Mustafa Altay ATALAY, Hafize SAV, Gonca DEMİR, Ayşe Nedret KOÇ

İNVAZİF ASPERGİLLOZ TANILI HASTALARDAN İZOLE EDİLEN ASPERGILLUS TÜRLERİNİN ANTİFUNGAL DUYARLILIKLARI

Bir küf mantarı olan Aspergillus doğada yaygın olarak bulunan saprof it bir mikroorganizmadır. Önceleri nadir inf ek- siyon etkeniyken son yıllarda sık görülmekte ve önemli ölçüde mortaliteye neden olmaktadır. Aspergillus inf eksiyonlarının tanısı, güvenilir ve kolay uygulanabilir tanı testlerinin olmaması nedeniyle genellikle gecikerek konur. Oysa klinikte iyi sonuç- ların alınabilmesi için tanının erken konulması ve etkin tedavinin başlanması gerekir. Etkin tedavinin yapılabilmesi için de antif ungal duyarlılık deneylerinin yapılıp yorumlanması gerekmektedir. Bu çalışmada, hastanemizde izole edilmiş Aspergillus izolatlarının tür dağılımı ve E-test ile elde edilen antif ungal duyarlılık sonuçları değerlendirilmiştir. Toplam 26 izolatın 21i (% 81) Aspergillus f umigatus, beşi (% 19) Aspergillus niger olarak tanımlanmıştır. Antif ungal duyarlılık testi için E-test yöntemi kullanılmış ve minimal inhibitör konsantrasyon (MİK) aralıkları amf oterisin B için 0.004-2 μg/ml, kaspof ungin için 0.004-1μg/ml ve vorikonazol için 0.016-0.64 μg/ml arasında bulunmuştur. Test edilen üç antif ungal arasında vorikonazol ve kaspof ungin MİK düzeylerinin amf oterisin Bye göre daha düşük olduğu gözlenmiştir. Sonuç olarak amf oterisin Bnin toksik etkileri de göz önüne alınırsa vorikonazol ve kaspof ungin klinisyenin kullanabileceği alternatif antif ungaller olabilirler.

Antifungal Susceptibility of Aspergillus Species Isolated from Patients Diagnosed with Invasive Aspergillosis

Aspergillus, a mould commonly f ound in nature, is a saprophytic microorganism. While it used to be a rare inf ectious agent, in recent years it is more f requent and causes signif icant mortality. Generally, Aspergillus inf ections cannot be diagno- sed early due to the lack of reliable and easy diagnostic tests. However, early diagnosis and initiation of an eff ective treatment is required in order to get good clinical outcomes. Antif ungal susceptibility tests should be perf ormed and interpreted f or an eff ective treatment. The present study evaluated species distribution of Aspergillus isolates which were isolated in our hospital and their antif ungal susceptibility results obtained by E-test. Of the total 26 isolates, 21 (81 %) were identif ied as Aspergillus f umigatus and f ive (19 %) were identif ied as Aspergillus niger. E-test method was used f or antif ungal susceptibility testing and the minimum inhibitory concentrations (MIC) were 0.004-2 μg/ml f or amphotericin B, 0.004-1μg/ml f or caspof ungin and 0.016-0.64 μg/ml f or voriconazole. Among three antif ungals tested, the MIC levels obtained f or voriconazole and caspof ungin were lower compared to amphotericin B. In conclusion, given the toxic eff ects of amphotericin B, voriconazole and caspof ungin may be alternative antif ungals that can be used by the clinicians.

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