Çağrı Ergin

An experience from an outbreak of tinea capitis gladiatorum due to Trichophyton tonsurans

‘Tinea corporis gladiatorum’ describes a dermatophytosis transmitted mainly from close skin contact among wrestlers. Although tinea corporis is well recognized, no data are available for tinea capitis infections in wrestlers. After finding tinea capitis infection in a student wrestler, we aimed to search for possible ringworm infections among wrestlers in a wrestling boarding‐school.

Environmental distribution of Cryptococcus neoformans and C. gattii around the Mediterranean basin

In order to elucidate the distribution of Cryptococcus neoformans and C. gattii in the Mediterranean basin, an extensive environmental survey was carried out during 2012-2015. A total of 302 sites located in 12 countries were sampled, 6436 samples from 3765 trees were collected and 5% of trees were found to be colonized by cryptococcal yeasts. Cryptococcus neoformans was isolated from 177 trees and C. gattii from 13. Cryptococcus neoformans colonized 27% of Ceratonia, 10% of Olea, Platanus and Prunus trees and a lower percentage of other tree genera. The 13 C. gattii isolates were collected from five Eucalyptus, four Ceratonia, two Pinus and two Olea trees. Cryptococcus neoformans was distributed all around the Mediterranean basin, whereas C. gattii was isolated in Greece, Southern Italy and Spain, in agreement with previous findings from both clinical and environmental sources. Among C. neoformans isolates, VNI was the prevalent molecular type but VNII, VNIV and VNIII hybrid strains were also isolated. With the exception of a single VGIV isolate, all C. gattii isolates were VGI. The results confirmed the presence of both Cryptococcus species in the Mediterranean environment, and showed that both carob and olive trees represent an important niche for these yeasts.

The prevalence, aetiological agents and therapy of onychomycosis in patients with psoriasis: a prospective controlled trial

Background.  Nail involvement morphologically resembling onychomycosis frequently accompanies psoriatic lesions. The role of psoriasis as a predisposing factor for onychomycosis and the possible influence of psoriasis on responsiveness of onychomycosis to treatment are controversial.

Fourier transform infrared spectral evaluation for the differentiation of clinically relevant Trichophyton species.

Routine mold identification methods have been established to provide actual data to facilitate reliable diagnoses in clinical laboratories, as well as the management of infection and health practice planning, particularly for dermatophytes. Some species of the Trichophyton genera, particularly T. rubrum and T. mentagrophytes complexes, exhibit more complexity in species recognition. In this study, the intriguing technique of Fourier-transform infrared (FT-IR) spectroscopy is evaluated for species recognition of Trichophyton spp. A total of 32 reference isolates, belonging to T. mentagrophytes (n=7), T. rubrum (n=21) complexes and Arthroderma spp. (n=4), were included in the study. Numerous spectral window FTIR spectroscopy data were analyzed by principal component analysis and hierarchical clustering was performed. There were not any spectral ranges presenting clusters at the main Trichophyton species (e.g. T. rubrum, T. mentagrophytes and Arthroderma spp.). Notably, only T. violaceum (including T. yaoundei and T. soudanense) was clustered in several ranges. In intra-species evaluation, T. erinacei, belonging to the T. mentagrophytes complex, was distinguishable by FT-IR spectroscopy with different spectral range calculations. We suggested that further research with several reference and clinical isolates of Trichophyton species will be crucial to accurately identify intra-species of T. rubrum and T. mentagrophytes complexes.

The first isolation of Cryptococcus neoformans from Eucalyptus trees in South Aegean and Mediterranean Regions of Anatolia in Turkey despite Taurus Mountains alkalinity

Eucalyptus trees are widespread in subtropical parts of Turkey that have alkaline environments due to the soil structure of Taurus Mountains. In this study, the existence of Cryptococcus neoformans in eucalyptus trees in the South Aegean and Mediterranean Regions of Anatolia, Turkey, was screened between March 1998 and September 2002. Only one strain of Cryptococcus neoformans var. grubii (Serotype A) was isolated from 1175 eucalyptus samples including debris and flowers in culture by Guizotia abyssinica agar. The environmental niche of the isolate was Eucalyptus camaldulensis Dehn in the Gokova Region, in the western part of the Taurus Mountains. In this study, the existence of Cryptococcus neoformans was shown in the eucalyptus flora of Turkey despite the alkaline soil condition.

Fundamental niche prediction of the pathogenic yeasts cryptococcus neoformans and cryptococcus gattii in europe

Fundamental niche prediction of Cryptococcus neoformans and Cryptococcus gattii in Europe is an important tool to understand where these pathogenic yeasts have a high probability to survive in the environment and therefore to identify the areas with high risk of infection. In this study, occurrence data for C. neoformans and C. gattii were compared by MaxEnt software with several bioclimatic conditions as well as with soil characteristics and land use. The results showed that C. gattii distribution can be predicted with high probability along the Mediterranean coast. The analysis of variables showed that its distribution is limited by low temperatures during the coldest season, and by heavy precipitations in the driest season. C. neoformans var. grubii is able to colonize the same areas of C. gattii but is more tolerant to cold winter temperatures and summer precipitations. In contrast, the C. neoformans var. neoformans map was completely different. The best conditions for its survival were displayed in sub-continental areas and not along the Mediterranean coasts. In conclusion, we produced for the first time detailed prediction maps of the species and varieties of the C. neoformans and C. gattii species complex in Europe and Mediterranean area.

Nasal antibiotic‐resistant Propionibacterium acnes carriage in acne vulgaris patients in Turkey

Dear Editor Propionibacterium spp. are present in pilosebaceous units but the role of these ubiquitous organisms in the pathogenesis of acne remains unclear. Recently, however, the spreading of antibiotic-resistant Propionibacterium acnes has been accepted as a cause of therapeutic failure in acne vulgaris. Many countries have reported antibiotic-resistant P. acnes from acne patients due to widely prescribing antibiotics for acne therapy. Although forehead skin samples are preferred for cultivation of P. acnes, recent studies have focused on the importance of nasal colonization and/or carriage. The aim of the study was to investigate the presence of nasal P. acnes carriage and the search for resistance to certain antibiotics in acne vulgaris patients. In this study, 120 acne vulgaris patients who had not been on an antibiotic therapy in the prior 4 weeks, were included. The detergent scrub technique of Williamson and Kligman was used for cutaneous bacteria sampling from forehead. Sterile cotton-tipped swabs were premoistened with sampling solution (0.075 mol/L phosphate buffer saline containing 0.1% Tween 80). For each patient, 4 cm of the skin surface was rubbed with the amount of pressure similar to that is used to erase with a pencil. The swab was returned to the tube and swirled in the fluid. This procedure was repeated four times. The same procedure was applied to the inner surface of nares. The sample was incubated at 36.5°C for 5 days in thioglycollate medium Brewer’s modification. After 5 days, bacteria from visibly growing parts of the thioglycollate tubes were transported with a Pasteur pipette to Trypticase-yeast extract-glucose broth (TYG) agar (20 gL tryptone, 10 gL yeast extract, 5 gL glucose, 15 gL agar) containing 2 μg/ml furazolidone (Sigma Chemical, Poole, Dorset, UK) to inhibit the growth of Staphylococci. This medium was also used for isolation of nasal Propionibacteria. Incubation was carried out for 5 days at 37°C in anaerobic conditions. P. acnes was identified according to the method of Marples and McGinley including Gram stain, aerotolerance, indol production and catalase test. Minimum inhibitory concentrations (MIC) were determined by agar dilution on Wilkins Chalgren agar (Oxoid) as described by the National Committee for Clinical Laboratory Standards (NCCLS). Erythromycin (EM), clindamycin (CLDM), tetracycline hydrochloride (TC) and doxycycline hydrochloride (DOXY) were used for susceptibility testing. The inocula contained 10 colony-forming units (CFU)/1 μL spot in TYG broth delivered by manual inoculator. MIC were recorded after 3 days of anaerobic incubation at 37°C as the lowest concentration yielding no growth or a barely visible haze as determined by the unaided eye. The MIC breakpoints 1 μg/ml for EM and CLDM, and 4 μg/ml for TC and DOXY were accepted as resistance levels. Statistical analyses were performed with EPI Info 2000 Ver 3.3.2 program (Centers for Disease Control and Prevention (CDC), Atlanta, USA). Fifty-three (44.2%) P. acnes were isolated from both skin and nares (Table 1). In the case of isolation of P. acnes from the skin, the nasal culture positivity was detected as 66.3% (as sensitivity). In the absence of skin P. acnes isolation, the nasal culture was negative in 80.0% (as specificity). Cutaneous and nasal isolates resistance rates were not statistically different between groups for EM (12.5% vs 11.8%), CLDM (10.0% vs 11.8%) and TC (2.5% vs 5.0%) (P > 0.05). DOXY resistance was not found within groups. Table 2 shows antibiotic MIC values of skin and nasal P. acnes isolates. The antibiotic susceptibility levels did not differ in skin and nasal samples (P > 0.05).

Environmental distribution of Cryptococcus neoformans and Cryptococcus gattii around the Mediterranean basin

In order to elucidate the distribution of Cryptococcus neoformans and C. gattii in the Mediterranean basin, an extensive environmental survey was carried out during 2012-2015. A total of 302 sites located in 12 countries were sampled, 6436 samples from 3765 trees were collected and 5% of trees were found to be colonized by cryptococcal yeasts. Cryptococcus neoformans was isolated from 177 trees and C. gattii from 13. Cryptococcus neoformans colonized 27% of Ceratonia, 10% of Olea, Platanus and Prunus trees and a lower percentage of other tree genera. The 13 C. gattii isolates were collected from five Eucalyptus, four Ceratonia, two Pinus and two Olea trees. Cryptococcus neoformans was distributed all around the Mediterranean basin, whereas C. gattii was isolated in Greece, Southern Italy and Spain, in agreement with previous findings from both clinical and environmental sources. Among C. neoformans isolates, VNI was the prevalent molecular type but VNII, VNIV and VNIII hybrid strains were also isolated. With the exception of a single VGIV isolate, all C. gattii isolates were VGI. The results confirmed the presence of both Cryptococcus species in the Mediterranean environment, and showed that both carob and olive trees represent an important niche for these yeasts.

Analysis of Eucalyptus camaldulensis Volatiles from Turkey Using DTD-GC-MS

Abstract The direct analyses of the volatile organic components of 30 Eucalyptus camaldulensis fruit samples, obtained from the Antalya, Aegean and Cukurova regions in Turkey, was studied using a direct thermal desorption (DTD) technique coupled with gas chromatography mass spectrometry (GC-MS). It was found that the E. camaldulensis samples yielded a similar chemical composition. However, some of the compounds were only seen in one region, such as thymol in the Aegean region, ocimen and cis-sabinene hydrate in the Antalya region and nerolidol and pentacosane in the Cukurova region. A total of 68 components were identified from 30 samples. The main compounds found in the volatiles were: ledene (0–23.08 %), aromadendrene (0.59–42.31 %), alloaromadendrene (0–24.14 %), globulol (0–19.97 %) and isolongifolen (0–50.04 %). However, some of the quantities of the main compounds differed between samples. DTD with GC-MS is a good method for analysis of complex mixtures, and in particular for plant samples, which can yield data without the traditional obligation for costly and time consuming extraction techniques.

HIV-negative case of bacillary angiomatosis with chronic hepatitis B.

Bacillary angiomatosis (BA) is an infectious disease which occurs predominantly in immunosuppressive patients and rarely in immunocompetent individuals. We had a case of BA who presented with a red cutaneous nodule on his left leg of which histopathological examination revealed marked lobular proliferation of capillaries throughout the interstitium and clusters of bacilli with hematoxylin–eosin and Warthin–Starry stains, respectively. Antibody titer against Bartonella henselae was 1/32. The only systemic disease the patient had was chronic hepatitis B. HIV was negative and no other immunosuppressive status was established. In this case we believe that the immunological differences secondary to chronic hepatitis B could have caused a tendency for the disease development.