Evaluation of species distribution of yeasts isolated from intensive care units during the four years period Yoǧun bakιm ünitelerinden dört yιllιk dönemde izole edilen mayalarιn tür daǧιlιmιnιn deǧerlendirilmesi

The aim of this study was to evaluate the distributions of yeast species according to the years and to detect the emerging pathogens in intensive care units (ICU). For this purpose, yeast isolation rates were detected retrospectively, in the following time periods: Period I: April-December 2001; period II: January-December 2002; period III: January-December 2003; period IV: January-December 2004. A total of 490 yeast isolates recovered from 462 clinical specimens obtained from 360 different ICU patients were investigated during these periods. Urine (62.1%), blood (13.6%) and tracheal aspirate (8.7%) samples were detected as the most common specimens. Of these isolates, 53.3% were identified as Candida albicans, 14.5% as C.tropicalis, 12.2% as C.glabrata, 6.5% as C.parapsilosis, 4.5% as Trichosporon spp., 3.9% as C.kefyr, 1.6% as C.krusei, 1.4% as Geotrichum candidum and 2.1% as other Candida species. The isolation rates of C.albicans in the periods of I to IV were found as 47.7%, 55.5%, 41.7% and 62.4%, respectively. The decrease between the second and third periods, and increase between third and fourth periods were statistically significant (x2=4.15, p=0.04 and x2=8.32, p=0.004). C.glabrata was the second most common species in the first and second periods (14.8% and 15.5%, respectively), followed by C.tropicalis (12.5% and 10.0%, respectively), however this array has changed in the third and fourth periods (C.tropicalis was the second with the rates of 16.7% and 16.8%, while C.glabrata placed in the third line with the rates of 14.8% and 7.6%, respectively), It was concluded that C.albicans has still been the most frequent species among yeast isolates of ICU's in our hospital; however, the incidence of non-albicans species like C.glabrata and C.tropicalis has increased

Molecular Epidemiological Surveillance of Candida Species Isolated from Patients Hospitalized in General Surgery Ward

In this study, epidemiological surveillance of 27 Candida species isolated from hospitalized patients in Dokuz Eylül University hospital general surgery ward between 05 April 2002-13 January 2003 was carried out by random amplified polymorphic DNA (RAPD) polimerase chain reaction. Candida species isolated from various clinical specimens of 16 patients were identified by germ tube test, morphology on corn meal tween 80 agar and API 20 C AUX system. The susceptibility of the strains against amphotericin B, fluconazole and ketoconazole were investigated by microdilution method in accordance with National Committee for Clinical Laboratory Standards (NCCLS) M27-A2 standards. Twenty one of the isolates were determined to be Candida albicans, where as 3 and 3 were identified as Candida tropicalis and Candida glabrata, respectively. The minimal inhibitory concentration values of the strains for amphotericin B were not relatively high. None of the isolates were resistant to fluconazole; however one was dose dependent susceptible. RAPD analyses of the strains were performed by using two primers (OPE-03 and RP4-2). Twelve and three different band patterns were observed with both primers for C. albicans and C. tropicalis strains while two band patterns were detected with one primer and three with the other primer for C. glabrata isolates. As a result; it can be concluded that the origin of the most of the Candida isolates recovered from various clinical specimens were possibly endogenous but a few of them might have been disseminated via exogenous route because of the isolation of identical and related strains from different patients during the same period

Karbonmonoksite Akut ve Kronik Maruziyetin Spektrofotometrik Yöntemlerle Tayini

CO zehirlenmesi sonucu ölen kişilerin (n: 18) ve CO'e kronik maruz kalan kişilerin (sigara içenler n: 100, içmeyenler n: 44) kanlarında karboksihemoglobin (COHb) düzeyleri spektrofotometrik yöntemlerle ölçülmüştür. Postmortem kan örneklerinde COHb tayininde, Dubowski ve Buch- wald'in modifiye mikro spektrofotometrik yöntemlerinden yararlanılmıştır. Sigara içenlerin kan örneklerinde COHb tayininde ise türev (derivative) UV spektrofotometresinden yararlanılmış ve yöntemlerin karşılaştırılması yapılmıştır. Postmortem kan örneklerinde COHb düzeyi % 63 - 88 arasında (ortalama % 73.11 ( 6.90) bulunmuştur. Sigara içenlerde COHb düzeyleri ise, günde 1-9 tane içenlerde (n: 44) % 1.94 ( 0.11 COHb, 10-20 tane içenlerde (n: 23) % 3.25(0. 19 COHb ve > 20 tane içenlerde ise (n: 31) % 4.36 ( 0.14 COHb belirlenmiştir. COHb düzeyi sigara içen tüm gruplarda içmeyenlere göre ( % 0.86 ( 0.05) anlamlı yüksek bulunmuştur. Dubowski yöntemi, CO ile akut zehirlenmelerin kantitatif tayininde, kullandığımız diğer spektrofotometrik yöntemlere göre ekonomik ve duyarlı bir yöntem olarak değerlendirilmiştir. Ayrıca kısa zamanda sonuç vermesi açısından da Adli Tıp laboratuvarında uygulanabilirliği bu araştırmada gösterilmiştir. Anahtar Kelimeler: Karbonmonoksit, Karboksihemoglobin, Akut Zehirlenme, Kronik Zehirlenme, UV Spektrofotometre, Türev (derivative) UV Spektrofotometre

The Use of Charge-Transfer Complexation in The Spectrophotometric Determination of Amlodipine Besylate

A simple and sensitive analytical method has been developed for the spectrophotometric assay of amlodipine besylate (ADB) in pure forms and tablets have been described. The method is based on the formation of a charge-transfer complex between the drug and tetrachloquinone (TCQ). This complex exhibit intense absorption bands in the electronic spectrum. The molecular ratio of the reactant in the complex was established and the experimental conditions leading to maximum charge-transfer band was also studied. The reaction proceeds quantitatively at pH 9 and 55°C for 10 min, the absorbance was measured at 346 nm. The method was applied to commercially available tablets and the results were statistically compared wrth those obtained by UV spectrophotometric method, using Newman-Keuls tests. In our method, Beer\u27s Law limits to 5-25 µg/ml. The optimum experimental parameters for colour production with reagent were studied and incorporated into procedure

Case report: A Fusarium fungaemia Olgu raporu: Bir Fusarium fungemisi

In this report, a case of Fusarium fungaemia developed in an acute lymphoblast leukemia (ALL) patient was presented. A seven year old girl who had weakness, loss of appetite, paleness and ecchymosis on legs applied to Pediatric Hematology Service and cytotoxic chemotherapy was started after she had been diagnosed as ALL-L1. Her chemotherapy was stopped because of increase in fever, leukopenia and neutropenia. Central venous catheter and peripheral blood cultures were obtained. Fusarium thapsinum was recovered from blood cultures, obtained in two consecutive days. Thereupon central venous catheter of the patient was removed and intravenous amphotericin B was added to the therapy. On the fifth day of febrile neutropenia attack, her fever was decreased after the onset of antifungal therapy. Radiological examinations were normal and no fungal growth was observed in the later blood cultures. On the 21st day of amphotericin B therapy, chemotherapy was started again and amphotericin B was changed to peroral itraconazole (200 mg/day) at the fifth week. The patient whose itraconazole therapy was stopped after three months, was still in remission and continued receiving her prolonged therapy. In conclusion, Fusarium infections which manifest with fungaemia and fever as the only symptoms, should be taken into consideration in neutropenic patients receiving immunosuppressive therapy

Comparison of minimum inhibitory and minimum effective concentration values for the detection of in vitro susceptibilities of Aspergillus species against caspofungin Aspergillus türlerinin kaspofungine karşι in vitro duyarlιlιǧιnιn saptanmasιnda minimum inhibitor ve minimum etkili konsantrasyon deǧerlerinin karşιlaştιrιlmasι

Caspofungin is a promising echinocandin-group antifungal agent used especially in the treatment of resistant invasive aspergillosis. The guidelines for in vitro susceptibility testing of Aspergillus species against caspofungin are not described by the Clinical and Laboratory Standards Institute (CLSI). The minimum inhibitory concentration that showed a prominent reduction of growth (MIC-2) and minimum effective concentration (MEC) endpoints are frequently used for the susceptibility testing of caspofungin as MIC determination criteria. The aim of this study was to evaluate the in vitro activity of caspofungin against Aspergillus species and to compare MIC-2 and MEC endpoints in the determination of MICs. A total of 32 Aspergillus species (18 A.fumigatus, seven A.flavus, five A.niger, and two A.versicolor) isolated from different clinical samples were included to the study. In vitro susceptibilities of the strains against 0.03-16 μg/ml caspofungin concentrations were searched by broth microdilution method as recommended by CLSI M-38A document, with the use of glucose supplemented 2% RPMI 1640 media. The MIC-2 and MEC endpoints were determined both at 24 and 48 hours. The concordance between MIC-2 and MEC endpoints of the strains at 24 and 48 hours incubations was found as 53% and 100%, respectively, with the difference of ±1 dilution. MIC-2 and MEC measurements showed the same values at the end of 48 hours, whereas 7% showed differences in ±1 dilution. MEC endpoints were also found to be more stable than MIC-2 in both of the incubation periods. In conclusion, MEC value is a more objective and stable endpoint and easier to use than MIC-2 for testing in vitro caspofungin activity against Aspergillus species