Feza Otag

An outbreak of Pichia ohmeri infection in the paediatric intensive care unit: case reports and review of the literature.

Since the first report in 1998, 10 cases of Pichia ohmeri infection have been reported in the literature. Here we present two new cases of P. ohmeri infection in the paediatric age group. The first case was an 8‐month‐old male infant, who was admitted with fever, convulsions and altered consciousness. Conservative therapy was started with a presumptive diagnosis of encephalitis. The patient failed to respond to the given treatments and died on the 21st day of hospitalisation. The second case was a 10‐year‐old male with B‐cell acute lymphoblastic leukaemia. He was hospitalised with neutropenic fever. He was discharged after 3 weeks of therapy. In both cases P. ohmeri was identified in blood samples. Growing evidence indicates that P. ohmeri should be added to the lengthening list of opportunistic fungal pathogens that can cause infection in all ages, including infants, and particularly in those who are immunocompromised.

Molecular identification, genotyping, and drug susceptibility of the basidiomycetous yeast pathogen Trichosporon isolated from Turkish patients

Deep-seated infections due to Trichosporon species are emerging mycoses that have a very poor prognosis in patients with persistent neutropenia. This study elucidated the mycological characteristics of Trichosporon strains obtained from deep-seated infections in Turkish patients and identified by DNA sequence analysis of intergenic spacer (IGS) region 1 of the rDNA locus. In addition, we genotyped the major causative agent, T. asahii, and evaluated the in vitro drug susceptibility of the isolates. While 87 (81.3%) of the 107 isolates were T. asahii, the remaining 20 were T. faecale (14.0%), T. asteroids (0.9%), T. coremiiforme (0.9%), T. japonicum, (0.9%), T. lactis (0.9%), and a new species (0.9%). In addition to the eight known T. asahii genotypes, one novel genotype was identified. The distribution of the T. asahii genotypes in this study were genotype 1 (79.3%), followed by 5 (8.0%), 3 (6.9%), 6 (3.4%), 4 (1.1%), and 9 (1.1%). Turkish isolates showed low susceptibility to amphotericin B, 5-flucytosine, and fluconazole. Although relatively low minimum inhibitory concentrations (MICs) were found with all drugs, voriconazole appeared to be the most active. The MICs of the non-Trichosporon asahiiTrichosporon species were similar to those of the T. asahii strains. Our findings suggest that Trichosporon species isolated from Turkish patients are more diverse than those reported from other countries.

Does Helicobacter pylori play a role in etiology of nasal polyposis

OBJECTIVE Investigation of the possible relation between nasal polyposis (NP) and Helicobacter pylori (HP). PATIENTS AND METHODS Biopsy specimens of 25 patients with NP were evaluated. There were 16 men and 9 women enrolled in the study (NP) group. There were 10 men and 4 women in the control group. Campylobacter-like organism (CLO) test, immunohistochemical examination on nasal polyp tissue biopsy specimens and serological analysis were used for detecting HP. RESULTS There was only one (4%) positive NP case for CLO test. There were six cases in the study group with positive anti HP IgG test. Two control nasal mucosa were CLO positive. There were three cases in control group with positive anti HP IgG. There were no positive cases with positive anti IgM HP regarding both the study and the control groups. The immunohistochemical examination of the specimens taken from the patients with NP and control patients revealed that all patients were negative for HP. Positive CLO test and serologic test ratios were not statistically significant between NP and control groups. CONCLUSION The results of this study did not confirm other investigators. The suggested role of HP in the previous reports regarding NP may demonstrate transient occurrence of HP. It may not be treated as a possible etiological factor in NP.

Evaluation of Antifungal Efficacy of 0.1% and 0.25% Riboflavin with UVA: A Comparative In Vitro Study

ABSTRACT Purpose: Antifungal efficacy of photochemical cross-linking (PACK-CXL) with 0.1% and 0.25% riboflavin was evaluated with a comparative in vitro study. Methods: Candida albicans and Aspergillus fumigatus ATCC reference strains, Candida parapsilosis, Aspergillus fumigatus, Fusarium solani, Scedosporium apiospermum, and Alternaria alternata strains isolated from keratitis cases were chosen as targeted microorganisms. Unique “black plate method” was developed in polystyrene microplates. Riboflavin suspensions in 0.1% and 0.25% were separately added into inoculated wells. Non-inoculated wells were filled by black colored dye in order to protect treated wells from reflection of UV treatment. After ultraviolet A (UVA) treatment, each well was evaluated by microbiological culture in order to count viable fungal colonies. Fungal killing rate was calculated by comparing fungal counts (CFU/mL) before and after UVA application of riboflavin-added wells. Results: Four different fungal inoculum concentrations of targeted microorganisms, including 104, 103, 102, and 101 CFU/mL, were assayed. PACK-CXL with 0.25% riboflavin was found to be highly effective on fungal cells even in 104 CFU/mL of concentration. Conclusions: PACK-CXL appears as a promising treatment option for difficult-to-treat cases of fungal keratitis and 0.25% riboflavin concentration increases fungicidal effect of the procedure dramatically.