Aylin Ates

Comparison of hairbrush, toothbrush and cotton swab methods for diagnosing asymptomatic dermatophyte scalp carriage

Background  Tinea capitis may also present as a minimal infection, termed carrier state. Anthropophilic dermatophytes (i.e. Trichophyton tonsurans and Trichophyton violaceum) have been generally associated with high rates of asymptomatic carriage.

Asymptomatic dermatophyte scalp carriage in school children in Adana, Turkey

The aim of this study was to determine the prevalence of asymptomatic dermatophyte scalp carriage and symptomatic tinea capitis in Adana Province, Çukurova region, Turkey. For this purpose, a screening study was performed in five schools, between January 2004 and May 2005, covering a total of 5143 children with 2740 (53.3%) boys and 2403 (46.7%) girls, aged 7–14 years (9.6 ± 2.0). The diagnosis was made using the cotton swab method with inoculation onto Sabouraud glucose agar amended with cycloheximide, chloramphenicol and gentamicin. Among 10 (0.2%) cases, six asymptomatic carriers (mean age 10.7 ± 2.3) and four symptomatic cases (mean age 8.3 ± 0.5) were detected, all of whom were boys and had immigrated from the south‐eastern and eastern region of Anatolia, Turkey. The mean age differences were found to be statistically significant (Mann–Whitney U = 3.000, P = 0.046). Boys were found to be more prone to asymptomatic carriage (P = 0.033), but not tinea capitis (P > 0.05). Zoophilic dermatophytes, namely Microsporum canis (40%) and Trichophyton mentagrophytes var. mentagrophytes (40%) were the most commonly isolated species, followed by anthropophilic Trichophyton tonsurans (10%), while no causative agent was detected in a case (10%) with tinea capitis superficialis. Scalp cultures were found to be dermatophyte‐negative after 3‐ to 8‐month follow‐up in cases with asymptomatic carriage. As a conclusion, the prevalence of asymptomatic carrier state was similar with the prevalence of symptomatic cases, and we found a predominance of zoophilic species.

Malassezia and Candida colonisation on glans penis of circumcised men

The Malassezia yeast are members of the normal human cutaneous flora in adults. They also are reported as part of the microflora of the male genital region in mostly uncircumcised males. It has been reported that Malassezia sympodialis and Malassezia globosa are the most frequent yeast belonging to the resident microflora of the penis as in other human skin areas. The aim was to evaluate the prevalence of Malassezia and Candida yeast colonisation on the glans penis of circumcised males. Impression preparations were made on modified Dixon agar. The isolates were identified by morphological and physiological characteristics. A total of 245 circumcised males were included in the study. Of the 245 patients examined, 55 (22.4%) were found to have a mycologically proven yeast fungi on their glans penis. In 17 (30.9%) Malassezia, in 36 (65.5%) Candida, in one (1.8%) Malassezia and Candida, and in one (1.8%) Saccharomyces strains were detected. Malassezia furfur (66.7%) was the most common species among the lipophilic yeast, followed by Malassezia globosa (11.1%), Malassezia obtusa (11.1%) and Malassezia slooffiae (11.1%). Candida albicans was the most common non‐lipophilic yeast (46.0%), that was isolated among the other yeast, followed by unidentified Candida strains (18.9%), Candida tropicalis (8.1%), Candida glabrata (8.1%), Candida parapsilosis (8.1%), Candida zeylanoides (5.4%), Candida guilliermondii (2.7%) and Saccharomyces cerevisiae (2.7%). The results of this study showed that Malassezia species were also colonised like Candida on the glans penis of circumcised males.

Performance of Chromogenic Candida Agar and CHROMagar Candida in recovery and presumptive identification of monofungal and polyfungal vaginal isolates

Chromogenic Candida agar (OCCA) is a novel medium facilitating isolation and identification of Candida albicans, C. tropicalis, and C. krusei, as well as indicating polyfungal population in clinical samples. We compare the performance of OCCA, to CHROMagar Candida (CAC) and Sabouraud chloramphenicol agar (SCA). Vaginal swab samples from 392 women were simultaneously inoculated onto three study media. A total of 161 (41.1%) were found to be positive for fungi of which 140 (87%) were monofungal, and 21 (13%) polyfungal. One-hundred and fifty-seven samples (97.5%) were positive on CAC, 156 (96.9%) on OCCA, 148 (91.9%) on SCA and 144 (89.4%) samples were positive on all three media. The yeasts were identified by conventional methods including germ tube test, microscopic morphology on cornmeal-Tween 80 agar, and the commercial API 20C AUX. The 182 isolates were C. albicans (n = 104), C. glabrata (n = 51), C. krusei (n = 7), C. tropicalis (n = 5), C. famata (n = 3), C. kefyr (n = 3), C. zeylanoides (n = 3), C. colliculosa (n = 2), and other species of Candida (n = 4). Among the 21 polyfungal populations, 20 (95.2%) were detected in OCCA, 14 (66.7%) in CAC, and 13 (61.9%) in CAC and OCCA (P <0.05). Most polyfungal populations (47.6%) yielded C. albicans + C. glabrata. The efficiency of both chromogenic media for C. albicans was >or=92.9% at 72 h. OCCA is more efficient and reliable for rapidly identifying C. albicans and polyfungal populations than CAC. However, CAC is more efficient for identifying C. krusei and C. tropicalis. A chromogenic agar with a higher isolation rate of yeasts and better detection of polyfungal populations than SCA, is suggested as a medium of first choice when available.

Glans penis and prepuce colonisation of yeast fungi in a paediatric population: pre- and postcircumcision results.

The members of the genera Candida and Malassezia comprise opportunistic yeast with a natural habitat on the skin of humans and warm‐blooded animals. This study aimed to compare the prevalence of these yeast fungi in samples from the glans penis and prepuce 3–5 min prior to circumcision and after 1‐month follow‐up by mycological examination. A total of 77 children aged between 0.01 and 13.0 years (mean age 5.8 ± 3.4) were included in the study. Impression preparations were made on modified Dixon and Leeming‐Notman agars without cycloheximide. The isolates were identified by morphological, biochemical and physiological characteristics. The frequency of yeast colonisation was found to be significantly decreased from 11.7% to 1.3% following circumcision (P = 0.008). The glans penis and prepuce were colonised with especially Candida albicans (50%) followed by Malassezia furfur (40%) and Malassezia sympodialis (10%). This study highlighted the potential medical benefits of circumcision as a significant factor decreasing the colonisation rate of yeast fungi. We suggest that circumcision, rather than age, plays an important part in the reduction of yeast fungi in genitalia.

Tinea cruris in Routine Urology Practice

Introduction: Tinea cruris is almost exclusively a male dermatophytosis. This infection is also sexually transmitted, and may cause epidemics in public areas such as common bathing facilities, dormitories and among military recruits. It has been aimed to investigate the prevalence and the causative agents of tinea cruris and tinea pedis in patients who were admitted to the Department of Urology with various pathologies. Materials and Methods: Direct microscopy and cultures of the epithelial scrapings were performed to identify the causative agent in patients who were admitted to the Department of Urology. Results: Out of a total of 155 cases examined, 39 (25.1%) were mycologically proven cases of dermatomycosis. In 11 (28.2%) of the patients tinea pedis, in 3 (7.7%) tinea cruris and in 10 (25.6%) Candida intertrigo were detected. In the remaining 15 (38.5%) cases, only direct microscopic examinations were found positive. The most common causative agent was Candida albicans (33.4%) followed by Trichophyton rubrum (29.1%), Trichophyton mentagrophytes var. interdigitale (29.1%), Candida glabrata (4.2%) and Candida tropicalis (4.2%).Conclusion: The investigation of genital dermatomycosis should be a part of routine urological examination and the clinical diagnosis should be confirmed by mycological methods.

Environmental study ofCryptococcus neoformans in and around Adana, Turkey

Fungal diseases affecting humans generally originate from the environment. Due to the rising of in human fungal infections in recent years, it is now extremely significant to know more about ecology in order to control fungal pathogens. The aim of this study was to evaluate the presence ofCryptococcus neoformans in its well-known ecological niches in eight different locations, in Çukurova region, Turkey. For this purpose, for a total of 1835, 1508 vegetable material from tree of the genusEucalyptus trees, 119 pigeon droppings and 208 soil samples were examined for the presence of yeast in a nigerseed mediumCryptococcus spp. was not recovered from any of these samples. We believe that in our region there are elements affecting the life cycle ofCryptococcus neoformans, such as alkaline pH and high carbon ratio of the soil.