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Background and Purpose: Scedosporium apiospermum complex as a ubiquitous environmental mold is increasingly reported to cause an invasive fungal infection in immunosuppressive hosts. Herein, we present the case of an immunosuppressive 54-year-old man who developed S. apiospermum complex lung infection and pulmonary adenocarcinoma. Case report: The patient had some complaints of dyspnea and cough during a neutropenic episode. The computed tomography (CT) scan of the patient revealed pleural effusion. After culturing the pleural fluid sample, the fungus was identified by microscopic examination and ITS sequencing. In addition, antifungal susceptibility testing was performed using the M38-A2 microdilution method. The minimum inhibitory concentrations of amphotericin B, voriconazole, posaconazole, and caspofungin were obtained as > 64, 0.06, 0.06, and 0.03 μg/mL, respectively. Voriconazole (administered in two doses of 6 mg/kg and a maximum of 250 mg) was preferred for treatment. The patient received antifungal treatment for 2 months; however, he was lost to follow-up. Conclusion: Scedosporium apiospermum complex should be considered a cause of systemic fungal infections in neutropenic patients. Furthermore, the determination of the in vitro antifungal susceptibilities of clinical strains may contribute to the development of therapeutic approaches.

Background and aim Infections caused by Candida species are significantly increasing today, and invasive Candida infections are generally associated with high mortality. Early diagnosis and identification of Candida spp. is important for the determination of antifungal agents that will be used for treatment. The aim of the present study was to provide a better regimen for Candida infections in the future. Materials and methods TheSensititre YeastOne (SYO) method was compared with The Clinical Laboratory Standards Institute (CLSI) reference broth microdilution (BMD) testing method. Endpoints of minimal inhibitory concentrations (MICs) were determined for both methods. Results By using both methods, MIC values of micafungin, caspofungin, voriconazole, and fluconazole were lower than amphotericin B. The values obtained with the SYO method were in high categorical agreement for ecinocandins and amphotericin B. The results of voriconazole and fluconazole were in low categorical agreement. The categorical agreement between the SYO and the BMD results at 24 h was 82.1% for VORI and 98.4% for AMB. Values obtained with SYO method for all antifungal agents were in high essential agreement with the data of the CLSI reference BMD method. The essential agreement between the SYO and the BMD results at 24 h was 94.0% for MFG and 99.0% for AMB. Conclusions The SYO method was ready-to use, so it appeared to be easier and more efficient for Candida isolates.

Bu calismada hastanemizde izole edilen Candida turlerinin iki farkli yontemle antifungal duyarliliklarinin incelenmesi amaclanmistir. Hastanemizde cesitli departmanlardan gelen klinik orneklerden toplam 200 Candida turu izole edildi. Bu turler geleneksel yontem (germ tup olusturma, corn-meal tween 80 besiyerinde mikroskobik gorunum) ve ticari kit API 20C (Biomerieux, France) ile tanimlandi. Bu turlerin flukonazol (FLU), vorikonazol (VORI), amfoterisin B (AMB) antifungal minimum inhibisyon konsantrasyonu (MIK) degerleri Clinical and Laboratory Standards Institute sivi mikrodilusyon ve disk-difuzyon (DD) yontemine gore degerlendirildi. Izole edilen 200 Candida turu; 100 C. albicans, 25 C. glabrata, 7 C. krusei, 43 C. parapsilosis ve 25 C. tropicalis olarak tanimlandi. Butun Candida izolatlari VORI ‘ye karsi duyarli bulundu. Yuksek direnc (%22,5) orani referans mikrodilusyon yontemi ile AMB antifungaline karsi tespit edilidi. Iki yontem arasinda en iyi kategorik oran sirasi ile VORI (%99), FLU (%84,9) ve AMB (%72,5) olarak hesaplandi.Vorikonazol, flukonazole direncli izolatlarda bile in vitro olarak flukonazolden daha iyi aktivite gostermistir. Ek olarak disk difuzyon yontemi VORI icin alternatif antifungal duyarlilik yontemi olarak degerlendirilebilir.

Background/aim: Dermatophytes are the causative agents of dermatophytosis, which is a common disease worldwide that affects the hair, skin, and nails. Dermatophytes comprise more than 40 species in 3 genera: Microsporum, Trichophyton, and Epidermaphyton. In this study, we aimed to determine the effectiveness of seven antifungal agents: amphotericin B, terbinafine, itraconazole, voriconazole, ketoconazole, miconazole, and fluconazole. Materials and methods: A sensitivity study was performed using a microdilution method in accordance with the CLSI M38-A2 standards using isolates of Trichophyton rubrum (n = 55), Microsporum canis (n = 9), and Trichophyton interdigitale (n = 2), which were identified by sequencing the internal transcribed spacer region of the rDNA. Results: According to the results of antifungal sensitivity tests, the geometric mean (GM) minimum inhibitory concentration (MIC) against T. rubrum was 0.10 μg/mL for ketoconazole, 0.20 μg/mL for itraconazole, 0.07 μg/mL for miconazole, 0.48 μg/mL for fluconazole, 2.27 μg/mL for amphotericin B, 0.06 μg/mL for voriconazole, and 0.06 μg/mL for terbinafine. Conclusion: The most effective antifungal drugs were voriconazole and terbinafine, both of which had a GM MIC of 0.06 μg/mL.