Okan Tore

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.

Multilocus sequence typing analysis reveals that Cryptococcus neoformans var. neoformans is a recombinant population

Cryptococcus neoformans var. neoformans (serotype D) represents about 30% of the clinical isolates in Europe and is present less frequently in the other continents. It is the prevalent etiological agent in primary cutaneous cryptococcosis as well as in cryptococcal skin lesions of disseminated cryptococcosis. Very little is known about the genotypic diversity of this Cryptococcus subtype. The aim of this study was to investigate the genotypic diversity among a set of clinical and environmental C. neoformans var. neoformans isolates and to evaluate the relationship between genotypes, geographical origin and clinical manifestations. A total of 83 globally collected C. neoformans var. neoformans isolates from Italy, Germany, France, Belgium, Denmark, Greece, Turkey, Thailand, Japan, Colombia, and the USA, recovered from different sources (primary and secondary cutaneous cryptococcosis, disseminated cryptococcosis, the environment, and animals), were included in the study. All isolates were confirmed to belong to genotype VNIV by molecular typing and they were further investigated by MLST analysis. Maximum likelihood phylogenetic as well as network analysis strongly suggested the existence of a recombinant rather than a clonal population structure. Geographical origin and source of isolation were not correlated with a specific MLST genotype. The comparison with a set of outgroup C. neoformans var. grubii isolates provided clear evidence that the two varieties have different population structures.

A comparative study of dermatophyte infections in Bursa, Turkey

A total of 555 specimens from 372 patients with symptoms compatible with superficial mycosis were included in this study. Those from patients clinically diagnosed as having dermatomycosis were thoroughly investigated by mycological examinations in the laboratory, including microscopic studies of KOH mounts and cultivation of the samples in culture. The results of this study and a previous study in our hospital conducted in 1980 were compared with respect to clinical presentation and etiological agents. Onychomycosis was the most common clinical form of dermatomycoses, and Trichophyton rubrum was the most common pathogen in this study.

Two cases of cryptococcal meningitis in immunocompromised patients not infected with HIV

We present the cases of two patients with cryptococcal meningitis who were predisposed to fungal infection because of diabetes mellitus (Case 1) and systemic lupus erythematosus (Case 2). Both patients were tested negative for anti‐HIV antibodies.

Persistence of candiduria in ICU catheterized patients is not linked to adherence and proteolytic activities of Candida strains.

ObjectiveIn this study, the patients who developed asymptomatic candiduria in the intensive care unit were followed prospectively for the persistence of candiduria after the replacement of indwelling urethral catheter and the correlation between persistence and virulence factors (proteinase enzyme activity and epithelial adhesion) was assessed.DesignProspective study.SettingIntensive care unit and mycology laboratory at a university hospital.PatientsThirty-four patients with asymptomatic candiduria were included in the study.ResultsCandiduria persisted in 19 of 34 patients(56%; group 1) and cleared in 15 of 34 patients(44%; group 2) after urinary catheters were changed. When the virulence factors (epithelial adhesion and proteinase activity) and distribution of Candida spp. were compared between two groups, no statistically significant correlation was found.ConclusionThe host immune response might be more important than virulence factors of Candida spp. for persistence of candiduria.

Influences of alternate therapy protocol and continuous infectious disease consultation on antibiotic susceptibility in ICU.

Abstract In this study, the effects of alternate use of imipenem and cefoperazone/sulbactam(CFP/Sul) on antibiotic resistance in the intensive care unit (ICU) were investigated. Between 1 April 1993 and 1 April 1994, the infectious diseases consultant saw patients when required and there was no alternative therapy for antibiotics. For the following 2 years, the same consultant followed up each patient from admission to discharge by daily visits to the ICU and an alternative therapy protocol was initiated. The most common microorganisms were found to be Acinetobacter baumannii and Staphylococcus aureus, followed by Pseudomonas aeruginosa and Klebsiella pneumoniae, respectively, in the two periods. This study demonstrated that sensitivity rates of imipenem, ciprofloxacin and aminoglycosides were improved as a result of this protocol.

Effects of Malassezia yeasts on serum Th1 and Th2 cytokines in patients with guttate psoriasis

Background  Systemic and focal infections caused by microorganisms have been known to induce or exacerbate psoriasis. Although the role of yeast species of the genus Malassezia in the pathogenesis of psoriasis is not fully understood, it is thought that these lipophilic yeasts may represent a triggering factor in the exacerbation of psoriatic lesions.

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.

Multiple intracranial abscesses due to Cryptococcus neoformans: an unusual clinical feature in an immunocompetent patient and a short review of reported cases

We present a case of multiple intracranial abscesses caused by Cryptococcus neoformans in a patient who presented with no symptoms of immunodeficiency.

Environmental distribution ofCryptococcus neoformansandC. gattiiaround 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.