الفهرس 
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Abstract
Background: Treatment of patients with hematological malignancies, particularly those with acute myeloblastic leukemia, has evolved toward the use of increasingly aggressive antineoplastic regimens and autologous or allogeneic bone marrow or peripheral blood stem cell transplantation. These therapeutic approaches induce severe neutropenia and have resulted in an increased incidence of fungal infections. Infections involved the oropharynx, esophagus, larynx, urinary tract, and gastrointestinal tract and serve as the origin for disseminated infection. Invasive fungal infections (IFIs) are now a growing problem in severely immunocompromised patients.
Aim: In our study we aimed at determination of the incidence of different fungal infections among patients of Oncology Center Mansoura University, identification of causative agents of fungal infections among patients of Oncology Center Mansoura University, determination of the antifungal susceptibility pattern of the isolated organisms, and diagnosis of systemic fungal infection by PCR.
Methods: Samples were collected from patients admitted to Oncology Center, Mansoura University showing symptoms and/ or signs of infections. Direct microscopic examination and culture were performed. diagnosis of systemic fungal infection was done by conventional blood culture and by PCR using whole blood and panfungal primer. Antifungal susceptibility testing was performed.
Results: positive results was obtained in 225 patients, 3 patients were included as possible invasive fungal sinusitis. The most common site of infection was blood stream infection represent 33.3% followed by urinary tract infection 26.3%. Fungal infections were more common in patients with haematological malignancy than patients with solid organ malignancy (52.4%). Candida albicans was the most common organism represent (53%). Sensitivity of PCR was 100% and specificity was 46%). Antifungal susceptibility pattern of the isolated organisms shows that: All isolates were sensitive to amphotricin B. Susceptibility to itraconazole: among Candida albicans was 97.9% and among non albicans Candida 80.8%.
Susceptibility to fluconazole among Candida albicans was 92.6% and among non albicans Candida 73.1%. There were nine cases of proven invasive fungal infection, four cases of probable invasive fungal infections, and twenty seven of possible invasive fungal infections.
Conclusion: The applications of PCR provide sensitive method for diagnosis of systemic fungal infection.