Study purpose was to determine the epidemiology of nocardiosis in Turkey. Data on 25 cases and agents were collected from different centers, 1997-2001. Female/ male ratio was 7/18, and age range 16-72. Site of infection: Lungs (18), brain (5)) skin (3)) abdomen-peritoneum (2). Risk factors: Steroid-and chemo-therapy, organ TX, Diabetes mellitus, AIDS, cancer and surgery.Agents: il! mteroides (18)) N. farcinica (5), N . otidiscauiarum (l), and Nocardia sp. (1). In antibiograni of 20 strains 12 (60%) were susceptible to TMP-SMX. Eleven patients received TMP-SMX, and other antibiotics. Nine were cured, 7 died, 5 showed clinical improvement, and 4 could not be followed up. Particularly in immuno-compromised/suppressed cases nocardiosis also as secondary infection should be consideredin the clinic and in the laboratory.Symptoms of mycetism (ingestion of toxic macrofungi) vary from transient gastrointestinal pain to liver or kidney failure that may be fatal. Rapid identification of the ingested fungus would help to decide, for instance, whether the patient needs dialysis treatment or some less intensive therapy. However, because of the great number of species of macrofungi and the rarity of cases, identification requires high expertise which is usually not available in hospitals.Proper identification of macrofungal samples is essential but often ignored. High-quality in situ photographs of poisonous fungi are shown in this presentation to give a picture on the variety of species, their diagnostic features and problems of specimen handling and data collection in hospitals.Optimally, a specialist should interview the palient and other involved persons in a systematic way and examine a fresh, untouched specimen of thc fungus as soon as possible. Microscopy may be needed, as well. Based on experience in Finland, we recommend that in larger hospitals, someone in the staff (e.g. in the mycology laboratory) should be assigned as a permanent coordinator for suspected mycetism cases. This person should establish relations with field mycology specialists outside the hospital and prepare interview sheets and instructions. The identifier of a given fungus can then be decided case by case, depending on best locally available knowledge.
Conclusions:Identification of toxic macrofungi should be systematically organized by hospitals in cooperation with external specialists.
Aim:To develop a rapid and sensitive real time quantitative PCR method for identification and typing of niedically important Candida and Rrpergillus spp. from clinical samples.
Method:We made primers targeting the 18s rRNA gene and probes specific for the variations between different fungal species within that region. The probes were specific for C. albicaiu, C. glabrata, C. parapsilosis, C. tropicalis, C. krusei, C. lusitaniae and one for the genus of Candida (common Candida) and A.fiinigatus. Primers and probes were adapted to fit the Lightcycler system. First DNA were extracted from all samples (ATCC strains and clinical samples) using MagNAPure automated DNA pre...
