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Papers by altay atalay

Turkish Journal of Medical Sciences

To explore the presence of ALS1 and HWP1 genes by multiplex polymerase chain reaction (PCR) in Ca... more To explore the presence of ALS1 and HWP1 genes by multiplex polymerase chain reaction (PCR) in Candida albicans strains. Materials and methods: By using the multiplex PCR method, the presence of agglutinin-like sequence 1 (ALS1) and hyphal wall protein 1 (HWP1) genes were investigated in 206 C. albicans strains that were isolated from various clinical samples. Phenotypic identification of slime formation by microplate and tube adherence tests was performed. Results: The presence of the ALS1 gene was detected in 53.9% of all strains, while the HWP1 gene was present in 5.3%. Slime formation was phenotypically detected in the 62.2% of the strains in which the ALS1 and/or the HWP1 gene was found, using the microplate and/ or tube adherence test. The genes evaluated were found to be present in the 76.7% of strains in which slime formation was detected by phenotypic tests. There was a moderate correlation between the presence of the ALS1 gene and the microplate method, yet there was no correlation when using the tube adherence test. Conclusion: It was concluded that various genes other than those evaluated could be present in slime formation of C. albicans, and the presence of the genes may not always be represented in the phenotype.

Turkish Journal of Medical Sciences

To investigate some virulence factors in Candida species isolated from patients with suspected in... more To investigate some virulence factors in Candida species isolated from patients with suspected invasive fungal infection and to identify their relationship with Candida genotypes. Materials and methods: Overall 45 isolates (20 Candida albicans and 25 non-albicans Candida spp.) genotyped by rep-PCR were included in this study. Virulence factors were studied in both aerobic and anaerobic conditions. In isolates, egg yolk agar was used for determining phospholipase activity, while bovine serum albumin agar was used for proteinase activity, Tween-80 medium for esterase activity, and Sabouraud dextrose agar with sheep blood for hemolysin activity. Biofilm formation was detected by the microplate method. Results: In both Candida spp., it was found that hemolytic activity and proteinase activity were higher in aerobic conditions, whereas biofilm formation was higher in anaerobic conditions. It was also found that phospholipase and esterase activity were only detected in C. albicans isolates, which were found to be higher in aerobic conditions. No difference was found in virulence factors evaluated among the C. albicans genotypes. Conclusion: The amount of oxygen in the atmosphere may affect the virulence of Candida spp. Further comprehensive studies are needed in order to identify the relationship between Candida genotypes and virulence factors.

Introduction: Candida species found in normal human flora can cause infection in immunocompromise... more Introduction: Candida species found in normal human flora can cause infection in immunocompromised patties. Although Candida infections are frequently observed with Candida albicans strains, the incidence of infections with non-albicans strains has increased recently. Candida kefyr, one of these, is a rare fungal pathogen. We aimed to present our experience in five patients with Candida kefyr infection between 2010-2018. Case report: C. kefyr grew from the blood culture in a 2-years-old girl with mediastinal T-cell lymphoblastic lymphoma when the absolute neutrophil count was 1070/mm 3 , and the patient was receiving oral voriconazole and iv amphotericin B. These two antifungal drugs were then switched to fluconazole. C. kefyr was re-established in blood culture 45 days after the first grew so fluconazole treatment continued because it was sensitive. A 2-years-old girl with pulmonary primitive neuroectodermal tumor was hospitalized for febrile neutropenia. Although antibiotic, fluconazole, and granulocyte colony stimulating factor treatment was used, C. kefyr grew in the blood cultures. Amphotericin b that found to be sensitive was switched. There was no reproduction in the control blood culture. One-year-old boy with infantile leukemia with a history of hematopoietic stem cell transplantation was admitted with diarrhea and hospitalized with a differential diagnosis of gastrointestinal graft versus host disease. Fluconazole therapy which was sensitive to the isolated strain was given to the patient. There was no reproduction in the follow up. A 17-year-old male patient with medullary and central nervous system relapse was hospitalized for hematopoietic stem cell transplantation. Lumber punction was performed because the patient has h high fever and headache. He was neutropenic, and C. keyfr was grew from the cerebro spinal fluid Amphothericin B was replaced with caspofungin which was found to be effective to the isolated C. kefyr. He was discharged with oral voriconazole therapy. A 9-year-olds girl with B-cell Acute lymphoblastic leukemia was hospitalized for neutropenic fever, and shortness of breath, cough, and mucositis. The C. kefyr grew from sputum, so fluconazole treatment was given for 21 days. Her respiratory symptoms were resolved with this treatment. Conclusion: C. keyfr is one of the most frequently isolated non albicans candida fungal pathogens in our treated patients. C. kefyr should be considered to as a relatively common and potentially causative non C. albicans agent in children with hematological malignancy and bone marrow transplantation.

Bolu Abant Izzet Baysal Universitesi Tip Fakultesi Abant Tip Dergisi, 2021

Süt çocukluğu dönemindeki kan dolaşımı enfeksiyon (KDE) etken dağılımının ve antibiyotik duyarlıl... more Süt çocukluğu dönemindeki kan dolaşımı enfeksiyon (KDE) etken dağılımının ve antibiyotik duyarlılıklarının belirlenmesi ampirik antibiyotik tedavisinde yol gösterici olacaktır. Bu çalışmada süt çocukluğu döneminde karşılaşılan bakteriyel KDE etkenlerinin dağılımı ve antibiyotik direncinin değerlendirilmesi amaçlanmıştır. YÖNTEM ve GEREÇLER: Ocak 2015 ile Ağustos 2020 tarihleri arasında hastaneye yatırılan bebeklerin (en az bir aylık ve 1 yaşından küçük) kan kültürü sonuçları geriye dönük olarak mikroorganizma dağılımı ve antimikrobiyal direnç açısından analiz edildi. BULGULAR: Farklı hastalara ait 20763 kan kültürünün 17706'sında (%85,3) üreme saptanmamışken, 1272 (%6,1) kan kültür şişesindeki üreme kontaminasyon kabul edilmiştir. Üreme tespit edilen 1785 kan kültürü sonucu çalışmamızda değerlendirmeye alınmıştır. Etkenlerin dağılımı incelendiğinde %72'sini (n=1286) Gram-pozitif, %28'sini (n=499) Gram negatif bakteriler oluşturmaktır. En sık izole edilen Gram pozitif mikroorganizma Staphylococcus epidermidis olurken Gram negatif patojen Klebsiella pneumoniae olmuştur. Metisilin dirençli Staphylococcus aureus (MRSA) oranı %19,7; Metisilin dirençli S. epidermidis (MRSE) oranı ise %85,9 olarak bulunmuştur. Vankomisin dirençli Enterekok (VRE) oranı ise %15,9 (14/88) saptanmıştır. Klebsiella spp. için Genişlemiş spektrumlu βlaktamaz (GSBL) üretim oranı %32,3 (67/207), karbapenem direnci %18,3 (n=33), kolistin direnci %6,6 (n=12) saptanmıştır. Yoğun Bakım Ünitelerinden (YBÜ) alınan kan kültürlerinde diğer pediatri kliniklerine göre daha fazla oranda üreme saptanmıştır. TARTIŞMA ve SONUÇ: Çalışmamız sonuçları Gram pozitif bakterilerde glikopeptid grubu antibiyotiklerin tedavide kullanımına devam edilebileceğini göstermektedir. Ancak Gram negatif bakteriler için elde edilen sonuçlar karbapenem türevi ilaçların tek başına kullanımını kısıtlamakta ve tedavide aminoglikozid ve polimiksin grubu antibiyotiklerin birlikte kullanımını desteklemektedir.

Fungal kan dolasimi enfeksiyonlari, immun yetmezlikli hastalarda mortalite ve morbiditenin onde g... more Fungal kan dolasimi enfeksiyonlari, immun yetmezlikli hastalarda mortalite ve morbiditenin onde gelen nedenlerinden birisidir. Invazif kandidiyazise neden olan turler arasinda Candida albicans halen en sik gorulen patojen olmakla beraber diger Candida turlerinin de orani artmaktadir. Bu calismada kan kulturlerinden izole edilen Candida turlerinin tanimlanmasi ve bunlarin amfoterisin B ve flukonazole duyarliliklarinin arastirilmasi amaclandi. Temmuz 2009–2011 tarihleri arasinda 97 hastanin kan kulturunden izole edilen Candida turleri calismaya alindi. Izolatlarin tanimlanmasinda, germ tup testi, misir unu-Tween 80 agar besiyerindeki morfolojik gorunumleri ve API 20C AUX (Biomerieux, Fransa) sistemi kullanildi. C. albicans en cok (% 68) izole edilen tur olup bunu C. parapsilosis (% 14.5) ve C. glabrata (% 9.3) izledi. Amfoterisin B, flukonazol duyarliliklari ve Minimum Inhibitor Konsantrasyon (MIK) degerleri E-test ( AB Biodisk, Isvec) yontemiyle yapildi. Izole edilen tum Candida susl...

Journal of Biotechnology and Strategic Health Research, 2020

Amaç: Hidrojen peroksitin penetrasyon özelliği zayıftır. Lümenli tıbbi cihazlarda, çap ve uzunluk... more Amaç: Hidrojen peroksitin penetrasyon özelliği zayıftır. Lümenli tıbbi cihazlarda, çap ve uzunluk sınırlaması olduğundan uygunluk açısından firmaların önerileri dikkate alınmalıdır. Bu çalışmada, iki farklı Hidrojen peroksit gaz plazma (H2O2 GP) cihazının lümenli tıbbi cihazları steril etmede uzunluk ve lümen çapı açısından, etilen oksitle sterilizasyona göre bir farklarının olup olmadığının araştırılması amaçlanmıştır. Yöntem: Özel olarak hazırlanmış, biyolojik indikatörün her iki ucundan da gaz girişine müsaade ettiği, biyolojik validasyon kitinin içine uzunlukları ve lümen çapları birbirinden farklı polietilen lümenli cihazlar konularak polyolefin paketleme malzemesi (Tyvek 60 gr, PMS; Türkiye) içine paketlendi. Sterilizasyon koşullarının en kötü olduğu vakum çıkış noktasına yakın bir yere konularak kısa döngüde sterilizasyon işlemi yapıldı. Bu işlemler Sterrad 100S (Advanced Sterilization Products; ABD) cihazında 55 °C’de 55 dk, LK/MJG-150 (Laoken, Low Temperature and Examinatio...

Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive, 2016

A 66-year-old female patient with multiple myeloma (MM) was admitted to the emergency service on ... more A 66-year-old female patient with multiple myeloma (MM) was admitted to the emergency service on 29.09.2014 with an inability to walk, and urinary and faecal incontinence. She had previously undergone autologous bone marrow transplantation (ABMT) twice. The patient was hospitalized at the Department of Haematology. Further investigations showed findings suggestive of a spinal mass at the T5-T6-T7 level, and a mass lesion in the iliac fossa. The mass lesion was resected and needle biopsy was performed during a colonoscopy. Examination of the specimens revealed plasmacytoma. The patient also had chronic obstructive pulmonary disease (COPD) and was suffering from respiratory distress. After consultation with an infectious diseases specialist the patient was placed on an intravenous antibiotherapy with piperacillin/tazobactam (4.5g x 3) on 17.10.2014. During piperacillin/tazobactam treatment, the patient suffered from drowsiness, her general condition deteriorated, and she had rales on ...

Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive, 2016

Nocardia otitidiscaviarum belongs to the agents of opportunistic infections seen in immunocomprom... more Nocardia otitidiscaviarum belongs to the agents of opportunistic infections seen in immunocompromised patients, but may occur rarely in immunocompetent patients. In this report we described a case of a previously healthy 69-year-old woman with cerebral and retroperitoneal abscess due to Nocardia otitidiscaviarum. The patient was admitted to hospital because of loss of strength in her right arm and leg. Nocardia spp. was isolated from the abscess material. The intracranial lesions were drained by stereotactic craniotomy. The large abscess located around the left kidney was drained and microscopic examination of aspirated material showed Nocardia spp. For species identification, 16S rRNA gene sequencing was carried out and was 100% concordant with Nocardia otitidiscaviarum. Use of 16S rDNA gene sequencing for identification permits detection of rare aetiologic agents that cause brain abscesses.

Journal of clinical laboratory analysis, 2016

Aspergillus species cause a wide range of diseases in humans, including allergies, localized infe... more Aspergillus species cause a wide range of diseases in humans, including allergies, localized infections, or fatal disseminated diseases. Rapid detection and identification of Aspergillus spp. facilitate effective patient management. In the current study we compared conventional morphological methods with PCR sequencing, rep-PCR, and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) for the identification of Aspergillus strains. A total of 24 consecutive clinical isolates of Aspergillus were collected during 2012-2014. Conventional morphology and rep-PCR were performed in our Mycology Laboratory. The identification, evaluation, and reporting of strains using MALDI-TOF-MS were performed by BioMérieux Diagnostic, Inc. in Istanbul. DNA sequence analysis of the clinical isolates was performed by the BMLabosis laboratory in Ankara. Samples consisted of 18 (75%) lower respiratory tract specimens, 3 otomycosis (12.5%) ear tissues, 1 sample from kera...

Nigerian journal of clinical practice

The Candida species, which are one of the most common causes of nosocomial bloodstream infections... more The Candida species, which are one of the most common causes of nosocomial bloodstream infections, present with high mortality and morbidity rates. This study aims to investigate the production of esterase, phospholipase, proteinase, and biofilm formation ability of the Candida strains isolated from the blood cultures. Between June 2011 and July 2012, the Candida strains, which were isolated from blood cultures of a total of 50 patients, were studied. The esterase activity was analyzed in the Tween-80 agar, while phospholipase activity was studied in the egg yolk agar. The proteinase activity and biofilm formation were identified by using the petri dish method and microplate method, respectively. Of 50 specimens obtained from individual patients, 17 (34%) were identified as C. albicans, 14 (28%) as C. glabrata, 9 (18%) as C. parapsilosis, 5 (10%) as C. krusei, 4 (8%) as C. kefyr, and 1 (2%) as C. tropicalis. The rate of proteinase, phospholipase, and esterase positivity was higher i...

Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive, 2013

The clinical and laboratory diagnosis of cerebral aspergillosis (CA) is problematic and mortality... more The clinical and laboratory diagnosis of cerebral aspergillosis (CA) is problematic and mortality is quite high, even in cases receiving appropriate treatment. Therefore, an early and accurate diagnosis may prove to be life saving in patients with the diagnosis of CA. In this report, a case of CA which developed in a pediatric patient with acute lymphoblastic leukemia (ALL) is presented. Upon development of neutropenia and focal seizures in the left arm during implementation of the ALL treatment protocol, brain MRI was performed in the patient and nodular lesions compliant with brain abscess were detected in the frontal lobe, left cerebellum and the cingulate gyrus on the superior aspect of the left corpus callosum. Direct assessment of brain tissue revealed fungal elements, while consecutive serum galactomannan (GM) values were determined as 3.39 ng/ml and 0.72 ng/ml, and the consecutive serum (1x3)-beta-D-glucan (BG) values were 93 pg/ml and 356 pg/ml. Negative serum real-time pol...

Erciyes Tıp Dergisi/Erciyes Medical Journal, 2012

Catheter-related bacteremia is a frequent complication in patients undergoing hemodialysis. We re... more Catheter-related bacteremia is a frequent complication in patients undergoing hemodialysis. We report the first case of catheter-related bacteremia with Streptococcus dysgalactiae subsp equisimilis in a patient on hemodialysis. The organism was isolated from both the hemodialysis catheter and blood of the patient. Although the hemodialysis cathether was removed and ceftriaxone was given, the patient died of a subarachnoidal bleeding complicating end-stage renal disease.

Dental Materials Journal, 2015

The aim of this study was to evaluate and compare the effects of resin infiltration and sealant t... more The aim of this study was to evaluate and compare the effects of resin infiltration and sealant type on enamel surface properties and Streptococcus mutans adhesion to artificial enamel lesions. Artificial enamel lesions were produced on the surfaces of 120 enamel specimens, which were divided into two groups: Group A and Group B (n=60 per group). Each group was further divided into four subgroups (n=15 per subgroup) according to sealant type: Group I-Demineralized enamel (control); Group II-Enamel Pro Varnish; Group III-ExciTE F; and Group IV-Icon. In Group A, hardness and surface roughness were evaluated; in Group B, bacterial adhesion was evaluated. Icon application resulted in significantly lower surface roughness and higher hardness than the other subgroups in Group A. In Group B, Enamel Pro Varnish resulted in lowest bacterial adhesion, followed by Icon. This study showed that resin infiltration of enamel lesions could arrest lesion progress.

Turkish Bulletin of Hygiene and Experimental Biology, 2013

Objective: Candida spp. are the most important pathogens in critically ill patients and the epide... more Objective: Candida spp. are the most important pathogens in critically ill patients and the epidemiology is changing. While Candida albicans remains the predominant pathogen, the proportion of infection caused by other species of Candida continues to increase. In recent years, due to the increase in incidence of infections with non-albicans strains and the development of resistance to antifungals, identification of Candida strains to species level gained significant importance.The aim of this study was to identify Candida strain isolated from various clinical specimens. Method: January 2011 to June 2012, Candida strains were isolated from 3905 clinical specimen. In identification of Candida species that were isolated, germ tube test, growth in Cornmeal-Tween 80 agar and formation of clamydospore, presence of pseudohyphae, carbonhytrate fermentation and assimilation tests, and the test of nitrate were studied Results: Finally 1122 Candida strains were isolated from 3905 various clinical specimens. The distribution of clinical specimens were as fallows: 556 from bronchoalveolar lavage (49.6%), 271 from sputum (24.2%), 114 from blood (10.2%), 51 vaginal swabs (4.6%), 50 from urine (4.4%), 30 from tissue (2.6%), 22 from endotracheal tracheal aspirate (ETA) (1.9%), nine from pleural mai (0.80%), six from peritoneal fluid (0.53%), four ÖZET Amaç: Candida türleri kritik hastalarda en önemli patojendir ve epidemiyolojisi sürekli değişmektedir. Candida albicans enfeksiyona neden olan türler arasında halen en sık görülen patojen olmakla beraber diğer Candida türlerinin de oranı artmaktadır. Son yıllarda albicans dışındaki diğer Candida'larla oluşan enfeksiyonlardaki artış ve antifugallare direnç gelişmesi Candida türlerinin oluşturduğu enfeksiyonlardan izole edilen etkenlerin tür düzeyinde tanımlanmasında önem kazanmıştır. Bu çalışmada çeşitli klinik örneklerden izole edilen Candida türlerinin tanımlanması amaçlanmıştır Yöntem: Ocak 2011-Haziran 2012 tarihleri arasında 3905 klinik örnekten Candida türleri izole edilmiştir. Candida türlerinin tanımlanmasında germ tüp testi, Cornmeal-Tween 80 agarda üreme ve klamidospor oluşumu, pseudohif bulunuşu, karbonhidrat fermantasyon ve asimilasyon testleri, üreaz testi, nitrat testi çalışılmıştır.

Turkish Bulletin of Hygiene and Experimental Biology, 2013

Objective: Urinary system infections caused by Candida species are the most common nosocomial inf... more Objective: Urinary system infections caused by Candida species are the most common nosocomial infections. Diabetes mellitus, urinary system defects, chronic renal failure, neutopenia, immunsuppressive treatment, and use of antimicrobials of patients increase the incidence of these infections. Antifungal tests should be applied with identification of species for effective treatment. In this study, identification of Candida species isolated from urine and investigation of susceptibility of these strains to amphotericin B, fluconazole, voriconazole and caspofungin by E-test method are aimed to be investigated. Method: 61 Candida strains isolated from urine cultures of hospitalized patients between June-December 2011 are included in the study. Germ tube test, growth on Cornmeal-Tween 80 agar and chylamidospore formation, presence of psudohyphae, carbohydrate fermentation and assimilation tests, urease test and nitrate tests were used to identificate Candida species. The antifungal (amphotericin B, fluconazole, voriconazole, and caspofungin) susceptibility of the identified Candida strains was investigated by E-test (AB Biodisk, Sweden) method. For this method, RPMI 1640 medium with 2% glucose and 1.5% agar (Sigma, USA) was used. The results were evaluated according to manufacturer recommendation. Results: Total of 61 strains were identified as follows; 18 (30%) were C. albicans, 18 (30%) were C. glabrata, 14 ÖZET Amaç: Candida türlerinin oluşturduğu üriner sistem enfeksiyonları en sık görülen hastane enfeksiyonlarındandır. Hastalardaki diabetes mellitus, üriner sistem defektleri, kronik böbrek yetmezliği, nötropeni, immunsupresif tedavi, antimikrobiyal kullanımı bu enfeksiyonların görülme oranını artırmaktadır. Etkin tedavi için tür tanımıyla birlikte antifungal testleri yapılmalıdır. Bu çalışmada idrar kültürlerinden izole edilen Candida türlerinin tanımlanması ve suşların amfoterisin B, flukonazol, vorikonazol ve kaspofungine duyarlılıklarının E-test Yöntemi ile araştırılması amaçlanmıştır. Yöntem: Haziran-Aralık 2011 tarihleri arasında yatan hastaların idrar kültürlerinden izole edilen 61 Candida suşu çalışmaya alınmıştır. Candida türlerinin tanımlanmasında germ tüp testi, Cornmeal-Tween 80 agarda üreme ve klamidospor oluşumu, pseudohif bulunuşu, karbonhidrat fermantasyon ve asimilasyon testleri, üreaz testi, nitrat testi kullanılmıştır. Tanımlanan Candida suşlarının antifungal (amfoterisin B, flukonazol, vorikonazol ve kaspofungine) duyarlılıkları E-test (AB Biodisk, İsveç) Yöntemi ile araştırılmıştır. Bu yöntemde %2 glikoz ve %1,5 agar içeren RPMI 1640 (Sigma, USA) besiyeri kullanılmıştır. Sonuçlar üretici firmanın önerisi doğrultusunda gerçekleştirilmiştir. Bulgular: Toplam 61 suşun 18 (%30)'i C. albicans, 18 (%30)'i C. glabrata, 14 (%23)'ü C. tropicalis, 7 (%11)'si C. parapsilosis, 2 (%3)'si C. krusei ve 2 (%3)'si de

Turkish journal of haematology : official journal of Turkish Society of Haematology, 2014

We aimed to investigate posttransplant Epstein-Barr virus (EBV) and parvovirus B19 DNA in allogen... more We aimed to investigate posttransplant Epstein-Barr virus (EBV) and parvovirus B19 DNA in allogeneic stem cell transplant patients between 2009 and 2010. Forty-five adult patients in whom allogeneic stem cell transplantation was performed between April 2009 and November 2010 in the Erciyes University Faculty of Medicine, Department of Internal Medicine, Division of Hematology and Oncology, were included in the study. EBV and parvovirus B19 DNA positivity was investigated by using real-time polymerase chain reaction technique in 135 plasma samples obtained after transplantation at between 1 and 6 months. Pretransplant serological markers of EBV and parvovirus B19 were provided from patient files. In 32 (71.1%) of the patients, EBV antibodies in the pretransplantation period were as follows: anti-EBNA-1 IgG (+), VCA IgM (-), and VCA IgG (+). In 2 patients (4.45%), these antibodies were as follows: anti-EBNA-1 IgG (+), VCA IgM (-), and VCA IgG (-). In 1 patient (2.2%), they were as fol...

Le infezioni in medicina: rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive

Pneumocystis jirovecii pneumoniae (PJP) may be difficult to diagnose. Since pneumocystis cannot b... more Pneumocystis jirovecii pneumoniae (PJP) may be difficult to diagnose. Since pneumocystis cannot be cultured, the diagnosis of PJP requires microscopic examination to identify pneumocystis from induced sputum or bronchoalveolar lavage (BAL) fluid. In order to evaluate the usefulness of (1-3) beta-D-glucan (BDG) levels in the early diagnosis of PJP, we describe the case of PJP in a 25-year-old male with acute lymphoblastic leukaemia (ALL) admitted to hospital with progressive dyspnea and fever with chills. The patient was not infected with human immunodeficiency virus (HIV). Sputum, blood, and urine cultures were negative; smears for acid-fast bacilli and tests for viral antibodies were both negative. The microbiology study of the BAL with Giemsa and immunofluorescence staining, seven days after admission showed the existence of P. jiroveci in the lungs. Further, one day and five days after admission, (1-3) beta-D-glucan (BDG) levels were very high. The high serum level of BDG conside...

Scandinavian Journal of Infectious Diseases, 2011

The detection of 1,3-β-d-glucan (BDG), a cell wall component of several medically important fungi... more The detection of 1,3-β-d-glucan (BDG), a cell wall component of several medically important fungi, is a promising tool for the diagnosis of invasive pulmonary aspergillosis. The aim of this study was to evaluate the diagnostic accuracy of the BDG test in invasive pulmonary aspergillosis (IPA) by focusing on the optimal cut-off value. The records of the Infection Control Committee were reviewed to identify patients with haematological malignancies and stem cell transplantation who had at least 1 BDG (Fungitell kit) measurement during the period January 2008 through April 2011. The European Organization for Research and Treatment of Cancer and the Mycoses Study Group (EORTC/MSG) criteria (independent of BDG results) were used to categorize the patients with IPA. Patients with possible IPA were not included in the study. A total of 128 patients (50 with proven or probable IPA) were included in the study. At the manufacturer's recommended cut-off value of 80 pg/ml, the sensitivity of BDG was 66% (95% CI 51.2-78.7), specificity 75.6% (95% CI 64.6-84.5), positive predictive value (PPV) 63.4%, and negative predictive value (NPV) 77.6%. A receiver operating characteristic (ROC) curve was constructed to define the optimum serum BDG cut-off for the diagnosis of IPA. At a cut-off value of 181 pg/ml, the sensitivity was 52% (95% CI 37.4-66.3), specificity 94.8% (95% CI 87.4-98.6), PPV 86.7%, and NPV 75.5%. Although higher cut-off levels increased the specificity of the BDG test, sensitivity decreased to an unacceptable level; the commercially recommended cut-off value appears to be appropriate for screening purposes.

Medical Journal of Trakya University, 2010

Objective: Streptococcus agalactiae (Group B streptococci, GBS) are frequently responsible for se... more Objective: Streptococcus agalactiae (Group B streptococci, GBS) are frequently responsible for sepsis and meningitis seen in the early weeks of life. GBS may cause perinatal infection and premature birth in pregnant women. The aim of this study was to serotype GBS strains isolated from clinical samples and evaluate their serotype distribution according to their susceptibilities to antibiotics and isolation sites. Material and Methods: One hundred thirty one S. agalactiae strains isolated from the clinical samples were included in the study. Of the strains, 99 were isolated from urine, 20 from soft tissue, 10 from blood and 2 from vaginal swab. Penicillin G and ceftriaxone susceptibilities of GBS were determined by the agar dilution method. Susceptibilities to erythromycin, clindamycin, vancomycin and tetracycline were determined by the Kirby-Bauer method according to CLSI criteria. Serotyping was performed using the latex aglutination method using specific antisera (Ia, Ib, II-VIII). Results: While in 131 GBS strains, serotypes VII and VIII were not detected, the most frequently isolated serotypes were types Ia (36%), III (30.5%) and II (13%) respectively. Serotype Ia was the most frequently seen serotype in all samples. All GBS isolates were susceptible to penicilin G, ceftriaxone and vancomycin. Among the strains, tetracycline, erythromycin and clindamycin resistance rates were determined as 90%, 14.5%, and 13% respectively. Conclusion: Penicillin is still the first choice of treatment for the infections with all serotypes of S. agalactiae in Turkey.

Turkish Journal of Medical Sciences

To explore the presence of ALS1 and HWP1 genes by multiplex polymerase chain reaction (PCR) in Ca... more To explore the presence of ALS1 and HWP1 genes by multiplex polymerase chain reaction (PCR) in Candida albicans strains. Materials and methods: By using the multiplex PCR method, the presence of agglutinin-like sequence 1 (ALS1) and hyphal wall protein 1 (HWP1) genes were investigated in 206 C. albicans strains that were isolated from various clinical samples. Phenotypic identification of slime formation by microplate and tube adherence tests was performed. Results: The presence of the ALS1 gene was detected in 53.9% of all strains, while the HWP1 gene was present in 5.3%. Slime formation was phenotypically detected in the 62.2% of the strains in which the ALS1 and/or the HWP1 gene was found, using the microplate and/ or tube adherence test. The genes evaluated were found to be present in the 76.7% of strains in which slime formation was detected by phenotypic tests. There was a moderate correlation between the presence of the ALS1 gene and the microplate method, yet there was no correlation when using the tube adherence test. Conclusion: It was concluded that various genes other than those evaluated could be present in slime formation of C. albicans, and the presence of the genes may not always be represented in the phenotype.

Turkish Journal of Medical Sciences

To investigate some virulence factors in Candida species isolated from patients with suspected in... more To investigate some virulence factors in Candida species isolated from patients with suspected invasive fungal infection and to identify their relationship with Candida genotypes. Materials and methods: Overall 45 isolates (20 Candida albicans and 25 non-albicans Candida spp.) genotyped by rep-PCR were included in this study. Virulence factors were studied in both aerobic and anaerobic conditions. In isolates, egg yolk agar was used for determining phospholipase activity, while bovine serum albumin agar was used for proteinase activity, Tween-80 medium for esterase activity, and Sabouraud dextrose agar with sheep blood for hemolysin activity. Biofilm formation was detected by the microplate method. Results: In both Candida spp., it was found that hemolytic activity and proteinase activity were higher in aerobic conditions, whereas biofilm formation was higher in anaerobic conditions. It was also found that phospholipase and esterase activity were only detected in C. albicans isolates, which were found to be higher in aerobic conditions. No difference was found in virulence factors evaluated among the C. albicans genotypes. Conclusion: The amount of oxygen in the atmosphere may affect the virulence of Candida spp. Further comprehensive studies are needed in order to identify the relationship between Candida genotypes and virulence factors.

Introduction: Candida species found in normal human flora can cause infection in immunocompromise... more Introduction: Candida species found in normal human flora can cause infection in immunocompromised patties. Although Candida infections are frequently observed with Candida albicans strains, the incidence of infections with non-albicans strains has increased recently. Candida kefyr, one of these, is a rare fungal pathogen. We aimed to present our experience in five patients with Candida kefyr infection between 2010-2018. Case report: C. kefyr grew from the blood culture in a 2-years-old girl with mediastinal T-cell lymphoblastic lymphoma when the absolute neutrophil count was 1070/mm 3 , and the patient was receiving oral voriconazole and iv amphotericin B. These two antifungal drugs were then switched to fluconazole. C. kefyr was re-established in blood culture 45 days after the first grew so fluconazole treatment continued because it was sensitive. A 2-years-old girl with pulmonary primitive neuroectodermal tumor was hospitalized for febrile neutropenia. Although antibiotic, fluconazole, and granulocyte colony stimulating factor treatment was used, C. kefyr grew in the blood cultures. Amphotericin b that found to be sensitive was switched. There was no reproduction in the control blood culture. One-year-old boy with infantile leukemia with a history of hematopoietic stem cell transplantation was admitted with diarrhea and hospitalized with a differential diagnosis of gastrointestinal graft versus host disease. Fluconazole therapy which was sensitive to the isolated strain was given to the patient. There was no reproduction in the follow up. A 17-year-old male patient with medullary and central nervous system relapse was hospitalized for hematopoietic stem cell transplantation. Lumber punction was performed because the patient has h high fever and headache. He was neutropenic, and C. keyfr was grew from the cerebro spinal fluid Amphothericin B was replaced with caspofungin which was found to be effective to the isolated C. kefyr. He was discharged with oral voriconazole therapy. A 9-year-olds girl with B-cell Acute lymphoblastic leukemia was hospitalized for neutropenic fever, and shortness of breath, cough, and mucositis. The C. kefyr grew from sputum, so fluconazole treatment was given for 21 days. Her respiratory symptoms were resolved with this treatment. Conclusion: C. keyfr is one of the most frequently isolated non albicans candida fungal pathogens in our treated patients. C. kefyr should be considered to as a relatively common and potentially causative non C. albicans agent in children with hematological malignancy and bone marrow transplantation.

Bolu Abant Izzet Baysal Universitesi Tip Fakultesi Abant Tip Dergisi, 2021

Süt çocukluğu dönemindeki kan dolaşımı enfeksiyon (KDE) etken dağılımının ve antibiyotik duyarlıl... more Süt çocukluğu dönemindeki kan dolaşımı enfeksiyon (KDE) etken dağılımının ve antibiyotik duyarlılıklarının belirlenmesi ampirik antibiyotik tedavisinde yol gösterici olacaktır. Bu çalışmada süt çocukluğu döneminde karşılaşılan bakteriyel KDE etkenlerinin dağılımı ve antibiyotik direncinin değerlendirilmesi amaçlanmıştır. YÖNTEM ve GEREÇLER: Ocak 2015 ile Ağustos 2020 tarihleri arasında hastaneye yatırılan bebeklerin (en az bir aylık ve 1 yaşından küçük) kan kültürü sonuçları geriye dönük olarak mikroorganizma dağılımı ve antimikrobiyal direnç açısından analiz edildi. BULGULAR: Farklı hastalara ait 20763 kan kültürünün 17706'sında (%85,3) üreme saptanmamışken, 1272 (%6,1) kan kültür şişesindeki üreme kontaminasyon kabul edilmiştir. Üreme tespit edilen 1785 kan kültürü sonucu çalışmamızda değerlendirmeye alınmıştır. Etkenlerin dağılımı incelendiğinde %72'sini (n=1286) Gram-pozitif, %28'sini (n=499) Gram negatif bakteriler oluşturmaktır. En sık izole edilen Gram pozitif mikroorganizma Staphylococcus epidermidis olurken Gram negatif patojen Klebsiella pneumoniae olmuştur. Metisilin dirençli Staphylococcus aureus (MRSA) oranı %19,7; Metisilin dirençli S. epidermidis (MRSE) oranı ise %85,9 olarak bulunmuştur. Vankomisin dirençli Enterekok (VRE) oranı ise %15,9 (14/88) saptanmıştır. Klebsiella spp. için Genişlemiş spektrumlu βlaktamaz (GSBL) üretim oranı %32,3 (67/207), karbapenem direnci %18,3 (n=33), kolistin direnci %6,6 (n=12) saptanmıştır. Yoğun Bakım Ünitelerinden (YBÜ) alınan kan kültürlerinde diğer pediatri kliniklerine göre daha fazla oranda üreme saptanmıştır. TARTIŞMA ve SONUÇ: Çalışmamız sonuçları Gram pozitif bakterilerde glikopeptid grubu antibiyotiklerin tedavide kullanımına devam edilebileceğini göstermektedir. Ancak Gram negatif bakteriler için elde edilen sonuçlar karbapenem türevi ilaçların tek başına kullanımını kısıtlamakta ve tedavide aminoglikozid ve polimiksin grubu antibiyotiklerin birlikte kullanımını desteklemektedir.

Fungal kan dolasimi enfeksiyonlari, immun yetmezlikli hastalarda mortalite ve morbiditenin onde g... more Fungal kan dolasimi enfeksiyonlari, immun yetmezlikli hastalarda mortalite ve morbiditenin onde gelen nedenlerinden birisidir. Invazif kandidiyazise neden olan turler arasinda Candida albicans halen en sik gorulen patojen olmakla beraber diger Candida turlerinin de orani artmaktadir. Bu calismada kan kulturlerinden izole edilen Candida turlerinin tanimlanmasi ve bunlarin amfoterisin B ve flukonazole duyarliliklarinin arastirilmasi amaclandi. Temmuz 2009–2011 tarihleri arasinda 97 hastanin kan kulturunden izole edilen Candida turleri calismaya alindi. Izolatlarin tanimlanmasinda, germ tup testi, misir unu-Tween 80 agar besiyerindeki morfolojik gorunumleri ve API 20C AUX (Biomerieux, Fransa) sistemi kullanildi. C. albicans en cok (% 68) izole edilen tur olup bunu C. parapsilosis (% 14.5) ve C. glabrata (% 9.3) izledi. Amfoterisin B, flukonazol duyarliliklari ve Minimum Inhibitor Konsantrasyon (MIK) degerleri E-test ( AB Biodisk, Isvec) yontemiyle yapildi. Izole edilen tum Candida susl...

Journal of Biotechnology and Strategic Health Research, 2020

Amaç: Hidrojen peroksitin penetrasyon özelliği zayıftır. Lümenli tıbbi cihazlarda, çap ve uzunluk... more Amaç: Hidrojen peroksitin penetrasyon özelliği zayıftır. Lümenli tıbbi cihazlarda, çap ve uzunluk sınırlaması olduğundan uygunluk açısından firmaların önerileri dikkate alınmalıdır. Bu çalışmada, iki farklı Hidrojen peroksit gaz plazma (H2O2 GP) cihazının lümenli tıbbi cihazları steril etmede uzunluk ve lümen çapı açısından, etilen oksitle sterilizasyona göre bir farklarının olup olmadığının araştırılması amaçlanmıştır. Yöntem: Özel olarak hazırlanmış, biyolojik indikatörün her iki ucundan da gaz girişine müsaade ettiği, biyolojik validasyon kitinin içine uzunlukları ve lümen çapları birbirinden farklı polietilen lümenli cihazlar konularak polyolefin paketleme malzemesi (Tyvek 60 gr, PMS; Türkiye) içine paketlendi. Sterilizasyon koşullarının en kötü olduğu vakum çıkış noktasına yakın bir yere konularak kısa döngüde sterilizasyon işlemi yapıldı. Bu işlemler Sterrad 100S (Advanced Sterilization Products; ABD) cihazında 55 °C’de 55 dk, LK/MJG-150 (Laoken, Low Temperature and Examinatio...

Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive, 2016

A 66-year-old female patient with multiple myeloma (MM) was admitted to the emergency service on ... more A 66-year-old female patient with multiple myeloma (MM) was admitted to the emergency service on 29.09.2014 with an inability to walk, and urinary and faecal incontinence. She had previously undergone autologous bone marrow transplantation (ABMT) twice. The patient was hospitalized at the Department of Haematology. Further investigations showed findings suggestive of a spinal mass at the T5-T6-T7 level, and a mass lesion in the iliac fossa. The mass lesion was resected and needle biopsy was performed during a colonoscopy. Examination of the specimens revealed plasmacytoma. The patient also had chronic obstructive pulmonary disease (COPD) and was suffering from respiratory distress. After consultation with an infectious diseases specialist the patient was placed on an intravenous antibiotherapy with piperacillin/tazobactam (4.5g x 3) on 17.10.2014. During piperacillin/tazobactam treatment, the patient suffered from drowsiness, her general condition deteriorated, and she had rales on ...

Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive, 2016

Nocardia otitidiscaviarum belongs to the agents of opportunistic infections seen in immunocomprom... more Nocardia otitidiscaviarum belongs to the agents of opportunistic infections seen in immunocompromised patients, but may occur rarely in immunocompetent patients. In this report we described a case of a previously healthy 69-year-old woman with cerebral and retroperitoneal abscess due to Nocardia otitidiscaviarum. The patient was admitted to hospital because of loss of strength in her right arm and leg. Nocardia spp. was isolated from the abscess material. The intracranial lesions were drained by stereotactic craniotomy. The large abscess located around the left kidney was drained and microscopic examination of aspirated material showed Nocardia spp. For species identification, 16S rRNA gene sequencing was carried out and was 100% concordant with Nocardia otitidiscaviarum. Use of 16S rDNA gene sequencing for identification permits detection of rare aetiologic agents that cause brain abscesses.

Journal of clinical laboratory analysis, 2016

Aspergillus species cause a wide range of diseases in humans, including allergies, localized infe... more Aspergillus species cause a wide range of diseases in humans, including allergies, localized infections, or fatal disseminated diseases. Rapid detection and identification of Aspergillus spp. facilitate effective patient management. In the current study we compared conventional morphological methods with PCR sequencing, rep-PCR, and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) for the identification of Aspergillus strains. A total of 24 consecutive clinical isolates of Aspergillus were collected during 2012-2014. Conventional morphology and rep-PCR were performed in our Mycology Laboratory. The identification, evaluation, and reporting of strains using MALDI-TOF-MS were performed by BioMérieux Diagnostic, Inc. in Istanbul. DNA sequence analysis of the clinical isolates was performed by the BMLabosis laboratory in Ankara. Samples consisted of 18 (75%) lower respiratory tract specimens, 3 otomycosis (12.5%) ear tissues, 1 sample from kera...

Nigerian journal of clinical practice

The Candida species, which are one of the most common causes of nosocomial bloodstream infections... more The Candida species, which are one of the most common causes of nosocomial bloodstream infections, present with high mortality and morbidity rates. This study aims to investigate the production of esterase, phospholipase, proteinase, and biofilm formation ability of the Candida strains isolated from the blood cultures. Between June 2011 and July 2012, the Candida strains, which were isolated from blood cultures of a total of 50 patients, were studied. The esterase activity was analyzed in the Tween-80 agar, while phospholipase activity was studied in the egg yolk agar. The proteinase activity and biofilm formation were identified by using the petri dish method and microplate method, respectively. Of 50 specimens obtained from individual patients, 17 (34%) were identified as C. albicans, 14 (28%) as C. glabrata, 9 (18%) as C. parapsilosis, 5 (10%) as C. krusei, 4 (8%) as C. kefyr, and 1 (2%) as C. tropicalis. The rate of proteinase, phospholipase, and esterase positivity was higher i...

Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive, 2013

The clinical and laboratory diagnosis of cerebral aspergillosis (CA) is problematic and mortality... more The clinical and laboratory diagnosis of cerebral aspergillosis (CA) is problematic and mortality is quite high, even in cases receiving appropriate treatment. Therefore, an early and accurate diagnosis may prove to be life saving in patients with the diagnosis of CA. In this report, a case of CA which developed in a pediatric patient with acute lymphoblastic leukemia (ALL) is presented. Upon development of neutropenia and focal seizures in the left arm during implementation of the ALL treatment protocol, brain MRI was performed in the patient and nodular lesions compliant with brain abscess were detected in the frontal lobe, left cerebellum and the cingulate gyrus on the superior aspect of the left corpus callosum. Direct assessment of brain tissue revealed fungal elements, while consecutive serum galactomannan (GM) values were determined as 3.39 ng/ml and 0.72 ng/ml, and the consecutive serum (1x3)-beta-D-glucan (BG) values were 93 pg/ml and 356 pg/ml. Negative serum real-time pol...

Erciyes Tıp Dergisi/Erciyes Medical Journal, 2012

Catheter-related bacteremia is a frequent complication in patients undergoing hemodialysis. We re... more Catheter-related bacteremia is a frequent complication in patients undergoing hemodialysis. We report the first case of catheter-related bacteremia with Streptococcus dysgalactiae subsp equisimilis in a patient on hemodialysis. The organism was isolated from both the hemodialysis catheter and blood of the patient. Although the hemodialysis cathether was removed and ceftriaxone was given, the patient died of a subarachnoidal bleeding complicating end-stage renal disease.

Dental Materials Journal, 2015

The aim of this study was to evaluate and compare the effects of resin infiltration and sealant t... more The aim of this study was to evaluate and compare the effects of resin infiltration and sealant type on enamel surface properties and Streptococcus mutans adhesion to artificial enamel lesions. Artificial enamel lesions were produced on the surfaces of 120 enamel specimens, which were divided into two groups: Group A and Group B (n=60 per group). Each group was further divided into four subgroups (n=15 per subgroup) according to sealant type: Group I-Demineralized enamel (control); Group II-Enamel Pro Varnish; Group III-ExciTE F; and Group IV-Icon. In Group A, hardness and surface roughness were evaluated; in Group B, bacterial adhesion was evaluated. Icon application resulted in significantly lower surface roughness and higher hardness than the other subgroups in Group A. In Group B, Enamel Pro Varnish resulted in lowest bacterial adhesion, followed by Icon. This study showed that resin infiltration of enamel lesions could arrest lesion progress.

Turkish Bulletin of Hygiene and Experimental Biology, 2013

Objective: Candida spp. are the most important pathogens in critically ill patients and the epide... more Objective: Candida spp. are the most important pathogens in critically ill patients and the epidemiology is changing. While Candida albicans remains the predominant pathogen, the proportion of infection caused by other species of Candida continues to increase. In recent years, due to the increase in incidence of infections with non-albicans strains and the development of resistance to antifungals, identification of Candida strains to species level gained significant importance.The aim of this study was to identify Candida strain isolated from various clinical specimens. Method: January 2011 to June 2012, Candida strains were isolated from 3905 clinical specimen. In identification of Candida species that were isolated, germ tube test, growth in Cornmeal-Tween 80 agar and formation of clamydospore, presence of pseudohyphae, carbonhytrate fermentation and assimilation tests, and the test of nitrate were studied Results: Finally 1122 Candida strains were isolated from 3905 various clinical specimens. The distribution of clinical specimens were as fallows: 556 from bronchoalveolar lavage (49.6%), 271 from sputum (24.2%), 114 from blood (10.2%), 51 vaginal swabs (4.6%), 50 from urine (4.4%), 30 from tissue (2.6%), 22 from endotracheal tracheal aspirate (ETA) (1.9%), nine from pleural mai (0.80%), six from peritoneal fluid (0.53%), four ÖZET Amaç: Candida türleri kritik hastalarda en önemli patojendir ve epidemiyolojisi sürekli değişmektedir. Candida albicans enfeksiyona neden olan türler arasında halen en sık görülen patojen olmakla beraber diğer Candida türlerinin de oranı artmaktadır. Son yıllarda albicans dışındaki diğer Candida'larla oluşan enfeksiyonlardaki artış ve antifugallare direnç gelişmesi Candida türlerinin oluşturduğu enfeksiyonlardan izole edilen etkenlerin tür düzeyinde tanımlanmasında önem kazanmıştır. Bu çalışmada çeşitli klinik örneklerden izole edilen Candida türlerinin tanımlanması amaçlanmıştır Yöntem: Ocak 2011-Haziran 2012 tarihleri arasında 3905 klinik örnekten Candida türleri izole edilmiştir. Candida türlerinin tanımlanmasında germ tüp testi, Cornmeal-Tween 80 agarda üreme ve klamidospor oluşumu, pseudohif bulunuşu, karbonhidrat fermantasyon ve asimilasyon testleri, üreaz testi, nitrat testi çalışılmıştır.

Turkish Bulletin of Hygiene and Experimental Biology, 2013

Objective: Urinary system infections caused by Candida species are the most common nosocomial inf... more Objective: Urinary system infections caused by Candida species are the most common nosocomial infections. Diabetes mellitus, urinary system defects, chronic renal failure, neutopenia, immunsuppressive treatment, and use of antimicrobials of patients increase the incidence of these infections. Antifungal tests should be applied with identification of species for effective treatment. In this study, identification of Candida species isolated from urine and investigation of susceptibility of these strains to amphotericin B, fluconazole, voriconazole and caspofungin by E-test method are aimed to be investigated. Method: 61 Candida strains isolated from urine cultures of hospitalized patients between June-December 2011 are included in the study. Germ tube test, growth on Cornmeal-Tween 80 agar and chylamidospore formation, presence of psudohyphae, carbohydrate fermentation and assimilation tests, urease test and nitrate tests were used to identificate Candida species. The antifungal (amphotericin B, fluconazole, voriconazole, and caspofungin) susceptibility of the identified Candida strains was investigated by E-test (AB Biodisk, Sweden) method. For this method, RPMI 1640 medium with 2% glucose and 1.5% agar (Sigma, USA) was used. The results were evaluated according to manufacturer recommendation. Results: Total of 61 strains were identified as follows; 18 (30%) were C. albicans, 18 (30%) were C. glabrata, 14 ÖZET Amaç: Candida türlerinin oluşturduğu üriner sistem enfeksiyonları en sık görülen hastane enfeksiyonlarındandır. Hastalardaki diabetes mellitus, üriner sistem defektleri, kronik böbrek yetmezliği, nötropeni, immunsupresif tedavi, antimikrobiyal kullanımı bu enfeksiyonların görülme oranını artırmaktadır. Etkin tedavi için tür tanımıyla birlikte antifungal testleri yapılmalıdır. Bu çalışmada idrar kültürlerinden izole edilen Candida türlerinin tanımlanması ve suşların amfoterisin B, flukonazol, vorikonazol ve kaspofungine duyarlılıklarının E-test Yöntemi ile araştırılması amaçlanmıştır. Yöntem: Haziran-Aralık 2011 tarihleri arasında yatan hastaların idrar kültürlerinden izole edilen 61 Candida suşu çalışmaya alınmıştır. Candida türlerinin tanımlanmasında germ tüp testi, Cornmeal-Tween 80 agarda üreme ve klamidospor oluşumu, pseudohif bulunuşu, karbonhidrat fermantasyon ve asimilasyon testleri, üreaz testi, nitrat testi kullanılmıştır. Tanımlanan Candida suşlarının antifungal (amfoterisin B, flukonazol, vorikonazol ve kaspofungine) duyarlılıkları E-test (AB Biodisk, İsveç) Yöntemi ile araştırılmıştır. Bu yöntemde %2 glikoz ve %1,5 agar içeren RPMI 1640 (Sigma, USA) besiyeri kullanılmıştır. Sonuçlar üretici firmanın önerisi doğrultusunda gerçekleştirilmiştir. Bulgular: Toplam 61 suşun 18 (%30)'i C. albicans, 18 (%30)'i C. glabrata, 14 (%23)'ü C. tropicalis, 7 (%11)'si C. parapsilosis, 2 (%3)'si C. krusei ve 2 (%3)'si de

Turkish journal of haematology : official journal of Turkish Society of Haematology, 2014

We aimed to investigate posttransplant Epstein-Barr virus (EBV) and parvovirus B19 DNA in allogen... more We aimed to investigate posttransplant Epstein-Barr virus (EBV) and parvovirus B19 DNA in allogeneic stem cell transplant patients between 2009 and 2010. Forty-five adult patients in whom allogeneic stem cell transplantation was performed between April 2009 and November 2010 in the Erciyes University Faculty of Medicine, Department of Internal Medicine, Division of Hematology and Oncology, were included in the study. EBV and parvovirus B19 DNA positivity was investigated by using real-time polymerase chain reaction technique in 135 plasma samples obtained after transplantation at between 1 and 6 months. Pretransplant serological markers of EBV and parvovirus B19 were provided from patient files. In 32 (71.1%) of the patients, EBV antibodies in the pretransplantation period were as follows: anti-EBNA-1 IgG (+), VCA IgM (-), and VCA IgG (+). In 2 patients (4.45%), these antibodies were as follows: anti-EBNA-1 IgG (+), VCA IgM (-), and VCA IgG (-). In 1 patient (2.2%), they were as fol...

Le infezioni in medicina: rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive

Pneumocystis jirovecii pneumoniae (PJP) may be difficult to diagnose. Since pneumocystis cannot b... more Pneumocystis jirovecii pneumoniae (PJP) may be difficult to diagnose. Since pneumocystis cannot be cultured, the diagnosis of PJP requires microscopic examination to identify pneumocystis from induced sputum or bronchoalveolar lavage (BAL) fluid. In order to evaluate the usefulness of (1-3) beta-D-glucan (BDG) levels in the early diagnosis of PJP, we describe the case of PJP in a 25-year-old male with acute lymphoblastic leukaemia (ALL) admitted to hospital with progressive dyspnea and fever with chills. The patient was not infected with human immunodeficiency virus (HIV). Sputum, blood, and urine cultures were negative; smears for acid-fast bacilli and tests for viral antibodies were both negative. The microbiology study of the BAL with Giemsa and immunofluorescence staining, seven days after admission showed the existence of P. jiroveci in the lungs. Further, one day and five days after admission, (1-3) beta-D-glucan (BDG) levels were very high. The high serum level of BDG conside...

Scandinavian Journal of Infectious Diseases, 2011

The detection of 1,3-β-d-glucan (BDG), a cell wall component of several medically important fungi... more The detection of 1,3-β-d-glucan (BDG), a cell wall component of several medically important fungi, is a promising tool for the diagnosis of invasive pulmonary aspergillosis. The aim of this study was to evaluate the diagnostic accuracy of the BDG test in invasive pulmonary aspergillosis (IPA) by focusing on the optimal cut-off value. The records of the Infection Control Committee were reviewed to identify patients with haematological malignancies and stem cell transplantation who had at least 1 BDG (Fungitell kit) measurement during the period January 2008 through April 2011. The European Organization for Research and Treatment of Cancer and the Mycoses Study Group (EORTC/MSG) criteria (independent of BDG results) were used to categorize the patients with IPA. Patients with possible IPA were not included in the study. A total of 128 patients (50 with proven or probable IPA) were included in the study. At the manufacturer's recommended cut-off value of 80 pg/ml, the sensitivity of BDG was 66% (95% CI 51.2-78.7), specificity 75.6% (95% CI 64.6-84.5), positive predictive value (PPV) 63.4%, and negative predictive value (NPV) 77.6%. A receiver operating characteristic (ROC) curve was constructed to define the optimum serum BDG cut-off for the diagnosis of IPA. At a cut-off value of 181 pg/ml, the sensitivity was 52% (95% CI 37.4-66.3), specificity 94.8% (95% CI 87.4-98.6), PPV 86.7%, and NPV 75.5%. Although higher cut-off levels increased the specificity of the BDG test, sensitivity decreased to an unacceptable level; the commercially recommended cut-off value appears to be appropriate for screening purposes.

Medical Journal of Trakya University, 2010

Objective: Streptococcus agalactiae (Group B streptococci, GBS) are frequently responsible for se... more Objective: Streptococcus agalactiae (Group B streptococci, GBS) are frequently responsible for sepsis and meningitis seen in the early weeks of life. GBS may cause perinatal infection and premature birth in pregnant women. The aim of this study was to serotype GBS strains isolated from clinical samples and evaluate their serotype distribution according to their susceptibilities to antibiotics and isolation sites. Material and Methods: One hundred thirty one S. agalactiae strains isolated from the clinical samples were included in the study. Of the strains, 99 were isolated from urine, 20 from soft tissue, 10 from blood and 2 from vaginal swab. Penicillin G and ceftriaxone susceptibilities of GBS were determined by the agar dilution method. Susceptibilities to erythromycin, clindamycin, vancomycin and tetracycline were determined by the Kirby-Bauer method according to CLSI criteria. Serotyping was performed using the latex aglutination method using specific antisera (Ia, Ib, II-VIII). Results: While in 131 GBS strains, serotypes VII and VIII were not detected, the most frequently isolated serotypes were types Ia (36%), III (30.5%) and II (13%) respectively. Serotype Ia was the most frequently seen serotype in all samples. All GBS isolates were susceptible to penicilin G, ceftriaxone and vancomycin. Among the strains, tetracycline, erythromycin and clindamycin resistance rates were determined as 90%, 14.5%, and 13% respectively. Conclusion: Penicillin is still the first choice of treatment for the infections with all serotypes of S. agalactiae in Turkey.