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.
Since December 2019, after the declaration of new cases regarding novel coronavirus disease, many variants have emerged as a consequence of the viral evolution. Though the SARS-CoV-2 variants have been studied for molecular basis, the clinical and pathologic disparities of them have been understood inadequately. The aim of this research was to figure out the differences between the SARS-CoV-2 Alpha (B1.1.7) variant and the classical Wuhan groups on the clinical basis and laboratory results of the COVID-19 patients who had positive PCR test.The study was done retrospectively inclusive of epidemiological, laboratory data and clinical symptoms of patients who were admitted to the emergency service between February 15 and March 15, 2021 and had positive COVID-19 PCR test results. Though there was no statistically significant difference in symptoms between SARS-CoV-2 Alpha variant and classical variant (Wuhan type) groups; C-reactive protein (CRP), lymphocyte and leukocyte counts were statistically significantly higher in the Wuhan type group; prothrombin time (PT), International Normalized Ratio (INR) and serum creatinine values were statistically significantly higher in the Alpha group. Studies such as ours that investigate both the clinical features and laboratory data of SARS-CoV-2 variants will close the knowledge gaps, so better decisions may be made by health policy makers. Additional studies in this area will increase the understanding of the topic.
Mycobacterium tuberculosis tanısında Ehrlich-Ziehl Neelsen (EZN) gibi aside dirençli boyama yöntemleri hızlı ve uygulaması kolay yöntemler olmasına rağmen kesin sonuç vermemektedir. Kültür yöntemleri altın standart olarak kabul edilmesine rağmen zaman alıcı yöntemlerdir. Nükleik asit amplifikasyon testleri ise sonuç verme süreleri kısa olduğu için tüberkülozun hızlı tanısında çok sık olarak kullanılmaktadır. Bu çalışmada, tüberküloz şüpheli klinik örneklerde GeneXpert MTB/RIF yöntemi ve artus® MTB-PCR yönteminin değerlendirilmesi amaçlanmıştır. Erciyes Üniversitesi Tıp Fakültesi, Tıbbi Mikrobiyoloji Anabilim Dalı Mikobakteriyoloji Laboratuvarına Ocak-Aralık 2013 tarihleri arasında gönderilen 432 klinik örnek EZN yöntemiyle boyanmıştır. Örnekler homojenize ve dekontamine edildikten sonra, BACTEC MGIT 960 kültür şişeleri ile eş zamanlı olarak Löwenstein-Jensen besiyerlerine ekim yapılmıştır. Nükleik asit amplifikasyon testi olarak örneklerin 196’sında GeneXpert MTB/RIF yöntemi, 236’sında da artus® MTB-PCR yöntemi kullanılmıştır. Toplam 432 klinik örneğin 8’i (%1.9) EZN yöntemi ile, 20’si (%4.6) kültür yöntemleri ile pozitif olarak bulunmuştur. Kültür yönteminin altın standart kabul edildiği bu çalışmada, EZN boyama, artus® MTB-PCR ve GeneXpert MTB/RIF yöntemlerinin duyarlılığı sırasıyla %35, %42.9 ve %83.3; özgüllüğü sırasıyla %99.7 %99.1 ve %97.9 olarak saptanmıştır. Bu çalışmada GeneXpert MTB/RIF ile artus® MTB-PCR yöntemleri tüberküloz tanısında benzer özgüllüğe sahiptir. Fakat GeneXpert MTB/RIF yönteminin yüksek duyarlılığı ve hızlı sonuç vermesi dikkat çekmektedir. Bu iki yöntemin eş zamanlı olarak karşılaştırılmasının, herhangi bir analitik tutarsızlığı kontrol etmeyi mümkün kılacağını değerlendirmekteyiz.
Objective The havoc caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic could not have been predicted, with children being affected worldwide. Testing for SARS-CoV-2 infection helped to define the interventions against the spread of the disease. A polymerase chain reaction (PCR) test has been the mainstay of diagnostic testing. Cycle threshold (Ct) is a semiquantitative value that indicates approximately how much viral genetic material was in the sample. The aim of this study was to evaluate the impact of Ct values among children with SARS-CoV-2 infection.
Methods Between May 3, 2020 and August 3, 2020, clinical laboratory input and the data of patients with positive SARS-CoV-2 PCR tests were retrospectively studied.
Results There was no statistical significance between Ct values and the patient's status, symptoms other than fever, or other laboratory findings. However, the Ct value of patients who had symptoms at the time of admission to the hospital was significantly lower.
Conclusion In this study, symptomatic patients had lower Ct than asymptomatic patients that reflected higher viral loads. In evidence-based medicine applications, it might be useful to correlate the clinical history with laboratory test results. Even symptomatic patients with high Ct value coinfections, or an alternative acute infection, should be considered.
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