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Öğe ANTIFUNGAL SUSCEPTIBILITIES OF ASPERGILLUS SPP. STRAINS ISOLATED FROM INVASIVE ASPERGILLOSIS CASES(Ankara Microbiology Soc, 2010) Gurcan, Saban; Tikvesli, Melek; Eryildiz, Canan; Evci, Canan; Ener, BeyzaAspergillus 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) (<= 0.125 mu g/ml) values were detected for caspofungin and posaconazole for Aspergillus spp, however, the highest MIC values were detected for amphotericin B (> 1 mu g/ml) MIC values of the all strains except one, were detected as <= 0 5 mu g/ml for voriconazole and itraconazole In one A niger strain itraconazole MIC value was 2 mu g/ml Since the number of other species was low, MIC(50) value was determined only for A fumigatus strains and it was found that the highest MIC(50) value was for amphotericin B (2 mu g/ml) and the lowest MIC(50) values were for posaconazole (0.064 mu g/ml), caspofungin (0 064 mu g/ml), itraconazol (0 25 mu g/ml) and voriconazol (0.25 mu g/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.Öğe A Case Report on Aspergillus lentulus Pneumonia(2013) Gürcan, Şaban; Tikveşli, Melek; Üstündağ, Sedat; Ener, BeyzaBackground: Aspergillus lentulus was described as a new species in 2005 but it was isolated from Turkey for the first time. Case report: A. lentulus was isolated as the cause of pneumonia from a patient who had renal transplantation 4 months ago. The patient received immunosuppressive treatment after transplantation. A. lentulus was isolated from his sputum as an agent in pneumonia developed 4 months after the transplantation. Leukocytes, blastospores, and hyphae were seen in both Gram- and Giemsa-stained smears of the sputum. The isolate was identified by using the Maren A. Klich algorithm and molecular methods and confirmed by the reference laboratory of the CBS Fungal Biodiversity Centre (The Netherlands). In the susceptibility tests of the isolate, minimal inhibitory concentrations for amphotericin B, voriconazole, posaconazole, and caspofungin were found to be 0.5 µg/mL, 0.25 µg/mL, 0.125 µg/mL, and 0.25 µg/mL, respectively. The patient recovered with voriconazole treatment (2x200 mg/day).Conclusion: The use of the molecular tests is important for identification of A. lentulus strains because they are very easily confused with A.fumigatus strains according to phenotypic characteristics.Öğe Evaluation of Virulence in Various Candida Species: In Vitro and In Vivo Study(Ortadogu Ad Pres & Publ Co, 2010) Gurcan, Saban; Alver, Oktay; Ercan, Ilker; Ener, BeyzaObjective: In vitro virulence features of Candida strains isolated from blood specimens of 85 non-neutropenic patients, and in vivo (murine) tissue invasions were assessed in this study. Material and Methods: Virulence tests were examined at a single strain (85 isolates) of the patients. Surface hydrophobicity, attachment to epithelial cells, phospholipase and proteinase enzyme activity were examined in vitro virulence factors. Strains diluted with PBS were inoculated through the tail veins of the mice (Swiss albino). Results: In vitro virulence of the persisting strains was not higher than the ones which were isolated only once. Phospholipase activity was only detected in C.albicans strains and 87.5% of the C.albicans strains showed tissue invasion. The only strain that did not demonstrate tissue invasion was the one which showed no in vitro enzyme activity. In vitro virulence of the other species which do not produce phospholipase were lower than C.albicans. The species with the lowest virulence was found to be C.krusei. Significant correlation between tissue invasion and enzyme secretion (phospholipase and/or proteinase) suggests that enzyme secretion was more important than adhesive property for invasion. However, the absence of invasion in C.parapsilosis strains with high proteinase secretion was an interesting finding. Conclusion: It was highlighted in this study that the identification of the clinical isolates at the species level is really important as Candida species had different in vivo and in vitro virulence factors.Öğe Frequency of azole resistance in clinical and environmental strains of Aspergillus fumigatus in Turkey: a multicentre study(Oxford Univ Press, 2022) Ener, Beyza; Ergin, Cagri; Gulmez, Dolunay; Agca, Harun; Tikvesli, Melek; Aksoy, Secil Ak; Otkun, MuserrefObjectives Aspergillus fumigatus causes several diseases in humans and azole resistance in A. fumigatus strains is an important issue. The aim of this multicentre epidemiological study was to investigate the prevalence of azole resistance in clinical and environmental A. fumigatus isolates in Turkey. Methods Twenty-one centres participated in this study from 1 May 2018 to 1 October 2019. One participant from each centre was asked to collect environmental and clinical A. fumigatus isolates. Azole resistance was screened for using EUCAST agar screening methodology (EUCAST E.DEF 10.1) and was confirmed by the EUCAST E.DEF 9.3 reference microdilution method. Isolates with a phenotypic resistance pattern were sequenced for the cyp51A gene and microsatellite genotyping was used to determine the genetic relationships between the resistant strains. Results In total, resistance was found in 1.3% of the strains that were isolated from environmental samples and 3.3% of the strains that were isolated from clinical samples. Mutations in the cyp51A gene were detected in 9 (47.4%) of the 19 azole-resistant isolates, all of which were found to be TR34/L98H mutations. Microsatellite genotyping clearly differentiated the strains with the TR34/L98H mutation in the cyp51A gene from the strains with no mutation in this gene. Conclusions The rate of observed azole resistance of A. fumigatus isolates was low in this study, but the fact that more than half of the examined strains had the wild-type cyp51A gene supports the idea that other mechanisms of resistance are gradually increasing.Öğe İnvazif aspergillozlu olgulardan izole edilen aspergıllus spp. suşlarının antifungal duyarlılıkları(2010) Gürcan, Şaban; Tikveşli, Melek; Eryıldız, Canan; Evci, Canan; Ener, BeyzaÇevrede ve hastane ortamında yaygın olarak bulunan Aspergillus türleri, özellikle bağışıklık sistemi yetersiz ya da baskılanmış hastalarda ciddi morbidite ve mortalite etkenidir. Bu retrospektif çalışmada, hastanede yatan hastaların klinik örneklerinden etken olarak izole edilen Aspergillus spp. suşlarının antifungal duyarlılıklarının araştırılması amaçlanmıştır. Çalışmaya, Ocak 2002-Ekim 2007 tarihleri arasında mantar enfeksiyonu şüphesi ile laboratuvarımıza gönderilen 569 hastaya ait toplam 678 örnek (420 solunum yolu örneği, 202 steril vücut sıvısı örneği, 56 biyopsi/doku örneği) dahil edilmiştir. Örnekler, beyin kalp infüzyonlu kanlı agar ve Sabouraud dekstroz agara ekilerek 25°C ve 35°C’de inkübe edilmiş; ayrıca tüm örneklerden hazırlanan Gram ve Giemsa boyalı preparatlar direkt mikroskobik olarak incelenmiştir. Küf mantarı üreyen örneklerde tanımlama konvansiyonel yöntemlerle yapılmış; olgularda “invazif aspergilloz” tanımı ise, Avrupa Kanser Araştırma ve Tedavi Kuruluşu, İnvazif Fungal Enfeksiyon Çalışma Grubunun aspergilloz tanı kriterlerine göre yapılmıştır. Çalışmada, tümünde malignite gibi altta yatan bir faktör olan 12 (%2.1) olgunun klinik örneklerinden (9 alt solunum yolu, birer asit, beyin biyopsisi ve plevral sıvı örneği) Aspergillus spp. izole edilmiş ve bu suşlar A.fumigatus (n= 8), A.flavus (n= 2) ve A.niger (n= 2) olarak tanımlanmıştır. İzolatların, kaspofungin, vorikonazol, itrakonazol ve amfoterisin B’ye karşı duyarlılıkları buyyon mikrodilüsyon yöntemiyle, posakonazole karşı duyarlılıkları ise E-test (AB Biodisk, İsveç) yöntemi ile araştırılmıştır. Aspergillus spp. suşlarında en düşük minimum inhibitör konsantrasyonu (MİK) değerleri kaspofungin ve posakonazol için (? 0.125 µg/ml); en yüksek MİK değerleri ise amfoterisin B için (? 1 µg/ml) tespit edilmiştir. Vorikonazol ve itrakonazol için, biri hariç tüm suşlarda MİK değerleri ? 0.5 µg/ml saptanırken, sadece bir A.niger suşunda itrakonazol için 2 µg/ml değeri elde edilmiştir. Diğer türlerin sayısının az olması nedeniyle, MİK50 değerleri sadece A.fumigatus için hesaplanmış ve A.fumigatus için en yüksek MİK50 değeri amfoterisin B (2 µg/ml) için saptanırken, en düşük MİK50 değerleri sırasıyla; posakonazol (0.064 µg/ml), kaspofungin (0.064 µg/ml), itrakonazol (0.25 µg/ml) ve vorikonazol (0.25 µg/ml) için belirlenmiştir. Sonuç olarak, suş sayımızın az olmasına rağmen, kaspofungin ve posakonazol için en düşük MİK değerlerinin tespit edilmiş olması, bu yeni antifungallerin hastanemizde aspergillozlu olguların tedavisinde akılda tutulması gereken seçenekler olduğunu vurgulamaktadır.Öğe Sporotrichosis, a disease rarely reported from Turkey, and an overview of Turkish literature(Blackwell Publishing, 2007) Gurcan, Saban; Konuk, Emel; Kilic, Haluk; Otkun, Metin; Ener, Beyza[Abstract Not Available]
