In response to the recent increase in Aspergillus infections, new antifungal agents have become available accompanied by studies on antifungal susceptibility tests for epidemiological follow-up. The ...aim of this study was to compare the efficacy of Clinical Laboratory Standards Institute (CLSI) M 38-A broth microdilution test with the disk diffusion and E-test in determining the susceptibility of Aspergillus spp. to amphotericin B, itraconazole and voriconazole.
The study was carried out on 18 A. fumigatus, 7 A. flavus, 5 A. niger and 2 A. versicolor strains isolated from clinical samples. The microdilution method was performed by following the instructions of CLSI M 38-A. The E-test and disk diffusion tests were performed according to the instructions of their manufacturers.
The percent agreement between the E-test and CLSI M38-A broth microdilution test at 24 (48) h within ± 2 dilutions was, respectively, 81% (69%) for amphotericin B, 75% (72%) for itraconazole and 85% (81%) for voriconazole. The disk diffusion test showed good correlation with the E-test but poor correlation with the broth microdilution test for the three antifungal agents we tested.
In conclusion, E-test and disk diffusion test have their advantages such as ease of application and interpretation, but their correlation with the broth microdilution should be improved.
In an attempt to determine the relationship between the features of houses and moulds growing indoors, 242 houses were examined in Izmir, a city on the west coast of Turkey with a mild climate. ...During house visits a questionnaire was given and air was sampled using an `air IDEAL' air sampler for quantitative fungal culture. The moulds most commonly isolated were Aspergillus, Penicillium, and Mucor spp. Aspergillus growth in houses older than 20 years was more common than other species when the features of houses and isolated fungi were compared. Mucor grew significantly more in houses where the air was humid, the temperature was cooler and there were pot plants. Penicillium grew more frequently in houses where visible mould was present and birds were bred. However, no relationship could be demonstrated between the method of heating, the number of household members, exposure to sun, type of building and flooring with a specific mould. As a conclusion, many household factors suggested as risk factors for mould growth have been examined and only a few relationships could be established between certain features of houses and moulds. However, mould growth is much affected by many conditions and the environment in a house is one of many factors that may facilitate growth.
With the participation of eight major reference hospitals in Turkey, 749 aerobic Gram-negative isolates obtained from 473 intensive care patients in 1997 were tested for their susceptibility to 13 ...commonly employed antibacterial agents. The frequency with which species were isolated and resistance rates were compared with data from the previous 2 years. Imipenem was the most active agent against the majority of isolates (75%), followed by ciprofloxacin, cefepime and amikacin. The per cent susceptibility to all antibiotics declined from 1995 to 1996. With the exception of imipenem, for which there was no change in resistance, the per cent susceptibility somewhat increased in 1997. However, it was still lower than in 1995.
Propolis is one of the few natural remedies that have maintained its popularity over a long period of time. The aim of this study is to investigate the antimicrobial properties of six propolis ...solutions and evaluate their cytotoxicity on gingival fibroblasts at different dilutions. Two different solutions of powder propolis (Sigma) and Turkish propolis were prepared and propylene glycol (PG) and alcohol were used as solvents for each propolis sample. In addition to the four propolis solutions, two other propolis samples of far geographic regions (USA and Australia) were included in the study. The antibacterial effects of six solutions on oral pathogen microorganisms were tested and their cytotoxic effects on human gingival fibroblasts were evaluated by MTT assay. The effective dilutions of the six propolis samples on periodontopathogen microorganisms were found to be cytotoxic to gingival fibroblasts. All solutions had strong antifungal activity and the effective dilutions were safe for gingival fibroblasts. Propolis could have a promising role in the future medicine, if appropriate solutions can be prepared being strongly antibacterial and non-cytotoxic as well.
Background. The aetiological spectrum of acute renal failure (ARF) has changed in developed countries. It was the purpose of the study to evaluate whether similar changes have occurred in this part ...of the world as well. Methods. In a prospective study a total of 439 patients with ARF were evaluated. They had been admitted to one hospital during two successive periods, i.e. 1983–1990 and 1991–1997. Results. Of 439 patients with ARF, 116 were admitted in 1983–1990 (first period) and 323 in 1991–1997 (second period). The age of presentation increased from 49.8±6.2 years in the first period to 58.8±16.4 years in the second. Medical causes were present in 259 cases (59%), surgical causes in 110 cases (25%), and obstetric causes in 70 cases (16%). The frequency of surgical cases decreased from 28.4% in the first period to 23.8% in the second period. The respective figures for obstetric cases were 18.9% and 14.8%. Mortality did not change with time (33.6% in the first and 31.0% in the second period); the overall mortality was 31.7%. The mortality was higher for surgical (45.5%) than for obstetric (27.8%) and medical ARF (24.3%). Conclusion. In the mid-1970s, the most common causes of ARF in Turkey were obstetric complications and septic abortion. The aetiological spectrum of ARF has changed and today medical causes predominate. ARF resulting from septic abortion has become rare, possibly because of liberalization of abortion in 1983 in Turkey.
The In-Vitro interaction and synergistic activity of the combination of fluconazole with some nonsteroidal anti-inflammatory drugs (sodium salicylate, piroxicam, tenoxicam and diclofenac sodium) were ...investigated in Candida albicans strains (n=7) by the microdilution checkerboard assay. The results were evaluated visually and by a spectrophotometric microplate reader at 492 nm wavelength. Fractional inhibitory index was calculated for every strain and combination according to the minimal inhibitory concentration (MICs). The combination of fluconazole with sodium salicylate, tenoxicam and diclofenac sodium showed synergy against 5, 5 and 3 of the C. albicans strains, respectively. The effect of fluconazole with piroxicam was synergistic against one strain but indifferent/additive against the others. These data suggest that combinations of sodium salicylate, tenoxicam and diclofenac sodium with fluconazole may prove to be useful as chemotherapeutic agents for the treatment of C. albicans infections caused by especially fluconazole-resistant strains. However, additional preclinical work and in vivo studies are necessary to determine their definite clinical use.
Oral antibiotics are often prescribed, especially for respiratory tract infections in the community. The widespread use of broad-spectrum antibiotics causes an increased incidence of ...antibiotic-associated diarrhea (AAD). Although AAD has been studied in hospitalized patients, there is little available information concerning the characteristics of AAD in outpatient populations. The aim of this study was to investigate the clinical and laboratory findings of adult patients with communityacquired AAD. Between June 1998 and December 2003, the clinical reports of 288 patients were retrospectively reviewed. We observed that the duration between the start of antibiotic treatment and onset of symptoms was 7 days in most of the patients (86%), and the mean time was 9±1.0 days. The diarrhea was self-limited in all cases and mean duration of symptoms was 3 (± 1.0) days (1-7 days). The most common symptoms were abdominal discomfort and tenesmus (61.1%), while elevated WBC counts and fever were detected rarely. We were able to perform microbiologic investigations in only 88 patients because of the financial problems. Of the 88 stool specimens tested, none of them were positive for pathogenic bacterial growth or toxin A production.
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