Species distribution and in vitro susceptibility of Candida bloodstream isolates to six new and current antifungal agents in a Turkish tertiary care military hospital, recovered through 2001 and 2006.

OBJECTIVE: Species distribution and antifungal susceptibility of Candida bloodstream isolates. METHODS: 173 Candida species recovered from fungemic patients admitted to the largest tertiary-care military hospital between 2001 and 2006 in Ankara, Turkey evaluated retrospectively. Antifungal susceptibility of 95 isolates (45 Candida parapsilosis, 35 C. albicans, 7 C. tropicalis, 4 C. krusei, 3 C. glabrata, and 1 C. kefyr) was determined against fluconazole, itraconazole, voriconazole, posaconazole, caspofungin, and amphotericin B. RESULTS: C. albicans was the most common yeast (48.0%), followed by C. parapsilosis. Almost all strains showed low minimal inhibitory concentration (MIC) values to all six antifungals tested. Only 2 of 45 C. parapsilosis isolates were resistant to fluconazole, one was susceptible in a dose-dependent manner (SDD) to itraconazole, and 14 were nonsusceptible to caspofungin. CONCLUSIONS: Increasing prevalence of C. parapsilosis emphasizes a need for better catheter care and continuous surveillance programs.

Fungal endophthalmitis caused by Aspergillus ustus in a patient following cataract surgery.

The first case of postoperative endophthalmitis after cataract surgery caused by Aspergillus ustus, a species that has only rarely been implicated in human disease, is described. Six weeks after cataract surgery, a 67-year-old medically controlled diabetic patient presented with uveitis, mild ciliary injection and ocular discomfort. Anterior chamber paracentesis, vitreous tap and finally complete vitrectomy with removal of the capsular bag including the intraocular lens were performed and several sets of culture yielded A. ustus. Despite vigorous systemic (itraconazole and caspofungin) and intravitreal (amphotericin B and caspofungin) antifungal therapy, the endophthalmitis did not improve. The painful eye with marked inflammation was finally enucleated. In vitro susceptibility testing of the isolate showed that it appeared resistant to amphotericin B, caspofungin, itraconazole, voriconazole, and posaconazole, and susceptible to terbinafine.

[Genotyping of Candida albicans strains isolated from nosocomial fungemia patients by pulsed-field gel electrophoresis]. / Nozokomiyal fungemili hastalardan izole edilen Candida albicans suslarinin "pulsed-field" jel elektroforezi ile genotiplendirilmesi.

Candida albicans has the most important place among fungal agents causing systemic infections. Molecular epidemiologic methods, especially pulsed-field gel electrophoresis (PFGE) are used frequently for outbreak investigations and to reveal existing clones in hospital environment. In this study, from 2000 through 2003, 42 C. albicans strains, isolated from the patients with nosocomial fungemia, were genotyped by PFGE. The results revealed that 31 different karyotypes existed among the study population. In conclusion, these C. albicans strains which were isolated in our hospital during the study period were not clonally related, whereas they were most probably arising from endogenous sources. It might be emphasized that the combination of PFGE method with a secondary method would be very useful to improve its discriminatory power although PFGE alone gives highly reproducible results.

Cryptococcus neoformans varieties from material under the canopies of eucalyptus trees and pigeon dropping samples from four major cities in Jordan.

To our best knowledge, any study related to the ecological distribution of Cryptococcus neoformans in Jordan does not exist in the medical literature. In order to determine the environmental occurrence of both varieties of Cryptococcus neoformans in Jordan, pigeon droppings and material under the canopies of eucalyptus trees were collected from four major cities of this country. For the isolation of Cryptococcus neoformans variety gattii from environmental sources, 500 samples of the mixed soil debris, including tree materials, under the eucalyptus trees from cities of Amman, Irbid, Jerash, and Ajlun were collected. Also, 509 samples of pigeon droppings were collected from the same cities for the isolation of Cryptococcus neoformans variety neoformans. After inoculating the samples onto modified Staib agar medium in Petri dishes, a total of 336 melanoid yeast colonies were picked up during screening process. At the end of serial mycological studies, none of these isolates was identified as Cryptococcus neoformans, but all were Cryptococcus species other than C. neoformans. For determining the exact status, more extensive environmental studies need to be done in the future.