Publications by authors named "Arikan-Akdagli S"

Incidence of Candida species increased in critically ill COVID-19 patients in intensive care units. This study aimed to investigate the impact of the COVID-19 pandemic on antifungal consumption and Candida species distribution in bloodstream infections. We observed that a significant increase in non-albicans Candida species cases (p = 0.

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Aim: To assess the impact of Aspergillus PCR on managing invasive aspergillosis (IA) in routine patient management.

Methods: A retrospective study included 235 patients who had Aspergillus PCR tests performed on respiratory samples (bronchoalveolar lavage, non-bronchoscopic lavage, and sputum) from November 2020 to April 2022.

Results: Of 293 tests, 11.

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Fungal nomenclature has been subject to change for many years and will probably continue to evolve and change in the future. One Fungus One Name principle guided the mycologists to reach a consensus on a single name. The change is inevitable in science; however, it comes with several challenges particularly in routine mycology laboratory practice and patient care, creating further difficulties and resistance to change.

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Mortalities due to mycoses have dramatically increased with the emergence of drug-resistant strains and growing immune-compromised populations globally. Azole antifungals have been the first choice against fungal infections of a wide spectrum and several azole derivatives with ester function were reported for their potentially promising and favorable activity against Candida spp. In this study, we designed and synthesized a series of 1-(aryl)-2-(1H-imidazol-1-yl/1H-1,2,4-triazol-1-yl)ethyl esters, and tested them against seven reference Candida strains using EUCAST reference microdilution method.

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Invasive candidiasis and candidemia remain a significant public health concern. The European Confederation of Medical Mycology (ECMM) conducted three pan-European multicentre studies from 1997 to 2022 to investigate various aspects of invasive Candida infections. These studies revealed shifting trends in Candida species distribution, with an increase of non-albicans Candida species as causative pathogens, increasing rates of antifungal resistance, and persistently high mortality rates.

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Introduction: Despite antifungal advancements, candidaemia still has a high mortality rate of up to 40%. The ECMM Candida III study in Europe investigated the changing epidemiology and outcomes of candidaemia for better understanding and management of these infections.

Methods: In this observational cohort study, participating hospitals enrolled the first ten consecutive adults with blood culture-proven candidemia.

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Scedosporium/Lomentospora is an opportunistic fungal pathogen found worldwide. While Scedosporium apiospermum and Scedosporium boydii are commonly observed globally, Lomentospora prolificans, which mainly affects immunosuppressed individuals, is rarely encountered and is more prevalent in arid climates, particularly in Australia and Spain. L.

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Article Synopsis
  • The study focuses on Candida auris, a fungus increasingly found in patients globally, specifically comparing biochemical tests and antifungal resistance in strains from Türkiye's first reported cases.
  • Different identification methods, including various API tests and MALDI-TOF MS, were used to identify the strains, which were mostly misidentified as other organisms.
  • Results showed high fluconazole resistance (≥64 mg/L) across all strains and indicated potential issues with false positives using CHROMagar Candida Plus, highlighting the need for further understanding of C. auris clade distributions in Türkiye.
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  • The document outlines the goal of creating standardized research definitions for invasive fungal diseases (IFD) in adult ICU patients without typical risk factors for these infections.
  • A panel of experts assessed existing definitions and lab tests for IFD, using the RAND/UCLA method to reach a consensus on new definitions.
  • Key standardized definitions were made for conditions like invasive candidiasis and aspergillosis, but more data is needed for other IFDs, with the intent to enhance future research studies.
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Antifungal prophylaxis with a mold-effective agent has led to a substantial decrease in invasive infections caused by Aspergillus spp. in the management of patients with acute myeloid leukemia undergoing induction chemotherapy. However, difficult-to-treat infections caused by other molds, such as Fusarium, Lomentospora, and Scedosporium species may still complicate the neutropenic period.

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Objectives: Galactomannan lateral flow assay (GM-LFA) is a reliable test for COVID-19 associated pulmonary aspergillosis (CAPA) diagnosis We aimed to assess the diagnostic performance of GM-LFA with different case definitions, the association between the longitudinal measurements of serum GM-ELISA, GM-LFA, and the risk of death.

Methods: Serum and nondirected bronchial lavage (NBL) samples were periodically collected. The sensitivity and specificity analysis for GM-LFA was done in different time periods.

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Background: Immune checkpoint inhibitors (ICIs) are a promising new treatment for different types of cancer. The infectious complications in patients taking ICIs are rare.

Case Report: A 58-year-old male who received chemotherapy consisting of pembrolizumab (PD-1 inhibitor) for esophagus squamous cell carcinoma one month before was admitted to the emergency room with shortness of breath soon after fiberoptic bronchoscopy, which was done for the inspection of the lower airway.

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Background: To date, azoles represent the only viable option for oral treatment of invasive Candida infections, while rates of azole resistance among non-albicans Candida spp. continue to increase. The objective of this sub-analysis of the European multicenter observational cohort study Candida III was to describe demographical and clinical characteristics of the cohort requiring prolonged hospitalization solely to complete intravenous (iv) antifungal treatment (AF Tx).

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Article Synopsis
  • The study aimed to evaluate the distribution of Candida species and their antifungal resistance in cases of candidaemia across Europe, analyzing data collected from 41 centers in 17 countries between 2018 and 2022.
  • The most common isolates identified were C. albicans, C. glabrata, and C. parapsilosis, with notable geographical variations in their prevalence and antifungal resistance patterns.
  • Resistance to fluconazole was observed in certain species, particularly C. glabrata and C. parapsilosis, with rare cases of echinocandin resistance found, including specific genetic mutations in resistant isolates.
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Article Synopsis
  • The ECMM conducted a study across 20 European countries to analyze the outcomes of patients with culture-proven candidaemia, focusing on how well hospitals followed treatment guidelines.
  • A total of 632 patients were included, revealing a high 90-day mortality rate of 43%, with factors such as age, ICU admission, comorbidity score, and specific types of Candida predicting mortality.
  • Adherence to clinical management guidelines, measured by EQUAL Candida scores, was associated with better survival outcomes, reinforcing the importance of following established treatment protocols.
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Azole antifungals, including fluconazole, have long been the first-line antifungal agents in the fight against fungal infections. The emergence of drug-resistant strains and the associated increase in mortality from systemic mycoses has prompted the development of new agents based on azoles. We reported a synthesis of novel monoterpene-containing azoles with high antifungal activity and low cytotoxicity.

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Introduction: There are no precise data about the effect of Aspergillus infection on lung function other than allergic bronchopulmonary aspergillosis (ABPA) in patients with cystic fibrosis (pwCF). Here, we aimed to determine clinical phenotypes caused by Aspergillus spp. using laboratory and immunologic parameters and to compare Aspergillus phenotypes in terms of pulmonary function tests (PFT) prospectively.

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Access to the appropriate tools is crucial for early diagnosis and clinical management of invasive fungal infections. This Review aims to describe the invasive fungal infection diagnostic capacity of Europe to better understand the status and the most pressing aspects that need improvement. To our knowledge, this is the first time that the mycological diagnostic capability and access to antifungal treatments of institutions has been evaluated at a pan-European level.

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The present study employed data collected during the Mycosands survey to investigate the environmental factors influencing yeasts and molds distribution along European shores applying a species distribution modelling approach. Occurrence data were compared to climatic datasets (temperature, precipitation, and solar radiation), soil datasets (chemical and physical properties), and water datasets (temperature, salinity, and chlorophyll-a concentration) downloaded from web databases. Analyses were performed by MaxEnt software.

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Objectives: Rezafungin EUCAST MIC testing has been associated with notable inter-laboratory variation, which prevented ECOFF setting for C. albicans. We assessed in vitro susceptibility and reproducibility for a modified EUCAST methodology and established associated wild-type upper limits (WT-ULs).

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Background: COVID-19-associated pulmonary aspergillosis (CAPA) has been reported as an important cause of mortality in critically ill patients with an incidence rate ranging from 5% to 35% during the first and second pandemic waves.

Objectives: We aimed to evaluate the incidence, risk factors for CAPA by a screening protocol and outcome in the critically ill patients during the third wave of the pandemic.

Patients/methods: This prospective cohort study was conducted in two intensive care units (ICU) designated for patients with COVID-19 in a tertiary care university hospital between 18 November 2020 and 24 April 2021.

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Article Synopsis
  • - The study aimed to determine the prevalence of azole resistance in Aspergillus fumigatus strains from clinical and environmental sources in Turkey, involving 21 centers over a 16-month period.
  • - A total of 1.3% of environmental isolates and 3.3% of clinical isolates showed azole resistance, with specific TR34/L98H mutations found in nearly half of the resistant samples.
  • - Although the overall rate of azole resistance was low, the presence of wild-type cyp51A in over half of the strains suggests that other resistance mechanisms may be developing.
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