Estimated burden of serious human fungal diseases in Turkey

Seyedmousavi, Seyedmojtaba/0000-0002-6194-7447; Denning, David/0000-0001-5626-2251; Hedayati, Mohammad T./0000-0001-6415-4648; Ilkit, Macit/0000-0002-1174-4182WOS: 000453770400004PubMed: 30107069The current number of fungal infections occurring each year in Turkey is unknown. We estimated the burden of serious human fungal diseases based on the population at risk, existing epidemiological data from 1920 to 2017 and modelling previously described by the LIFE program (). Among the population of Turkey (80.8 million in 2017), approximately 1 785 811 (2.21%) people are estimated to suffer from a serious fungal infection each year. the model used predicts high prevalences of allergic fungal rhinosinusitis episodes (312 994 cases) (392/100 000), of severe asthma with fungal sensitisation (42 989 cases) (53.20 cases/100 000 adults per year), of allergic bronchopulmonary aspergillosis (32 594 cases) (40.33/100 000), of fungal keratitis (26 671 cases) (33/100 000) and of chronic pulmonary aspergillosis (5890 cases) (7.29/100 000). the estimated annual incidence for invasive aspergillosis is lower (3911 cases) (4.84/100 000 annually). Among about 22.5 million women aged 15-50 years, recurrent vulvovaginal candidiasis is estimated to occur in 1 350 371 (3342/100 000) females. the burden of three superficial fungal infections was also estimated: tinea pedis (1.79 million), tinea capitis (43 900) and onychomycosis (1.73 million). Given that the modelling estimates reported in the current study might be substantially under- or overestimated, formal epidemiological and comprehensive surveillance studies are required to validate or modify these estimates

Do incubation temperature, incubation time, and carbon dioxide affect the chromogenic properties of CHROMagar?

WOS: 000309796300005Aim: On CHROMagar medium Candida species form different colors; thus, the medium enables the differentiation of these species from each other as well as from other Candida species. The aim of this study is to investigate the effect of incubation temperatures, incubation times, and CO2 on the chromogenic properties of CHROMagar. Materials and methods: A total of 112 strains of Candida spp. were used. A 0.5 McFarland suspension of each strain was inoculated onto CHROMagar with a calibrated loop and incubated at 26 degrees C and 35 degrees C for 24-48 h in normal atmosphere and in an atmosphere of 5% CO2. The results were evaluated at the end of 24 and 48 h by 2 of the authors working in strict separation. Results: The chromogenic property of the medium was best observed at an incubation temperature of 35 degrees C. Incubation in an atmosphere of 5% CO2 yielded more prominent colonies at the end of 48 h. The chromogenic differentiation of C. dubliniensis from C. albicans was not easy, for C. albicans yielded a green color and C. dubliniensis a somewhat darker green color. Conclusion: To obtain the best results with CHROMagar, the medium should be incubated at 35 degrees C for 48 h in an atmosphere of 5% CO2. A control C. albicans strain should be inoculated on each medium plate to differentiate the color tones of C. albicans and C. dubliniensis

Evaluation of Antifungal Susceptibility Testing with Microdilution and Etest Methods of Candida Blood Isolates

WOS: 000293000600003PubMed ID: 21424603Candida species that show an increasing number of clinical and/or microbiological resistance to several antifungals and are the most common agents of invasive fungal infections. The aim of this study was to investigate the in vitro susceptibility of Candida blood isolates to antifungal agents (amphotericin B, fluconazole, itraconazole, and voriconazole) by comparative use of the CLSI reference microdilution method and Etest. Four hundred Candida blood isolates (215 Candida albicans, 185 non-albicans Candida strains) were included in the study. The broth microdilution test was performed according to the CLSI M27 A2 document. Etest was carried out according to the manufacturer's instructions. The MIC results obtained with reference microdilution were compared with those obtained with the Etest by using percent and categorical agreements. According to MIK90 values, voriconazole was the most active and itraconazole was the least active drug in vitro against all Candida species. Other than voriconazole, statistically significant differences were found when the susceptibility of Candida albicans and non-albicans Candida spp. to amphotericin B, fluconazole, and itraconazole were compared. These antifungal agents were found to be more active to C. albicans. Among the non-albicans Candida species, the lowest MIC values were obtained for Candida parapsilosis isolates. When the standard method was compared with Etest, the total agreement was higher for C. albicans than for non-albicans species, especially for fluconazole and voriconazole. In view of the findings, it was concluded that itraconazole showed the lowest activity against all Candida species. Etest could be an alternative method in assessing the in vitro antifungal susceptibility of Candida spp., but it is more convenient to use the microdilution method for studying in vitro susceptibility of non-albicans species, in particular for those possessing high MIC values against azoles.Ege UniversityEge University [04 TIP 029]This study was supported by Ege University Scientific Research Fund (Research 04 TIP 029). We would like to thank Gul Kitapcioglu for statistical analysis