Bacteremia and fungemia are significant causes of morbidity and mortality that frequently occur as co-infections with viral respiratory infections, including SARS-CoV-2. The aim of this study was to evaluate the microorganisms that were... more
Bacteremia and fungemia are significant causes of morbidity and mortality that frequently occur as co-infections with viral respiratory infections, including SARS-CoV-2. The aim of this study was to evaluate the microorganisms that were isolated from the blood cultures of SARS-CoV-2-positive and negative patients and investigate their antimicrobial resistance patterns. A retrospective analysis was performed of 22,944 blood cultures sent to the laboratory between November 2020 and December 2021. Blood culture analyses were performed using the BD Bactec FX automated system. Identification was carried out using conventional methods, namely, VITEK-2 and MALDI-TOF MS. Antibacterial/antifungal susceptibility tests were performed according to EUCAST/CLSI recommendations. SARS-CoV-2 tests were performed with RT-PCR. Culture positivity was detected in 1630 samples from 652 patients. Of these 652 patients, 633 were tested for SARS-CoV-2; 118 (18.6%) were positive and 515 (81.3%) were negative...
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In order to indicate the cross-resistance between rifampin (RMP) and rifabutin (RBU), minimal inhibitory concentrations (MICs) of RBU were investigated in 50 Mycobacterium tuberculosis strains. The MIC values of 25 RMP-susceptible (to 2... more
In order to indicate the cross-resistance between rifampin (RMP) and rifabutin (RBU), minimal inhibitory concentrations (MICs) of RBU were investigated in 50 Mycobacterium tuberculosis strains. The MIC values of 25 RMP-susceptible (to 2 microg/ml) and 25 RMP-resistant (to 2 microg/ml) M. tuberculosis strains against RBU were determined by the Bactec TB 460 system. All of the RMP-susceptible strains were also susceptible to RBU (MIC < or = 1 microg/ml). Three out of 25 (12%) RMP-resistant strains were determined as susceptible to RBU. The high level cross-resistance (88%) obtained in this study highlights the importance of testing susceptibility to RBU prior to its inclusion in the tuberculosis treatment regimens at the Istanbul Faculty of Medicine.
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The purpose of this study was to establish species distribution of Candida isolates from pediatric patients in Istanbul, Turkey, and to determine risk factors associated with nosocomial Candida infections. This study was conducted between... more
The purpose of this study was to establish species distribution of Candida isolates from pediatric patients in Istanbul, Turkey, and to determine risk factors associated with nosocomial Candida infections. This study was conducted between June 2013 and June 2014 by participation of 7 medical centers in Istanbul. Candida spp strains isolated from the clinical specimens of pediatric patients were included. Clinical features were recorded on a standardized data collection sheet. A total of 134 systemic Candida infections were identified in 134 patients. The patients were admitted in pediatric and neonatal intensive care units (41.8% and 9.7%, respectively) and in pediatric wards (48.5%). Candida albicans was the most prevalent species (47%), followed by Candida parapsilosis (13.4%), Candida tropicalis (8.2%), Candida glabrata (4.5%), Candida lusitaniae (3.7%), Candida kefyr (2.2%), Candida guilliermondii (1.5%), Candida dubliniensis (0.7%), and Candida krusei (0.7%). Types of Candida infections were candidemia (50.7%), urinary tract infection (33.6%), surgical site infection (4.5%), central nervous system infection (3.7%), catheter infection (3.7%), and intra-abdominal infection (3.7%). In multivariate analysis, younger age (1-24 months) and detection of non-albicans Candida spp was found to be risk factors associated with candidemia (P = 0.040; odds ratio [OR], 4.1; 95% confidence interval [CI], 1.06-15.86; and P = 0.02; OR, 2.4; 95% CI, 1.10-5.53, respectively). This study provides an update for the epidemiology of nosocomial Candida infections in Istanbul, which is important for the management of patients and implementation of appropriate infection control measures.
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The purpose of this study is to determine the prevalence of tinea pedis and onychomycosis in children of elementary school age and to examine the socio-demographic attributes that may be effective in correlation of both mycoses. 3,390... more
The purpose of this study is to determine the prevalence of tinea pedis and onychomycosis in children of elementary school age and to examine the socio-demographic attributes that may be effective in correlation of both mycoses. 3,390 female and 3,768 male children between ages 6-14 have been examined in seven schools. Skin scrapings and nail samples were taken from 13 students who were suspected to have tinea pedis and from 49 students who were suspected to have onychomycosis. According to direct microscopy (10-15% KOH+calcofluor white) and culturel examination (Sabouraud dextrose agar and dermatophyte test medium) 11 students were diagnosed as tinea pedis and 24 were diagnosed as onychomycosis. Trichophyton rubrum was isolated in 3 students with tinea pedis whose culture was positive and five Candida albicans, five Candida glabrata and one Candida tropicalis cases were isolated from 11 samples with onychomycosis. Tinea pedis prevalence has been found to be 3.3%0. Differences between onychomycosis prevalence based on age have been found to be significant (p < 0.001). In conclusion, it has been determined that the prevalence of tinea pedis and onychomycosis among children is low. Candida spp. was isolated from all of the 14 samples diagnosed as onychomycosis. Our study shows similar results with previous studies done in Turkey and that Trichophyton rubrum continues to be the most isolated agent.
Research Interests: Anthropology, Turkey, Adolescent, Social Class, Humans, and 7 moreChild, Female, Male, Prevalence, Collegium, Adult, and Onychomycosis
Research Interests: Disease Outbreaks, Pregnancy, Humans, Female, Male, and 6 moreAged, Middle Aged, Adult, Intensive Care Units, Cross-infection, and Mycoses
Tinea incognito is a dermatophytosis of atypical clinical character, usually misdiagnosed and treated with corticoster-oids. A 17-year-old girl had erythematous papules and pustules on her face, diagnosed earlier as allergy and mistreated... more
Tinea incognito is a dermatophytosis of atypical clinical character, usually misdiagnosed and treated with corticoster-oids. A 17-year-old girl had erythematous papules and pustules on her face, diagnosed earlier as allergy and mistreated by topical corticosteroids and antihistamines. Facial lesions had only been investigated by bacteriological methods. Propionibacterium acnes was isolated on blood agar. Culture plates of the patient were inadvertently kept in the labo-ratory for approximately two weeks until the growth of white powdery colonies, which were identified as Trichopyton mentagrophytes complex. Epithelial scrapings were collected again and reinvestigated by mycological methods; after two weeks T. mentagrophytes complex was isolated once again on culture media. Thus, the case was diagnosed acciden-tally as Tinea incognito. It was realized that the patient previously was misdiagnosed and mistreated by topical steroids. J Microbiol Infect Dis 2011; 1(2): 84-86 Kazara tanı a...
Although conventional identification of pathogenic fungi is based on the combination of tests evaluating their morphological and biochemical characteristics, they can fail to identify the less common species or the differentiation of... more
Although conventional identification of pathogenic fungi is based on the combination of tests evaluating their morphological and biochemical characteristics, they can fail to identify the less common species or the differentiation of closely related species. In addition these tests are time consuming, labour-intensive and require experienced personnel. We evaluated the feasibility and sufficiency of DNA extraction by Whatman FTA filter matrix technology and DNA sequencing of D1-D2 region of the large ribosomal subunit gene for identification of clinical isolates of 21 yeast and 160 moulds in our clinical mycology laboratory. While the yeast isolates were identified at species level with 100% homology, 102 (63.75%) clinically important mould isolates were identified at species level, 56 (35%) isolates at genus level against fungal sequences existing in DNA databases and two (1.25%) isolates could not be identified. Consequently, Whatman FTA filter matrix technology was a useful method for extraction of fungal DNA; extremely rapid, practical and successful. Sequence analysis strategy of D1-D2 region of the large ribosomal subunit gene was found considerably sufficient in identification to genus level for the most clinical fungi. However, the identification to species level and especially discrimination of closely related species may require additional analysis.
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Pseudomonas aeruginosa which is widely found in the environment, may lead to serious nosocomial infections. Due to its intrinsic resistance to many antibacterial agents, treatment of P.aeruginosa infections usually present difficulty.... more
Pseudomonas aeruginosa which is widely found in the environment, may lead to serious nosocomial infections. Due to its intrinsic resistance to many antibacterial agents, treatment of P.aeruginosa infections usually present difficulty. Quinolones, especially ciprofloxacin, are crutial antibiotics for the treatment of P.aeruginosa infections. However resistance developing to quinolones may become an important problem. Resistance to quinolones is often a result of chromosomal mutations and by the effect of efflux pumps. Recently plasmid-mediated quinolone resistance have been reportedin the members of Enterobacteriaceae family. The gene responsible for this resistance is called qnr. In addition to qnr genes there is also another gene called aac(6)-Ib-cr responsible for plasmid-mediated quinolone resistance and aminoglycoside resistance. Limited studies which to screen P.aeruginosa strains for the presence of qnr gene region, revealed no positivity. The aim of this study was to investi...
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The purpose of this study is to determine the prevalence of tinea pedis and onychomycosis in children of elementary school age and to examine the socio-demographic attributes that may be effective in correlation of both mycoses. 3,390... more
The purpose of this study is to determine the prevalence of tinea pedis and onychomycosis in children of elementary school age and to examine the socio-demographic attributes that may be effective in correlation of both mycoses. 3,390 female and 3,768 male children between ages 6-14 have been examined in seven schools. Skin scrapings and nail samples were taken from 13 students who were suspected to have tinea pedis and from 49 students who were suspected to have onychomycosis. According to direct microscopy (10-15% KOH+calcofluor white) and culturel examination (Sabouraud dextrose agar and dermatophyte test medium) 11 students were diagnosed as tinea pedis and 24 were diagnosed as onychomycosis. Trichophyton rubrum was isolated in 3 students with tinea pedis whose culture was positive and five Candida albicans, five Candida glabrata and one Candida tropicalis cases were isolated from 11 samples with onychomycosis. Tinea pedis prevalence has been found to be 3.3%0. Differences betwe...
Research Interests: Anthropology, Turkey, Adolescent, Social Class, Humans, and 7 moreChild, Female, Male, Prevalence, Collegium, Adult, and Onychomycosis
A mini epidemic of Dipodascus capitatus (teleomorph of Geotrichum capitatum) involving three cases is reported. The index case was pulmonary infection and a fulminant course of fungal infection, which resulted in the patient's death... more
A mini epidemic of Dipodascus capitatus (teleomorph of Geotrichum capitatum) involving three cases is reported. The index case was pulmonary infection and a fulminant course of fungal infection, which resulted in the patient's death with acute myelocytic leukemia. In the other cases, the patients were simultaneously hospitalized, the first in the intensive care unit. In all cases, D. capitatus was identified in different samples (sputum, deep tracheal aspiration, blood, and urine) from each of the patients. Growing evidence indicates that D. capitatus should be added to the lengthening list of opportunistic fungal pathogens that can cause infection in people of all ages and particularly in those who are immunocompromised. Further, the danger of cross-contamination and potential "outbreak" should be kept in mind during hospital management.
Research Interests: Disease Outbreaks, Pregnancy, Humans, Female, Male, and 6 moreAged, Middle Aged, Adult, Intensive Care Units, Cross-infection, and Mycoses
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ABSTRACT
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Research Interests: Turkey, HIV, Humans, Female, Candida, and 9 moreMale, Clinical Sciences, Aged, Prevalence, Middle Aged, Adult, Mouth, Viral Load, and Mycoses
Abstract In recent years, hospital infections caused by oppor-tunist micro-organisms in immunosupressed patients groups have become increasingly important. These micro-organisms grow easily in water distribution systems even to the extent... more
Abstract In recent years, hospital infections caused by oppor-tunist micro-organisms in immunosupressed patients groups have become increasingly important. These micro-organisms grow easily in water distribution systems even to the extent of producing bio-film. In the present study the ...
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Abstracts The purpose of this study is to determine the prevalence of tinea pedis and onychomycosis in children of elementary school age and to examine the socio-demographic attributes that may be effective in correlation of both mycoses.... more
Abstracts The purpose of this study is to determine the prevalence of tinea pedis and onychomycosis in children of elementary school age and to examine the socio-demographic attributes that may be effective in correlation of both mycoses. 3,390 female and 3,768 male children ...
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Fungal infections have increased dramatically in recent years and candidemia is a major risk factor for morbidity and mortality in intensive care units (ICUs). Candidemia has been considered to be a nosocomial infection that is strongly... more
Fungal infections have increased dramatically in recent years and candidemia is a major risk factor for morbidity and mortality in intensive care units (ICUs). Candidemia has been considered to be a nosocomial infection that is strongly associated with neutropenia, recent surgery or presence of intravascular lines, and previous colonization is an independent risk factor. We evaluated the in vitro efficacy of fluconazole and amphotericin B against yeasts isolated from various clinical specimens of colonized or infected patients treated in the ICUs of the Institute of Cardiology, Istanbul University. A total of 1397 ICU patients were treated at the Institute of Cardiology between January 2000 and December 2002. A total of 117 yeasts isolated from 97 patients were included in this study. These ICU patients were hospitalized for a mean of 29 days. All yeasts were identified by conventional methods and using the API (20C AUX, ID 32C) system (Bio Meriéux, France). Susceptibility to fluconazole and amphotericin B was evaluated using the E-test (AB Biodisk, Solna, Sweden). The most commonly isolated yeast was Candida albicans (72.6%), followed by Candida tropicalis (16.2%), Candida kefyr, Candida krusei, Candida parapsilosis, Trichosporon mucoides and Geotrichum spp. Fluconazole and amphotericin B MIC90 values were 0.75 microg/ml; 0.19 microg/ml and 1 microg/ml; 0.38 microg/ml for C. albicans and C. tropicalis, respectively. All Geotrichum spp. were found to be susceptible-dose dependent (SDD) (MIC=16-32 microg/ml) to fluconazole. Two C. albicans, two C. tropicalis, one C. krusei and one Geotrichum spp. had a MIC value of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or = 0.38 microg/ml for amphotericin B. The rate of colonization was 3.36% (47/1397). Only 10 (0.71%) patients out of a total of 1397 developed candidemia during the period of the investigation. Of these, 7 (70%) were caused by non-albicans Candida spp.
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Aim: Mycobacteria other than tuberculosis (MOTT) cause increasingly serious infections especially in immunosuppressive patients by direct transmission from the environment or after colonization. However, identification of these species is... more
Aim: Mycobacteria other than tuberculosis (MOTT) cause increasingly serious infections especially in immunosuppressive patients by direct transmission from the environment or after colonization. However, identification of these species is difficult because of the cost and difficulties in defining to species level. Identification and distribution of these species can help clinician in the choice of treatment.
Materials and methods: A total of 90 MOTT strains obtained from four different centers were included in the study. These strains were identified by sequence analysis of 16S rRNA and Hsp65 genetic regions.
Results: Accordingly, within the 90 MOTT strains, 17 different species were identified. In order of frequency, these species were M. gordonea (n = 21), M. abscessus (n = 13), M. lentiflavum (n = 9), M. fortuitum (n = 8), M. intracellulare (n = 6), M. kumamotonense (n = 6), M. neoaurum (n = 5), M. chimaera (n = 5), M. alvei (n = 5), M. peregrinum (n = 3), M. canariasense (n = 3), M. flavescens (n = 1), M. mucogenicum (n = 1), M. chelona (n = 1), M. elephantis (n = 1), M. terrae (n = 1) and M. xenopi (n = 1). Most frequently identified MOTT species according to the geographical origin were as follows: M. abscessus was the most common species either in Istanbul or Malatya regions (n = 6, n = 6, consequently). While M. kumamotonense was the most frequent species isolated from Ankara region (n = 6), M. gordonea was the most common for Samsun region (n = 14).
Conclusion: Our study revealed that frequency of MOTT varies depending on the number of clinical samples and that frequency of these species were affected by the newly identified species as a result of the use of novel molecular methods. In conclusion, when establishing diagnosis and treatment methods, it is important to know that infections caused by unidentified MOTT species may vary according to the regions in Turkey. The results of the study showed that there were differences in the frequency of MOTT species in the different geographical regions of Turkey.
Materials and methods: A total of 90 MOTT strains obtained from four different centers were included in the study. These strains were identified by sequence analysis of 16S rRNA and Hsp65 genetic regions.
Results: Accordingly, within the 90 MOTT strains, 17 different species were identified. In order of frequency, these species were M. gordonea (n = 21), M. abscessus (n = 13), M. lentiflavum (n = 9), M. fortuitum (n = 8), M. intracellulare (n = 6), M. kumamotonense (n = 6), M. neoaurum (n = 5), M. chimaera (n = 5), M. alvei (n = 5), M. peregrinum (n = 3), M. canariasense (n = 3), M. flavescens (n = 1), M. mucogenicum (n = 1), M. chelona (n = 1), M. elephantis (n = 1), M. terrae (n = 1) and M. xenopi (n = 1). Most frequently identified MOTT species according to the geographical origin were as follows: M. abscessus was the most common species either in Istanbul or Malatya regions (n = 6, n = 6, consequently). While M. kumamotonense was the most frequent species isolated from Ankara region (n = 6), M. gordonea was the most common for Samsun region (n = 14).
Conclusion: Our study revealed that frequency of MOTT varies depending on the number of clinical samples and that frequency of these species were affected by the newly identified species as a result of the use of novel molecular methods. In conclusion, when establishing diagnosis and treatment methods, it is important to know that infections caused by unidentified MOTT species may vary according to the regions in Turkey. The results of the study showed that there were differences in the frequency of MOTT species in the different geographical regions of Turkey.