Ayse Nedret Koc

Erciyes Üniversitesi, Caesarea, Kayseri, Turkey

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Publications (25)44.22 Total impact

  • F Filiz Tekinşen, A Nedret Koç
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    ABSTRACT: Pneumocystis jirovecii causes pneumonia in premature, newborn or malnourished children, as well as in immunocompromised subjects such as chemotherapy receiving, transplant and AIDS patients. Since the mortality and morbidity rates of Pneumocystis pneumonia (PCP) in these patients were high, rapid and accurate diagnosis is important. The aim of this study was to evaluate the diagnostic value of Giemsa staining (GS), direct fluorescent antibody (DFA) assay, (1→3)-β-D-Glucan (BDG) test and real-time polymerase chain reaction (PCR) for the detection of P.jirovecii in clinical specimens. A total of 100 PCP-suspected patients with underlying diseases who were followed-up in outpatient and inpatient clinics of our hospital between December 2008-July 2010 were included in the study. All the patients (66 male, 34 female; mean age: 42.04 years) were under long-term immunosuppressive drug therapy due to their hematological malignancies, kidney transplantation, neutropenia or chronic diseases. Respiratory samples [86 bronchoalveolar lavage (BAL), 8 endotracheal aspirate, 1 nasotracheal aspirate, 3 pleural, 2 lung biopsy samples] obtained from the patients have been studied with GS (Merck, Germany), DFA (Pneumo Cel, Cellabs, Australia) and PCR (primers targeting MSG gene, LightCycler, Roche, USA), while serum samples (n= 100) with BDG (Fungitell, ACC Inc, USA) and PCR methods. In BAL samples two were found positive by GS, DFA and PCR, and six were positive only by PCR, yielding a total positivity in 8 (8%) samples. All of the sera were negative with PCR, however 29 of them were positive (> 80 pg/ml), five were equivocal (61-79 pg/ml) and 66 were negative (< 60 pg/ml) with BDG test. Eight patients with positive results in BAL-PCR were also positive with BDG test. Although the agreement between GS and DFA was high (κ= 1), it was observed as low between PCR and DFA (κ= 0.38), DFA and BDG (κ= 0.07), BAL-PCR and BDG (κ= 0.28). DFA taken as the gold standard, the sensitivity and specificity values of GS, PCR and BDG methods were calculated as 100% and 100%; 100% and 93%; 100% and 67%, respectively. In the ROC analysis performed for BDG test, with DFA and BAL-PCR taken as the gold standards, the sensitivity, specificity and cut-off values of BDG were estimated as 100%, 93.9% and 494 pg/ml, and 100%, 72.8% and 62 pg/ml, respectively. Our data indicated that, overall specificity was high (100%) when using GS and DFA tests together, while the sensitivity has been elevated to 93% with the additional use of PCR and BDG tests, in the diagnosis of PCP-suspected patients. In conclusion, combination of all these tests should be performed for the laboratory diagnosis of P.jirovecii.
    Mikrobiyoloji bülteni 10/2013; 47(4):658-67. · 0.61 Impact Factor
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    ABSTRACT: Blastoschizomyces capitatus is a rare fungal pathogen that may lead to severe and fatal systemic infections especially in immunosuppressive individuals. B.capitatus strains have also been reported as the cause of hospital-acquired infections and outbreaks. In this report, three fungemia cases caused by B.capitatus with hematologic malignancies have been presented. The first case was a 20-year-old female with acute lymphoblastic leukemia, the second was a 26-year-old female with B-cell malignant lymphoma and the third was a 7-year-old male with B-cell acute lymphoblastic leukemia. All of the patients have been receiving chemotherapy, and treated with antibacterial and antifungal agents due to neutropenia. The blood cultures obtained from the second and third patients yielded B.capitatus although they were under empirical caspofungin therapy. Those patients have been treated with voriconazole and amphotericin B after the identification of B.capitatus, and clinical improvement were noted during their follow-up. However the first patient who was also under caspofungin therapy had died just before the isolation of B.capitatus from her blood culture. Conventional mycological methods [macroscopic and microscopic morphology, germ tube test, urea hydrolysis, carbohydrate assimilation tests (API 20C AUX; BioMerieux, France), growth temperature, cycloheximide sensitivity] were used for the identification of the isolates. The strains were identified as B.capitatus with the characteristics of annelloconidia formation, urease negativity, carbohydrate utilization, growth at 45°C and resistance to cycloheximide. Antifungal susceptibilities of isolates were determined by using microdilution method (for amphotericin B, fluconazole, itraconazole, voriconazole, ketoconazole) and E-test (for caspofungin). Minimum inhibitory concentration (MIC) values of the three B.capitatus strains were detected as 0.25, 0.125, 0.032 µg/ml for amphotericin B; 2, 2, 16 µg/ml for fluconazole; 0.064, 0.032, 0.032 µg/ml for itraconazole and 0.125, 0.064, 0.064 µg/ml for ketoconazole, respectively, while MIC values of all strains were 0.032 µg/ml for voriconazole and > 32 µg/ml for caspofungin. Since B.capitatus strains were isolated from the cases within about 15 days -sequentially-, the genotypes of the isolates were determined by repetitive sequence-based PCR (DiversiLab System; BioMerieux, France) to investigate the similarity rates. The results of analysis indicated 97% similarity between two (case 1 and 2) strains and 94.9% similarity in one strain (case 3) of B.capitatus, however the transmission route could not be clarified due to the absence of environmental sampling. In conclusion, B.capitatus should also be considered as a cause of systemic fungal infections in immunocompromised patients. Determination of the in vitro antifungal susceptibilities of clinical B.capitatus strains may contribute to the therapeutic approaches and epidemiological data.
    Mikrobiyoloji bülteni 10/2013; 47(4):734-41. · 0.61 Impact Factor
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    ABSTRACT: Background: To investigate the relationship between depression, nutritional status, and inflammatory markers in patients on peritoneal dialysis (PD). Patients and Methods: This prospective study included 40 PD patients and 20 healthy people. The severity of depressive symptoms was assessed using the Beck Depression Inventory, the Hamilton Depression Rating Scale, and the Hamilton Anxiety Rating Scale. The depressive patients received antidepressant drug for 8 weeks. Blood samples were taken before and after antidepressant treatment for the high-sensitive C-reactive protein (hs-CRP), interleukin (IL)-1, IL-6, and tumor necrosis factor-α (TNF-α) levels. Results: Ten (25%) of the 40 PD patients had depression. No significant difference was determined between depressive patients and nondepressive patients. The mean erythrocyte sedimentation rate was higher in depressive patients. There was no significant difference for other inflammation parameters, including hs-CRP, TNF-α, IL-1, and IL-6, between depressive patients and nondepressive patients. In the depressive patients, we did not observe any significant change in nutritional parameters after antidepressant treatment. When we evaluated inflammation parameters of the depressive patients before and after antidepressant treatment, only IL-1 and IL-6 levels were significantly increased after antidepressant treatment. Conclusion: The depressive disorder in PD patients is a common psychopathology and has no significant effects on nutritional status and inflammation.
    Renal Failure 11/2012; · 0.94 Impact Factor
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    ABSTRACT: Abstract The aim of this study was to assess the prevalence of denture-related stomatitis (DRS) in different attachment-retained overdenture wearers and its association with particular colonizing Candida species. Thirty-seven edentulous patients with implant-supported maxillary or mandibular overdentures were enrolled. A full clinical history was obtained, including details of their oral hygiene practices and the levels of erythema based on Newton's classification scale. Swabs were taken from the palate and investigated mycologically to identify the yeast colonies. Quantitative and qualitative microbiological assessments were performed, recording the total numbers of colonies (cfu), their color, and their morphological characteristics. Significant differences were found in cfu values from the attachment and inner surfaces of locator- and bar-retained overdentures (P < 0.05). Candida albicans was the most common species in both evaluations, being isolated from 81.3% of bar-retained overdentures and 38.1% of locator-retained overdentures. DRS developed in all patients using bar-retained overdentures, but in only 71.4% of those using locator-retained overdentures. No statistically significant relationship was found between bar and locator attachments according to smoking habit, overnight removal, or plaque and gingival indices (P > 0.05).
    Journal of Oral Implantology 09/2012; · 1.15 Impact Factor
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    ABSTRACT: Objective  In this study, we aimed to determine the prevalence of agents that cause superficial mycoses and clinical types of superficial mycoses in terms of age and gender in our region were aimed. Methods  Five hundred samples of nails, skin and skin with hair taken from 476 children and adult patients pre-diagnosed with superficial mycoses were examined by direct microscopy and cultural methods between October 2009 and October 2010. Results  Fungal elements were determined in 212 (42.4%) of the samples by using direct microscopy. Fungal growth was detected in 111 (22.2%) cultures of the same samples. It was found that the most common agents in superficial mycoses were Trichophyton rubrum (43.7%), Candida spp. (28%) and less often, Aspergillus spp., Malassezia spp., Saccharomyces spp., Rhodotorula spp., Trichosporon spp. and Trichophyton verrucosum. Conclusion  The significance of diagnosis by using direct microscopy and culturing together was again shown for the diagnosis of superficial fungal infections that follow a chronic course and affect the quality of life of patients. The most common agents in the superficial mycoses were T. rubrum. With this study, defining the aetiological agents of superficial mycoses in the Kayseri region is expected to contribute to the literature in terms of epidemiological data.
    Journal of the European Academy of Dermatology and Venereology 06/2012; · 2.69 Impact Factor
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    ABSTRACT: The aim of this study is to determine the clinical contribution of (1→3)-β-d-glucan (BDG) screening in the case of patients undergoing autologous haematopoietic stem-cell transplantation (HSCT). The records at our stem-cell transplantation centre were reviewed to identify the patients who underwent autologous HSCT between April 2009 and December 2010. Patients were classified as having proven invasive aspergillosis (IA), probable IA, or possible IA on the basis of the criteria established by the European Organization for Research and Treatment of Cancer and Mycoses Study Group (independent of the BDG results). During the study period, the patients were screened for BDG twice a week from transplant (day 0) until engraftment. Three patients were diagnosed with probable IA and five were diagnosed with possible IA. A total of 354 serum samples from79 patients who met the study inclusion criteria were used for statistical analysis. At the cut-off value of 80 pg ml(-1) , the sensitivity was 27.2% [95% confidence interval (CI); 7.3-60.6]; specificity, 94.4% (95% CI; 91.3-96.5); positive predictive value, 6.2%; and negative predictive, 93.7%. The clinical contribution of the BDG assay as a screening test was relatively limited in this cohort of patients undergoing autologous HSCT.
    Mycoses 04/2012; · 1.28 Impact Factor
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    ABSTRACT: To evaluate the presence of the relationship between depression and proinflammatory cytokine levels in hemodialysis (HD) patients. The study included 40 HD patients and 20 healthy controls. All participants were evaluated for the presence of depression using the structured clinical interview based on criteria defined by Diagnostic and statistical manual mental disorders (Fourth Edition, Text Revision) Axis I disorders. The severity of depressive symptoms was assessed using the Beck Depression Inventory, the Hamilton Depression Rating Scale, and the Hamilton Anxiety Rating Scale. The depressive patients received antidepressants for 8 weeks. Blood samples were taken at baseline and after 8 weeks of antidepressant treatment for interleukin-1 (IL-1), IL-6, and tumor necrosis factor-α (TNF-α) levels. A total of 9 (22.5%) of the 40 HD patients had depression. IL-1, IL-6, and TNF-α levels were significantly higher in HD patients compared with that in the control group, but were not significantly different between HD patients with and without depression. In the depressive patients, we observed no significant difference in proinflammatory cytokine levels after antidepressant treatment. The psychometric measurements in depressive patients decreased significantly after antidepressant treatment. We observed that depression is a common psychiatric disorder and has no significant effect on proinflammatory cytokine levels in HD patients; no important improvement in cytokine levels was observed after antidepressant therapy.
    Renal Failure 01/2012; 34(3):275-8. · 0.94 Impact Factor
  • Gokhan Metan, Ilkay Bozkurt, Ayse Nedret Koc
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    ABSTRACT: Respiratory infections are of particular concern in transplant patients. However, there is a significant overlap in the symptoms caused by different pathogens. Here, we report a case of Pneumocystis jiroveci pneumonia (PCP) in a renal transplant patient which was initially misdiagnosed as pandemic influenza H1N1. The patient did not improve under oseltamivir treatment and bronchoscopy was performed five days later after hospitalization. PCP was diagnosed by microscoping evaluation of bronchoalveolar lavage (BAL) fluid. Besides, BAL and serum of the patient yielded a large amount of 1,3-beta-D-glucan, a cellwall compotent of medically important mycoses including P. jiroveci. The patient was successfully treated with intravenous trimethoprim-sulfamethoxazole. Due to the lack of sensitivity of influenza case definitions, the attending physicians should be careful about alternative diagnoses particularly in transplant patients with severe respiratory infections.
    Le infezioni in medicina: rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive 09/2011; 19(3):182-4.
  • Aslihan Cokuk, Ayse Nedret Koc, Altay Atalay
    Current Opinion in Biotechnology - CURR OPIN BIOTECHNOL. 01/2011; 22.
  • Mycoses 03/2010; 54(4):363-4. · 1.28 Impact Factor
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    G Metan, C Ağkuş, H Buldu, A N Koç
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    ABSTRACT: The aim of this study was to investigate the interaction between intravenous piperacillin/tazobactam treatment and Aspergillus galactomannan antigen (GM) and 1,3-beta-D: -glucan (BDG) test results in patients without known risk factors for invasive fungal infections (IFI). Patients without known risk factors for IFI and who were to receive piperacillin/tazobactam monotherapy were considered eligible for the study. Serum samples were obtained both before and after antibiotic infusion on the first, third, seventh and tenth days of a piperacillin/tazobactam treatment course and 4 days after the last dose. GM was determined by Platelia Aspergillus ELISA (Bio-Rad Laboratories) and BDG was assayed using the Fungitell kit (Associates of Cape Cod, East Falmouth, MA) according to manufacturers' specifications. A total of 135 serum samples were collected from 15 patients. When a cut-off level of >or=0.7 was used for GM positivity, there were no false positive results. When a cut-off level of >or=0.5 was used, six serum samples were positive. There were no statistically significant differences between the median GM indices or median BDG levels of the various sampling times. However, 24 of 135 serum samples were positive for BDG for a threshold of 80 pg/mL. After ruling out fungal infections and all known potential causes of false BDG positivity, environmental contamination remained a possible cause of BDG reactivity. No significant interaction was observed between piperacillin/tazobactam administration and Aspergillus GM and BDG assays. Positive results for these tests should be evaluated cautiously in patients at high risk for IFI receiving piperacillin/tazobactam.
    Infection 03/2010; 38(3):217-21. · 2.44 Impact Factor
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    The Veterinary record 08/2009; 165(2):57-8. · 1.80 Impact Factor
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    Peritoneal dialysis international: journal of the International Society for Peritoneal Dialysis 01/2009; 29(5):581-2. · 2.21 Impact Factor
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    ABSTRACT: To investigate blood flow velocities in the ophthalmic and central retinal arteries (CRAs) in patients with diabetic retinopathy before and after atorvastatin treatment. 45 patients with type 2 diabetes were included in this double-blind, placebo-controlled study. The patients with diabetes were divided into three subgroups: group 1 (n = 15) included patients with non-proliferative diabetic retinopathy (NPDR); group 2 (n = 15) had patients with proliferative diabetic retinopathy (PDR); and group 3 (n = 15; placebo group) included 8 patients with NPDR and 7 patients with PDR. The patients in groups 1 and 2 (atorvastatin group) received 10 mg atorvastatin daily for 10 weeks. Pre-treatment and post-treatment serum levels of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and triglyceride were recorded before and after treatment. Ocular blood flow velocities of the ophthalmic artery and CRA were evaluated by colour Doppler imaging before and after treatment in each group. The baseline haemodynamic parameters were similar between atorvastatin and placebo groups (p>0.05 for both). Atorvastatin significantly decreased serum levels of total cholesterol, low-density lipoprotein cholesterol and triglycerides in groups 1 and 2 compared with pretreatment levels (p<0.001 for both). The mean peak systolic flow velocities (PSVs) of the ophthalmic artery in group 2, and the mean PSV and resistive indices of the CRA in groups 1 and 2 decreased significantly after atorvastatin treatment (p<0.05 for both), whereas the mean end diastolic flow velocity of the ophthalmic artery and CRA did not change (p>0.05). There was no significant difference in ocular blood flow velocities in the placebo group (p>0.05). Atorvastatin may have a role in reducing diabetic retinal complications, with improvement in vascular resistance and decrease in the mean PSVs of the ophthalmic artery and CRA. However, further studies with large numbers of patients are needed to obtain the long-term results of this drug.
    British Journal of Ophthalmology 02/2007; 91(1):69-73. · 2.73 Impact Factor
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    Ayse Nedret Koc, silicis@erciyes.edu.tr, Fatma Mutlu-Sariguzel, Osman Sagdic
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    ABSTRACT: Fruit juices and soft drinks are targets for spoilage yeasts, moulds and bacteria. The aim of this study is to examine the antifungal effect of ethanolic extract of Turkish propolis (EETP) treatments in four nonpasteurized fruit juices including apple, orange, white grape and mandarin against 6 different yeasts isolated from the corresponding spoiled juices. These isolated yeasts include: Candida famata, C. glabrata, C. kefyr, C. pelliculosa, C. parapsilosis and Pichia ohmeri. Minimum Inhibitory Concentration (MIC) ranges were determined responding to the National Committee for Clinical Laboratory Standards (NCCLS) M27-A that were slightly modified with broth microdilution method. In this study, the presence of propolis in apple (pH=3.9), orange (pH=3.7), white grape (pH=3.8) and mandarin (pH=3.4) juices ranging from 0.01 to 0.375 mg/mL inhibited the growth of all spoilage yeasts at 25 °C. MIC ranges of propolis were 0.02–0.375, 0.04–0.375, 0.01–0.185, 0.02–0.185 and 0.04–0.375 mg/mL in mandarin, apple, orange, white grape juices and RPMI medium, respectively. MIC ranges of Na benzoate, which was used as positive control, were 80–320, 80–320, 40–640, 40–80 and 320–1280 μg/mL in mandarin, apple, orange, white grape and RPMI medium as blank control, respectively. In terms of MIC ranges, propolis showed greater antifungal activity than Na benzoate. As a result, propolis had significant antimicrobial activity against the yeast isolates from spoiled fruit juices. It was concluded that propolis is worthy to study further as a natural preservative for foods prone to fungal spoilage.
    Food Technology and Biotechnology (imacan@pbf.hr); Vol.45 No.1. 01/2007;
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    ABSTRACT: Thein vitro susceptibilities of propolis and antifungal drugs were determined against some yeasts isolated from patients with superficial mycoses. The agents tested included fluconazole, itraconazole, ketoconazole, terbinafine and propolis. MICs were determined by the broth microdilution technique following National Committee for Clinical Laboratory Standards document M27-P. For allCandida albicans isolates from the patients with superficial mycoses, ketoconazole presented higher (P
    Annals of Microbiology 01/2007; 57(2):269-272. · 1.55 Impact Factor
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    S Silici, A N Koc
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    ABSTRACT: To test a total of 15 strains belonging to four species of yeasts by different in vitro methods against propolis and itraconazole (ITC). Three methods were compared for susceptibility testing of yeast isolates to propolis: disc diffusion method, agar dilution method and National Committee for Clinical Laboratory Standards (NCCLS, M27A) broth microdilution method. ITC was selected as the antifungal agent for comparison study. Using the broth microdilution method, the geometric mean for MIC (microg ml(-1)) with regard to all isolates was < or =0.06 for propolis and < or =0.35 for ITC. The broth microdilution and the agar dilution methods were in good agreement (75%) for propolis against yeasts isolated from patients with superficial mycoses. Using the diffusion method, all strains showed a broad zone of inhibition at the first available reading time (24 or 48 h). An increase of MIC values was accompanied by a decrease of growth inhibition zone diameter. A favourable correlation was found between MIC and inhibition zone around the disc for propolis sample and the correlation coefficient was: r = -0.626 (P < 0.01). This study suggests the potential value of the agar dilution and disc diffusion method as a convenient alternative method for testing of yeasts to propolis. This study demonstrated that propolis and ITC were very active against yeasts from patients with superficial mycoses. The other prominent finding in this study is that RPMI 1640 with L-glutamine was the available broth for the in vitro susceptibility testing of yeasts.
    Letters in Applied Microbiology 09/2006; 43(3):318-24. · 1.63 Impact Factor
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    ABSTRACT: Vulvovaginal candidiasis is one of the most frequent infections of the female genital tract with a high incidence. Although numerous antimycotical agents are available for treatment of yeast vaginitis, there are few comparative data on the in vivo and in vitro activity of these drugs. The aim of this open, randomized, and comparative study was to determine in vivo and in vitro effectiveness of the 3 systemic antifungal agents: terbinafine and 2 azoles (itraconazole and fluconazole) in the treatment of patients with Vulvovaginal candidiasis. A total of 44 patients who had signs and symptoms of Vulvovaginal candidiasis were recruited for the study. Patients were randomly assigned to 3 groups: terbinafine 500 mg/d orally was used for 7 days, itraconazole 200 mg/d orally was used for 7 days, and fluconazole 150 mg orally was used as a single dose. Both clinical and mycologic examinations were performed for posttreatment assessment at week 4. This study revealed a clinical cure rate 33.3% for terbinafine, 60% for itraconazole, and 66.6% for fluconazole (P>0.05). Mycologic cure rates were 33.3%, 10%, and 66.6% respectively (P<0.05). Overall cure rates were 33.3%, 10%, and 53.3% (P>0.05). Terbinafine could be an alternative treatment option in Vulvovaginal candidiasis because there were no significant differences in the clinical and overall cure rates among 3 antifungal agents. However, terbinafine could not be suggested as a first-line treatment in Vulvovaginal candidiasis. Systemic use of terbinafine in larger numbers of cases may give more information about the effectiveness of this drug in the treatment of patients with vulvovaginal candidiasis.
    American Journal of Therapeutics 06/2006; 13(4):332-6. · 1.29 Impact Factor
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    ABSTRACT: The aim of this study has been to evaluate patients with tinea pedis for their demographic data and attitudes affecting the treatment of disease, and to compare the in vitro activity of 10 antifungal agents and to relate them to their in vivo activity. Patients with positive mycological examination were enrolled in the study, and a questionnaire comprised of 22 questions was administered. A mycological culture was carried out for each specimen. The antifungal susceptibility of the subcultured species was determined for griseofulvin, terbinafine, ciclopiroxolamine, fluconazole, ketoconazole, itraconazole, bifonazole, sulconazole, oxiconazole and miconazole with microdilution. Mycological cultures were carried out from 59 patients and there were 35 positive cultures (59.3%). The dermatophytes were Trichophyton rubrum (n = 25) and Trichophyton mentagrophytes (n = 3). The yeasts were Candida albicans (n = 7), Candida glabrata (n = 1) and Trichosporon (n = 2). In the minimum inhibitory concentration (MIC) study, the mean +/- standard error of the mean (SEM) MICs of the antifungals for T. rubrum were as follows: terbinafine 0.01 +/- 0.003, oxiconazole 0.16 +/- 0.05, sulkonazole 0.31 +/- 0.05, miconazole 0.45 +/- 0.15, itraconazole 0.74 +/- 0.01, ketokonazole 1.03 +/- 0.17, ciclopiroxolamine 1.30 +/- 0.12, bifonazole 1.94 +/- 0.51, griseofulvin 4.87 +/- 0.61, and fluconazole 17.91 +/- 3.67 microg/mL. Our study supports that azoles could be used as first-line treatment, as oxiconazole is very effective for both dermatophytes and C. albicans. Correlation between in vitro results and clinical outcomes of cases of dermatophytes is still to be established and interpretive breakpoints defined, in order to increase the quality of patient care in tinea pedis.
    Journal of the European Academy of Dermatology and Venereology 03/2006; 20(2):158-65. · 2.69 Impact Factor
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    ABSTRACT: The in vitro activities of propolis against 29 strains of dermatophytes were compared with those of terbinafine, itraconazole, ketoconazole, and fluconazole. Minimal inhibitory concentrations (MICs) were determined according to a National Committee for Clinical Laboratory Standards broth microdilution method. Among the systemic antifungals tested, terbinafine was the most potent. Propolis showed important antifungal activity and it merits further investigation as a potentially useful agent for the treatment of dermatophytosis.
    Mycoses 06/2005; 48(3):205-10. · 1.28 Impact Factor

Publication Stats

104 Citations
44.22 Total Impact Points

Institutions

  • 2005–2013
    • Erciyes Üniversitesi
      • • Department of Medical Microbiology
      • • Faculty of Medicine
      • • Department of Infectious Diseases and Clinical Microbiology
      • • Department of Animal Science
      Caesarea, Kayseri, Turkey