Otomycosis usually requires long-term treatment and tends to recur. This study was performed on 87 patients with the clinical diagnosis of otomycosis and 20 controls in order to determine the pathogenic agents, predisposing factors and a cost-effective treatment. The predisposing factors included wearing head clothes (74.7 per cent), presence of dermatomycoses (34.5 per cent) and swimming (27.6 per cent). The most common pathogenic fungus was Aspergillus niger (44.8 per cent) in the otomycosis group. The only isolate was Candida albicans in the control group (2.5 per cent). We concluded that administration of four per cent boric acid solution in alcohol and frequent suction cleaning of the ear canal might be a cost-effective treatment for otomycosis since 77 per cent of the patients were treated effectively this way. Eighty per cent of the resistant cases had mixed fungal-bacterial infections, and 50 per cent of them had dermatomycoses. These resistant cases were treated by administration of tioconazole ointment.

No abstract

The minimum inhibitory concentrations (MIC, microg ml-1) of itraconazole and terbinafine against overall 34 Aspergillus isolates from the external ear canals with otomycosis have been determined with M38-P microdilution method suggested by National Committee for Clinical Laboratory Standards (NCCLS). MIC intervals in 48 h determined by taking MIC-2 value of itraconazole (the lowest drug concentration causing 50% inhibition of visible fungal growth) and MIC-0 value of terbinafine (the lowest drug concentration causing 100% inhibition of visible fungal growth) as a basis have been found as follows: 0.125-1 and 0.06-0.5 microg ml-1 for A. niger (22 strains), 0.06-0.25 and 0.06-0.125 microg ml-1 for A. flavus (10 strains), 0.125 and 0.125-0.5 microg ml-1 for A. terreus (two strains). It has been observed that both of the antifungal agents showed an in vitro activity against all Aspergillus species tested.

Despite the fact that a range of molecular methods have been developed as tools for the diagnosis of Malassezia species, there are several drawbacks associated with them, such as inefficiency of differentiating all the species, high cost, and questionable reproducibility. In addition, most of the molecular methods require cultivation to enhance sensitivity. Therefore, alternative methods eliminating cultivation and capable of identifying species with high accuracy and reliability are needed. Herein, a multiplex polymerase chain reaction (PCR)-based method was especially developed for the detection of eleven Malassezia species. The multiplex PCR was standardized by incorporating a consensus forward primer, along with Malassezia species-specific reverse primers considering the sizes of the PCR products. In the method, the multiplex-PCR primer content is divided into three parts to circumvent the problem of increased nonspecific background resulting from the use of a large number of primers. DNA extraction protocol described by Harju and colleagues was modified using liquid nitrogen instead of -80 °C to break down the yeast membrane. By a modified extraction procedure followed by multiplex PCR and electrophoresis, the method enables identification and differentiation of Malassezia species from both of the samples obtained directly from skin and yeast colonies grown in culture. Fifty-five patients who were confirmed with pityriasis versicolor were enrolled in the study. Multiplex PCR detected and differentiated all 55 samples obtained directly from the patients' skin. However, 50 out of 55 samples yielded Malassezia colony in the culture. In addition, eight of 50 colonies were misdiagnosed or not completely differentiated by conventional methods based on the sequence analysis of eight colonies. The method is capable of identifying species with high accuracy and reliability. In addition, it is simple, quick, and cost-effective. More importantly, the method works efficiently for the diagnosis of Malassezia species obtained directly from patient samples.

A woman with a skin infection because of Scedosporium apiospermum, in the interdigital spaces of her feet is presented. The minimum inhibition concentration values (MIC, microg ml(-1)) of this isolated mould for itraconazole, amphotericin B and terbinafine after 48 h were determined as 1, 8 and 16, respectively. The patient was treated successfully with oral terbinafine and topical clotrimazole.

The data show that frequent testing for resistance to erythromycin of group A beta-haemolytic streptococci is required for the use of this antibiotic in our country.

Backround: Candida species take the fourth place among the microorganisms which cause hospital infections. New therapeutic agents are needed because of rapidly increasing resistance rates. Boric acid preparations are preferred in local treatment especially in resistant cases while azole formulations are the first choice in oral treatment. The only boric acid analog that was approved by FDA (Food and Drug Administration) for systemic use is Bortezomib (Velcade). Bortezomib is a proteasome inhibitor and proteasome inhibitors cause apoptosis of eukaryotic cells. Although the yeast also has a well preserved 20S proteasome region, the studies on the effects of proteasome inhibitors on the yeast are limited. In this study, the effects of the one of the most potent proteasome inhibitor, MG-262, on Candida spp. were investigated.Methods: C. albicans ATCC 90028, C. krusei ATCC 6258 and C. glabrata (clinical strain) strains were used in our study. Antifungal susceptibilities of the strains against MG-262 and effects of MG-262 on oxidative metabolism, proteasome activity and apoptosis as well as virulence factors such as hyphal transformation, pseudohypha, germ tube and biofilm formation were investigated. CLSI (Clinical and Laboratory Standards Institute) guidelines were used for antifungal susceptibility tests. The effect on hypha and pseudohypha formation and germ tube were determined with conventional tests. Biofilm formation was detected according to the microplate method. Oxidative metabolism experiments, proteosome activity and apoptosis tests were performed with Alamarblue dye, fluorogenic peptides and DNA ladder assays, respectively.Findings: MG-262 exhibited minimum inhibitory activity at 25 µg/ml concentration for C. albicans ATCC 90028 and at 50 µg/ml concentration for C. krusei ATCC 6258 and C. glabrata. Minimum fungicidal concentrations for all species were 50 µg/ml. Hypha, pseudohypha, germ tube and biofilm formation, proteosome activity and oxidative metabolism were all inhibited at 50 µg/ml and higher concentrations. The apoptosis was detected at 200 µg/ml. Conclusion:MG-262 caused apoptosis by inhibiting oxidative metabolism and showed fungicidal activity. It also inhibited the virulence factors such as hypha, pseudohypha germ tube and biofilm formation. Inhibition of proteasome is promising in terms of discovery of a new generation antifungal agent.

ÖZET Kontaminasyon KaynaklarıUzun yıllar, mikoplazma ile, kirlenmiş olan sığır serumlarının kullanılması hücre kültürlerinin en önemli kontaminasyon kaynağı olmuştur. Bugün fir-