Objectives Aspergillus fumigatus causes several diseases in humans and azole resistance in A. fumigatus strains is an important issue. The aim of this multicentre epidemiological study was to investigate the prevalence of azole resistance in clinical and environmental A. fumigatus isolates in Turkey. Methods Twenty-one centres participated in this study from 1 May 2018 to 1 October 2019. One participant from each centre was asked to collect environmental and clinical A. fumigatus isolates. Azole resistance was screened for using EUCAST agar screening methodology (EUCAST E.DEF 10.1) and was confirmed by the EUCAST E.DEF 9.3 reference microdilution method. Isolates with a phenotypic resistance pattern were sequenced for the cyp51A gene and microsatellite genotyping was used to determine the genetic relationships between the resistant strains. Results In total, resistance was found in 1.3% of the strains that were isolated from environmental samples and 3.3% of the strains that were isolated from clinical samples. Mutations in the cyp51A gene were detected in 9 (47.4%) of the 19 azole-resistant isolates, all of which were found to be TR34/L98H mutations. Microsatellite genotyping clearly differentiated the strains with the TR34/L98H mutation in the cyp51A gene from the strains with no mutation in this gene. Conclusions The rate of observed azole resistance of A. fumigatus isolates was low in this study, but the fact that more than half of the examined strains had the wild-type cyp51A gene supports the idea that other mechanisms of resistance are gradually increasing.

Candida species are among the top 10 pathogens causing bloodstream infections associated with high morbidity, mortality. In spite of the development of new antifungal drugs, epidemiological studies have shown that resistance to antifungal drugs among Candida isolates is becoming a serious problem. The aim of this study was to compare the antifungal broth microdilution methods of the Clinical and Laboratory Standards Institute (CLSI) and European Committee on Antimicrobial Susceptibility Testing (EUCAST) for amphotericin B, fluconazole, itraconazole, voriconazole, posaconazole and anidulafungin susceptibility of Candida blood isolates. The study consisted of 74 Candida albicans, 67 Candida parapsilosis, 30 Candida glabrata, and 18 Candida tropicalis isolates. The minimum inhibitory concentrations were determined after 24 and 48 hour of incubation with CLSI method and only 24 hour of incubation with EUCAST method except anidulofungin. The MIC values obtained by both methods were considered to be compatible within ± 2 dilution limits. The categorical agreement between methods for each antifungal agent was assessed using clinical break points and epidemiological cut-off values. The agreement (± 2 dilution) between the methods was found to be species, drug, and incubation time dependent. After 24 hour incubation, good agreement category (> 90%) was detected between amphotericin B, itraconazole, posaconazole and anidulofungin, but was lower category (< 85%) was determined with fluconazole and voriconazole especially for relatively slow growing C.glabrata and C.parapsilosis isolates. Excellent categorical agreement (100%) was observed for amfoterisin B/C.parapsilosis, C.glabrata, C.tropicalis and anidulofungin/C.albicans, C.glabrata, C.tropicalis but least category was determined for posaconazole and C.albicans (71.6% at 24 hour; 73% at 48 hour). In vitro resistance of therapeutically used fluconazole and anidulafungin determined by both methods was rare among C.albicans (1.3%, 2.7% respectively), C.glabrata (0%, 3.3% respectively) and C.tropicalis (0%, 5.6% respectively) isolates but, an increase of non-susceptible isolates were observed among C.parapsilosis (11.9% at 24 hour of incubation; 17.9% at 48 hour of incubation) for fluconazole. There was also a cross resistance between fluconazole and voriconazole for three C.parapsilosis isolates and one multidrug resistant (fluconazole, itraconazole, posaconazole and anidulofungin) C.albicans isolate (fluconazole, itraconazole, posaconazole and anidulofungin). As a result in this study, it was determined thatboth methods were similar and can be used according to preference of laboratories. The CLSI antifungal susceptibility test results can be assessed at the end of 24 hour incubation, but sometimes it is important that the evaluation should be performed as a result of 48 hour incubation in slow growing species such as C.glabrata.

tarihleri arasında Uludağ Üniversitesi Tıp Fakültesi Sağlık Uygulama ve Araştırma Merkezi Parazitoloji Laboratuvarı'na gastroenterit klinik bulgularıyla gönderilen olguların dışkı örneklerinde nativ-lugol ve amip antijeni saptama yöntemleri ile alınan sonuçların retrospektif olarak karşılaştırılarak performanslarının değerlendirilmesi amaçlanmıştır. Yöntemler: Çeşitli poliklinik ve servislerden, Parazitoloji Laboratuvarı'na gönderilen 116 hastaya ait dışkı örnekleri incelenmiştir. Tüm dışkı örneklerinde nativ-lugol yöntemi ve (enzyme-linked immunosorbent assay) ELISA kiti (Wampole ® E. histolytica II Techlab ® Inc., Blacksburg, Virginia) ile E. histolytica spesifik antijen araştırılması yapılmıştır. Bulgular: Direkt mikroskobik (nativ-lugol) inceleme ile 116 dışkı örneğinin 1'inde (%0,86) E. histolytica/E. dispar kist ve/veya trofozoitleri görülmüştür. E. histolytica/E. dispar kist ve/veya trofozoitleri görülen örnekte ELISA testi ile pozitif sonuç verdiği gözlenmiştir. Çalışmada E. histolytica spesifik antijeni saptanan 34 (%29,3) olguya uygun tedavi başlanmıştır. En yüksek E. histolytica spesifik antijeni pozitiflik oranının 11-19 yaş grubunda olduğu belirlenmiştir. Sonuç: Direkt mikroskopinin duyarlılığının düşük olması nedeniyle, amibiyaz şüphesi olan hastalarda yanlış tanı ve bunun sonucunda gereksiz tedavi almalarının önlenmesi açısından ucuz ve deneyimli personel gerektirmeyen ELISA yönteminin kullanılmasının uygun olacağı düşünülmüştür. (Turkiye Parazitol Derg 2015; 39: 185-9) Anahtar Kelimeler: Entamoeba histolytica, gastroenterit, Bursa