[Antifungal susceptibilities of Aspergillus spp. strains isolated from invasive aspergillosis cases]. / Invazif aspergillozlu olgulardan izole edilen Aspergillus spp. suslarinin antifungal duyarliliklari.

Aspergillus species found abundantly in the outer environment and hospital setting may lead to serious morbidity and mortality particularly in patients with suppressed immunity. This retrospective study was aimed to investigate the antifungal susceptibilities of Aspergillus spp. isolated from aspergillosis cases being hospitalized. Aspergillus spp. isolated from samples of the patients with suspected fungal infections between January of 2002 and October of 2007, were investigated. A total of 678 samples (420 lower respiratory tract, 202 sterile body fluids, and 56 biopsy/tissue specimens) from 569 patients were included in the study. The samples were incubated in 25 degrees C and 35 degrees C on brain-heart-infusion agar supplemented with blood and on Sabouraud dextrose agar. Gram and Giemsa stained samples were also examined by microscopy. Mold type of fungi were identified by conventional techniques. "Invasive aspergillosis" was described according to criteria of Invasive Fungal Infections Cooperative Group of the European Organization for Research and Treatment of Cancer. A. fumigatus (n = 8), A. flavus (n = 2) and A. niger (n = 2) were isolated from 12 patients' samples (2.1%), 9 of them were lower respiratory tract and one of each was ascid, brain biopsy and pleural fluid specimens. All of those patients have had an underlying diseases such as malignancy. The susceptibility of the isolates to caspofungin, voriconazole, itraconazole and amphotericin B was tested by broth microdilution susceptibility testing and to posaconazole by E-test (AB Biodisk, Sweden). The lowest minimum inhibitory concentration (MIC) (< or = 0.125 microg/ml) values were detected for caspofungin and posaconazole for Aspergillus spp., however, the highest MIC values were detected for amphotericin B (> 1 microg/ml). MIC values of the all strains except one, were detected as < or = 0.5 microg/ml for voriconazole and itraconazole. In one A. niger strain itraconazole MIC value was 2 microg/ml. Since the number of other species was low, MIC50 value was determined only for A. fumigatus strains and it was found that the highest MIC50 value was for amphotericin B (2 microg/ml) and the lowest MIC50 values were for posaconazole (0.064 microg/ml), caspofungin (0.064 microg/ml), itraconazol (0.25 microg/ml) and voriconazol (0.25 microg/ml). Since caspofungin and posaconazole revealed the lowest MIC values, they should be taken into consideration in choice of therapy of aspergillosis cases in our hospital.

Molecular identification, genotyping, and drug susceptibility of the basidiomycetous yeast pathogen Trichosporon isolated from Turkish patients.

Deep-seated infections due to Trichosporon species are emerging mycoses that have a very poor prognosis in patients with persistent neutropenia. This study elucidated the mycological characteristics of Trichosporon strains obtained from deep-seated infections in Turkish patients and identified by DNA sequence analysis of intergenic spacer (IGS) region 1 of the rDNA locus. In addition, we genotyped the major causative agent, T. asahii, and evaluated the in vitro drug susceptibility of the isolates. While 87 (81.3%) of the 107 isolates were T. asahii, the remaining 20 were T. faecale (14.0%), T. asteroids (0.9%), T. coremiiforme (0.9%), T. japonicum, (0.9%), T. lactis (0.9%), and a new species (0.9%). In addition to the eight known T. asahii genotypes, one novel genotype was identified. The distribution of the T. asahii genotypes in this study were genotype 1 (79.3%), followed by 5 (8.0%), 3 (6.9%), 6 (3.4%), 4 (1.1%), and 9 (1.1%). Turkish isolates showed low susceptibility to amphotericin B, 5-flucytosine, and fluconazole. Although relatively low minimum inhibitory concentrations (MICs) were found with all drugs, voriconazole appeared to be the most active. The MICs of the non-Trichosporon asahiiTrichosporon species were similar to those of the T. asahii strains. Our findings suggest that Trichosporon species isolated from Turkish patients are more diverse than those reported from other countries.

[Cystic echinococcosis in Turkey from 2001-2005]. / Türkiye'de 2001-2005 Yillari Arasinda Kistik Ekinokokkozis.

Cystic echinococcosis (CE) caused by the metacestode form of Echinococcus granulosus is a major public health problem especially in animal-raising regions of the world. In the present study, CE cases were determined during 2001-2005 by investigating different hospital and health directorship documents and Health Ministry documents, retrospectively. Our results show that there were 2534 (13.13%) cases in the Marmara region; 2114 (16.94%), in the Aegean region; 2578 (16.09%), Mediterranean region; 5404 (38.57%), in the Middle Anatolian region; 428 (5.70%), in the Black Sea region; 844 (6.80%), in the eastern Anatolian region; and 887 (2.75%), in the southeastern Anatolian region making a total of 14,789 CE cases. Finally, it has been determined that the patients were hospitalized for a total of 149,464 days.

[Retrospective evaluation of patients who were diagnosed as infectious mononucleosis between 1984-2005]. / 1984-2005 Yillari arasinda enfeksiyöz mononikleoz tanisi alan hastalarin retrospektif olarak degerlendirilmesi.

In this study, the clinical and laboratory features of 26 infectious mononucleosis (IMN) cases who have been diagnosed between the years of 1984-2005 were evaluated retrospectively. The mean age of the patients was 26+/-11 years, the rate of being hospitalized was 65%, and mean hospitalization period was 9.2+/-6 days. Fever (81%), weakness (50%), sore throat (50%), headache (50%) and swollen neck (35%) were the most common symptoms, while in the physical examination cervical lymphadenopathy (81%), splenomegaly (69%), hyperemic pharynx (65%), hepatomegaly (54%) and tonsillitis (50%) were observed. Laboratory results yielded leukocytosis in 21%, leucopenia in 12%, anemia in 44%, thrombocytopenia in 5% and elevated transaminase levels in 84% of the patients. Of the patients 15 (57.7%) had the history of using antibiotics before the diagnosis. Serological diagnosis was performed by Paul-Bunnel test and/or IgM positivity against Epstein-Barr virus (EBV) viral capsid antigen (VCA). Tonsillo-pharyngitis secondary to edema and respiratory distress due to lymphadenopathy pressure were detected in four patients, whereas pancytopenia was established only in one patient, as complications. This study emphasized that, although IMN is a self-limited infection, the diagnostic difficulties may arise when the clinical course is atypical, and rarely seen life-threatening complications may also develop during IMN course.

[Meningitis caused by Oerskovia xanthineolytica]. / Oerskovia xanthineolytica menenjiti.

Oerskovia species are Nocardia-like bacteria that have been only and rarely associated with human infections. In this report, a meningitis case caused by Oerskovia xanthineolytica was presented. A 44 years old male patient who had experienced ventriculo-peritoneal shunt (V-P shunt) due to hydrocephaly, developed meningitis. O. xanthineolytica was isolated from three of the cerebrospinal fluid (CSF) samples and V-P shunt cultures. Identification of the isolate was performed by Phoenix SystemTM (NMIC/ID-5 panel, Becton Dickson, Sparks, MD, USA). Empirical vancomycin (2x1 g/day iv) plus rifampin (1x600 mg/day po) therapy has failured. Since CSF cultures were still positive in the 22nd day of therapy, the shunt was removed and continuation of the same antimicrobial treatment for 42 days resulted in complete cure.