Fungal colonization and infection in children with acute leukemia and lymphoma during induction therapy.

BACKGROUND: Fungal infection represents a growing problem in children with hematologic malignancies. During chemotherapy induced neutropenia, colonization with fungi is considered a major risk factor for subsequent fungal infection. The rates and risk factors for mycotic infections in pediatric oncology patients is undetermined, particularly for centers in developing countries. The aim of this study was to evaluate the rates and risk factors of fungal colonization in children with acute leukemia and lymphoma at one of the major pediatric hematology/oncology centers in Turkey. PROCEDURE: Fifty-two consecutive children newly diagnosed with acute leukemia and lymphoma during intensive remission induction therapy were evaluated for the occurrence of fungal colonization (defined as at least one positive surveillance culture) and infection. RESULTS: Thirty-six of the 52 patients (69.2%) were colonized by Candida albicans which was the only fungus isolated from surveillance cultures. There were three (5.8%) proven systemic fungal infections: two cases of candidemia and one case of brain abscess with Aspergillus spp. isolated from tissue. All patients with fungal colonization were receiving prophylactic or curative antibiotics. No significant association was found between type of disease and fungal colonization, but there was a significant association with neutropenia. CONCLUSIONS: Our findings suggest that there is a high rate of fungal colonization in children receiving remission induction therapy for acute leukemia and lymphoma. Limiting the use of antibiotics and instituting antifungal chemoprophylaxis may decrease the rate, while the early initiation of empiric antifungal therapy in patients with fever and suspected mycotic colonization may increase survival in these patients.

[Activities of microorganisms isolated from clinical material from dermatophytoses]. / Dermatofitoz klinik tanili olgulardan izole edilen etkenler.

Hundred and nine dermatophytes, 14 yeast, 3 bacteria, 11 saprophyte mold were isolated from hair, skin and nail examples of 225 cases. Among isolated dermatophytes, T. rubrum and among yeast species, C. albicans are dominant.

[Comparative evaluation of the isolation of dermatophytes by direct laboratory evidence and MSDA with MDTM culture media]. / Dermatofitozlarin laboratuvar tanisinda direkt baki ve MSDA ile MDTM besiyerlerinde izolasyon oranlarinin karsilastirilmasi.

In this study, the hair, skin and nail examples taken from 225 patients suspected dermatophytoses clinically were investigated with direct microscopic examination and cultivated methods. Direct microscopic examination were positive in 135 examples (60%) and dermatophytes were isolated from 109 samples (48.4%). In the isolation of dermatophytes, the effectiveness of modified Sabouraud Dextrose Agar (mSDA) was 93.5% (102/109) and the effectiveness of modified Dermatophyte Test Medium (mDTM) was 95.4% (104/109). It was detected that there were no significant difference between these media for the isolation rate.

[Prevalence of G. vaginalis, Mycoplasma, Ureaplasma, T. vaginalis, yeast, N. gonorrhoeae and other bacteria in women with vaginal discharge]. / Vajinal akintisi olan kadinlarda G. vaginalis mikoplazma, üreaplazma, T vaginalis, maya ve N. gonorrhoeae ve diger bakterilerin sikligi.

Vaginal discharge of 118 women attended to outdoor clinics of obstetrics and gynaecology at Medical Faculty of Ankara University (A.U.T.F.), have been examined. Direct microscopy has been made by means of wet mount, Gram and Giemsa staining. Vaginal pH has been measured, by 10% KOH the presence of "fishy odor" has been investigated. For culturing vaginal secretions in Amies transport medium have been brought to Microbiology Department of Ankara University, Faculty of Medicine Inoculations have been made on to Blood agar, MacConkey agar, Sabouraud Dextrose agar, New York City. Medium, % 5 Human blood bilayer Tween 80 Medium (HBT), Vivey Trichomonas Agar Medium and into M-broth and U9 broth. In this study, we have isolated 9 (7.62%) Gardnerella vaginalis, 41 (33.89%) Ureaplasma, 13 (11.01%) Mycoplasma, 25 (21.18%) yeasts, 4 (3.38%) Trichomonas vaginalis and 43 (36.46%) various bacteria, 26 cases were found to have polymicrobial etiology.

[Isolation of beta-hemolytic streptococci from throat and nasal swabs and their antibiotic susceptibility]. / Bogaz-burun kültürlerinden izole edilen beta hemolitik streptokoklarve antibiyotiklere duyarliliklari.

1218 throat and 888 nasal swabs were collected from non hospitalized patients were examined for beta haemolytic streptococci. The samples were cultured on blood agar. To facilitate the isolation of beta haemolytic streptococci the samples were also cultured on biologically anaerobic sheep blood agar. From throat swabs and nasal swabs 174 and 13 beta haemolytic streptococci were isolated respectively. 113 beta haemolytic streptococci were identified as a group A (60%). In this study we evaluated the antibiotic susceptibility of streptococci. As a result the most effective antibiotics are in order Cefuroxime, Cefotaxime, Cephalothin, Thiamphenicol, Erythromycin.