR)

  • 1. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 14, Issue 11 Ver. IV (Nov. 2015), PP 27-30 www.iosrjournals.org DOI: 10.9790/0853-141142730 www.iosrjournals.org 27 | Page Rapid identification of dermatophyte species by 28S rDNA Polymerase Chain Reaction (PCR) Dr. T. Santhi. MD¹, Dr. C. Subhashini. MD2 , Dr. S. Jhansi Lakshmi MD3 ¹Assistant Professor, 2 Assistant Professor, 3 Assistant Professor, Dept. of DVL, Andhra Medical College, Visakhapatnam – 530002. Abstract: Dermatophytes are the main cause of onychomycoses, but various nondermatophyte filamentous fungi are often isolated from abnormal nails. The correct identification of the aetiological agent of nail infections is necessary in order to recommend appropriate treatment. To evaluate a rapid polymerase chain reaction (PCR) assay based on 28S rDNA for fungal identification in nails on a large number of samples in comparison with cultures. Infectious fungi were analyzed using PCR in 22 samples of swabs and nail samples in which fungal elements were observed in situ by direct mycological examination (positive samples). The results were compared with those previously obtained by culture of fungi on Sabouraud agar from the same samples. PCR identification of fungi in nails allowed validation of the results obtained in culture when three Trichophyton spp. and one Microsporum spp grew from infected samples. Improved sensitivity for the detection of fungi in nails was obtained using the PCR assay. Rapid and reliable molecular identification of the infectious fungus can be used routinely and presents several important advantages compared with culture in expediting the choice of appropriate antifungal therapy. Keywords: Dermatophytes, Trichophyton spp., Microsporum spp., PCR, 28S rDNA I. Introduction Molecular techniques are increasingly being employed in the clinical microbiological laboratory for identification and direct detection of microbes in clinical specimens because of the high sensitivity, specificity and speed (1). Classical diagnosis of dermatophytosis consists of direct microscopy and culture with a subsequent species identification mainly based on macroscopic and microscopic features of the culture (2, 3, 4). Dermatophytes commonly infect keratinaceous tissue such as hair, skin, and nails. This characteristic is thought to be due to an inhibitory agent in blood or serum that precludes establishment of infections at other body sites. While these organisms are pathogenic in man, they freely exist as soil saprophytes or zoopathogens. Microsporum and Trichophyton are human and animal pathogens. Epidermophyton is a human pathogen. The dermatophytes can be geophilic, zoophilic, or anthropophilic (5). The term geophilic is used for fungi whose natural habitat is in soil. Zoophilic refers to fungi that infect humans as well as lower animals. Anthropophilic means man-loving. Organisms in this category prefer to infect man (6). It is important to underscore the distinction between molecular diagnostics, which relates to the direct detection of dermatophyte DNA in the clinical specimen (nail, skin or hair), and molecular identification in the sense of application of molecular tools for species identification of fungal isolates (7, 8). Numerous targets within the fungal genome have been evaluated, with much of the current work using sequence areas within the ribosomal DNA (rDNA) gene complex (9). This section of the genome includes the 18S, 5.8S and 28S genes which code for ribosomal RNA (rRNA) and which have a relatively conserved nucleotide sequence among fungi (10). II. Research Methodology 2.1. Samples collection 22 Samples were collected from Dept. of Dermatology, King George Hospital, Visakhapatnam in the period of March 2011 to August 2013. Infected nail clippings and swabs were collected from patients. 2. 2. Culturing and lacto phenol blue staining Samples were inoculated on sabourand dextrose agar and incubated for 7-10 days. Cultured specimens were stained with cotton blue and observed under microscope. Cotton blue (China blue) stains chitin and cellulose. Since cell walls of fungi are primarily chitin, this stain is an excellent choice for observing fungi in clinical specimens (11). Placed a small drop of lactophenol cotton blue (LPCB) in the center of a clean glass slide. Removed a fragment of fungus culture with a teasing needle and placed in the LPCB and gently tease apart. Gently placed a cover slip onto the preparation. Examined the slide using the low power (10x) objective of a microscope (12).
  • 2. Rapid identification of dermatophyte species by 28S rDNA Polymerase Chain Reaction (PCR) DOI: 10.9790/0853-141142730 www.iosrjournals.org 28 | Page 2.3 DNA Isolation To evaluate a rapid polymerase chain reaction (PCR) assay based on 28S rDNA for fungal identification in samples (nails and swabs) on a large number of samples in comparison with cultures (9, 10). Infectious fungi were analyzed using PCR in 22 samples of swabs and nail samples in which fungal elements were observed in situ by direct mycological examination (positive samples). Scrap the fungal 1-2 colonies into a 1.5mL tube which is containing phosphate buffer or distilled water. Centrifuge at 1100g for 3 min. Make the pellet homogenous by hand flicking the tube. Added 5% Chelax (Resin) which is just vortexed and add 0.2µg Proteinase K and mix well. Incubated the samples at 65˚C for 20 min followed by 100˚C for 10 min. Centrifuge at 1100g for 3 min. Supernatant was used for subsequent PCR reactions. 2. 4. Amplification A polymerase chain reaction (PCR) was then carried out to amplify the DNA sequences of interest by denaturing the DNA molecule and replicating it by utilizing primers, free nucleotides, and a polymerase designed to help the DNA withstand the high temperatures involved in PCR. Because PCR can only be applied when the nucleotide sequence of at least one DNA segment is known, primers were used. 28S rDNA forward primer was 5'- GGTTGGTTTCTTTTCCT -3' and its reverse primer was 5’- AAGTAAAAGTCGTAACAAGG -3'. PCR conditions as follows, 5 minute denaturing at 95°C, denaturing at 95°C for 30 seconds, annealing at 53°C, and 30 seconds extension at 72°C for 40 cycles (13-15). 2.5. Electrophoresis and Analysis Agarose gel electrophoresis was then performed to analyze the DNA samples using a 2% agarose gel at 100 V for 30 minutes. Ethedium bromide was used to colour each band under ultraviolet light. Band sizes were subsequently compared to the molecular weight band markers for 100-1000 base pairs for confirmation. III. Results Figure-1 shows the mycological culture and microscopic images of T. metagrophytes and M. audouinii.
  • 3. Rapid identification of dermatophyte species by 28S rDNA Polymerase Chain Reaction (PCR) DOI: 10.9790/0853-141142730 www.iosrjournals.org 29 | Page Figure-2 shows the mycological culture and microscopic images of T. rubrum and T.tonsurans. Figure -3 shows the PCR bands for 28SrDNA
  • 4. Rapid identification of dermatophyte species by 28S rDNA Polymerase Chain Reaction (PCR) DOI: 10.9790/0853-141142730 www.iosrjournals.org 30 | Page Among 22 samples, successfully we isolated 4 species, 3 belonged to Trichophyton, and one belonged to the Microsporum. L1 - Trichophyton rubrum, L2- Trichophyton tonsurans gave band size 650bp. L3- Trichophyton mentagrophytes and L4- Microsporum audouinii gave band at 900bp. L5- 100bp DNA ladder. IV. Discussion Dermatophytes are fungi that belong to three genera: Epidermophyton, Microsporum, and Trichophyton. Identification of dermatophyte species is essential for appropriate diagnosis and treatment of dermatophytosis (16). Routine identification depends on macroscopic and microscopic morphology, which is time-consuming and does not identify dermatophyte strains (17, 18). In this study, PCR-based method used for their abilities to identify 22 dermatophyte isolates obtained from KGH hospital patients to the species and strain levels. Here in the present study we employed a method: PCR amplification, using 28S rDNA primers. Dermatophyte strains were also identified using a conventional culture method (19). Out of 22 samples, successfully we isolated 4 species, 3 belonged to Trichophyton, and one belonged to the Microsporum. Our results showed that the conventional culture method identified four species: Microsporum audouinii, Trichophyton mentagrophytes Trichophyton rubrum, and Trichophyton tonsurans. Trichophyton rubrum, Trichophyton tonsurans gave band size 650bp. Trichophyton mentagrophytes and Microsporum audouinii gave band at 900bp. Moreover, both PCR methods agreed with the diagnosis made using the conventional approach. This report describes the application of PCR fingerprinting for the identification of species and varieties of common dermatophytes and related fungi utilizing 28S rDNA primer (20). The primer was able to amplify all the strains, producing species-specific profiles for Microsporum audouinii, Trichophyton rubrum, Trichophyton mentagrophytes, and Trichophyton tonsurans. V. Conclusion Improved sensitivity for the detection of fungi in clinical samples were obtained using the PCR assay. The spectrum of fungi detected depends on the test designs and requires careful evaluation with the local epidemiology in mind. Challenges associated with DNA extraction from clinical specimens seem to be resolved. Rapid and reliable molecular identification of the infectious fungus can be used routinely and presents several important advantages compared with culture in expediting the choice of appropriate antifungal therapy. However, very few assays have been externally evaluated, and thus future studies are needed for nonbiased validations. References [1]. Ajello, L. 1962. Present day concepts in the dermatophytes. Mycopathol. Mycol. Appl. 17:315–324. [2]. Ajello, L. 1968. A taxonomic review of the dermatophytes and related species. Sabouraudia 6:147–159. [3]. Ajello, L. 1974. Natural history of the dermatophytes and related fungi. Mycopathol. Mycol. Appl. 53:93–110. [4]. Ajello, L. 1977. Milestones in the history of medical mycology: the dermatophytes, p. 3–11. In K. Iwata (ed.), Recent advances in medical and veterinary mycology. University of Tokyo Press, Tokyo. [5]. Ajello, L. 1977. Taxonomy of the dermatophytes: a review of their imperfect and perfect states, p. 289–297. In K. Iwata (ed.), Recent advances in medical and veterinary mycology. University of Tokyo Press, Tokyo. [6]. Anonymous. 1990. Onychomycosis and terbinafine. Lancet i:636. (Editorial.) [7]. Bowman, B. H., and J. W. Taylor. 1992. Molecular evolution of the fungi: human pathogens. J. Mol. Biol. Evol. 9:893–904. [8]. Gra¨ ser Y, Scott J, Summerbell R. The new species concept in dermatophytes a polyphasic approach. Mycopathologia 2008; 166:239–256. [9]. Berk, S. H., N. S. Penneys, and G. D. Weinstein. 1976. Epidermal activity in annular dermatophytosis. Arch. Dermatol. 112:485– 488. [10]. Larone, DH: Medically Important Fungi, A Guide to Identification, 2nd Edition, New York, Elsevier Science Publishing Co., 1987. [11]. Baron, EJ, Finegold, SM: Baily & Scott's Diagnostic Microbiology, 8th Edition, St. Louis, C.V. Mosby Company, 1990. [12]. Koneman, EW, Roberts, GD: Practical Laboratory Mycology, Baltimore, The Williams and Wilkins Co., 1985. [13]. Badillet, G. 1988. Dermatophytes et immigration. Ann. Biol. Clin. 46:37–43. [14]. Chmel, L. 1980. Zoophilic dermatophytes and infections in man. Med. Mycol. 8(Suppl.):61–66. [15]. Bentley, M. D., R. J. Anderegg, P. J. Szaniszlo, and R. F. Davenport. 1986. Isolation and identification of the principal siderophore of the dermatophyte Microsporum gypseum. Biochemistry 25:1455–1457. [16]. Bronson, D. M., D. R. Desai, S. Barskey, and S. McMillen Foley. 1983. An epidemic of infection with Trichophyton tonsurans revealed in a 20 year survey of fungal infections in Chicago. J. Am. Acad. Dermatol. 8:322–330 [17]. Apodaca, G., and J. H. McKerrow. 1990. Expression of proteolytic activity by cultures of Trichophyton rubrum. J. Med. Vet. Mycol. 28:159–171. [18]. Baer, R. L., S. A. Rosenthal, J. L. Litt, and H. Rogachefsky. 1956. Experimental investigations on the mechanism producing acute dermatophytosis of the feet. JAMA 160:184–190. [19]. Babel, D. E., and S. A. Baughman. 1989. Evaluation of the adult carrier state in juvenile tinea capitis caused by Trichophyton tonsurans. J. Am. Acad. Dermatol. 21:1209–1212. [20]. Birnbaum, J. E. 1990. Pharmacology of the allylamines. J. Am. Acad. Dermatol. 23:782–785.