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Among sexually transmitted diseases, HIV causes very serious clinical manifestations that can lead to death. As a result, millions of people have to live with this problem that threatens their health. The virus attacks the immune system of the host, especially CD4+ T lymphocytes, causing the suppression of the immune system. CD4, CD8 counts, and HIV RNA viral loads are monitored in HIV-infected patients with antiretroviral treatment, and CD4 counts play an important role in determining the effectiveness of the treatment. Despite the advances in treatment in the present day, opportunistic infections are the main cause of morbidity and mortality in these patients, and the evaluation of immunological parameters is valuable for the prognosis of the disease in this process. In the present study, the purpose was to investigate the opportunistic infections faced by naive HIV-positive patients who applied to our laboratory and were diagnosed between 2019 and 2022 during their one-year treatment period, and the correlation of the immunological parameters was also evaluated retrospectively using the hospital automation system and laboratory data. A total of 107 opportunistic causative microorganisms were identified in 87 of the 230 HIV-positive patients over one year. T. pallidum was detected in 43 (18.6%) of these patients, Cytomegalovirus (CMV) in 32 (13.9%), Epstein–Barr virus (EBV) in 9 (3.9%), Hepatitis B virus (HBV) in 10 (4.3%), C. albicans in 7 (3%), M. tuberculosis in 3 (1.3%), Hepatitis C virus (HCV) in 2 (0.8%), and C. glabrata in 1 (0.4%) patient. Although mono-agent co-infections were determined in 69 of 87 people living with HIV, two-agent co-infections were detected in 16 HIV patients, and three-agent co-infections were identified in two HIV patients. Considering the correlation between the CD4/CD8 ratio and infection positivity, a moderate negative correlation was determined with HIV RNA viral load and CMV infection. The CD4/CD8 ratio had a low negative correlation with EBV and C. albicans infections. It was also found that the follow-up of HIV RNA load in the diagnosis of T. pallidum, CMV, EBV, and C. albicans may be meaningful. Opportunistic infections mainly affect immunosuppressed patients and can be prevented with effective treatment. Although it is already known that HIV patients may face different infections during their treatment, it was concluded that more attention should be paid to T. pallidum, CMV, EBV, and C. albicans agents. These infections should be routinely monitored with HIV viral load and the CD4/CD8 ratio.

Bacteremia and fungemia are significant causes of morbidity and mortality that frequently occur as co-infections with viral respiratory infections, including SARS-CoV-2. The aim of this study was to evaluate the microorganisms that were isolated from the blood cultures of SARS-CoV-2-positive and negative patients and investigate their antimicrobial resistance patterns. A retrospective analysis was performed of 22,944 blood cultures sent to the laboratory between November 2020 and December 2021. Blood culture analyses were performed using the BD Bactec FX automated system. Identification was carried out using conventional methods, namely, VITEK-2 and MALDI-TOF MS. Antibacterial/antifungal susceptibility tests were performed according to EUCAST/CLSI recommendations. SARS-CoV-2 tests were performed with RT-PCR. Culture positivity was detected in 1630 samples from 652 patients. Of these 652 patients, 633 were tested for SARS-CoV-2; 118 (18.6%) were positive and 515 (81.3%) were negative. The bacteria and fungi that were isolated at the highest rate in SARS-CoV-2-positive patients were methicillin-resistant coagulase-negative staphylococci (MR-CoNS) (21.5%), Escherichia coli (12.4%), Klebsiella pneumoniae (12.4%), Candida albicans (1.65%), and Candida glabrata complex (1.65%), while in the negative patients, the highest rates were for E. coli (21.3%), MR-CoNS (13.5%), K. pneumoniae (12.05%), C. albicans (2.1%), Candida parapsilosis (1.1%), and Candida tropicalis (0.9%). No statistically significant difference was determined between COVID-19-positive and negative patients in terms of detection, such as with the Pseudomonas spp., Enterococcus spp., and methicillin-resistant Staphylococcus aureus isolated from the blood cultures (p > 0.05). The most common isolate was MR-CoNS in SARS-CoV-2-positive patients (p = 0.028). Acinetobacter baumannii was more frequent (p = 0.004) and carbapenem-resistant K. pneumoniae was isolated at a higher rate (60% vs. 43%) in SARS-CoV-2-positive patients compared to SARS-CoV-2-negative patients (p > 0.05). These findings highlight the fact that isolation procedures should not be disregarded and the distribution of bacterial/fungal agents of bloodstream infections and their antibiotic resistance should be followed up during a pandemic, such as in the case of COVID-19.

In recent years, several molecular methods have been introduced for diagnosis of Mycobacterium tuberculosis complex (MTBC), and detecting the drug resistance in clinical specimens. The FluoroType MTB (FT MTB) assay uses real-time polymerase chain reaction (PCR) to detect MTBC in clinical specimens. GenoType MTBDRplus is a line probe assay which detects MTBC, as well as rifampicin, and isoniazid resistance. In this study, the diagnostic performances of FT MTB and GenoType MTBDRplus were evaluated. In total, 247 specimens (124 respiratory, 123 non-respiratory) were analyzed comparing mycobacterial growth methods and FT MTB. GenoType MTBDRplus was used for the specimens positive for MTBC. In all, 23 (9.3%) of 247 specimens were positive for both the culture and FT MTB assay; therefore, the GenoType MTBDRplus assay was performed on 23 clinical specimens. The results were concordant with the drug susceptibility test results. The FT MTB assay provided quick and reliable direct detection of MTBC from the clinical specimens with high sensitivity (95.8%) and specificity (100%). Although the performance of GenoType MTBDRplus was problematic in clinical specimens with mycobacterial levels below the detection limits of the assay, it was a reliable test for cultivated specimens.

In recent years, there has been an increase in invasive infections caused by “'rare' Candida species”. The intrinsic resistance characteristics of these species along with their higher antifungal MIC values reduce the success of antifungal treatment. Although molecular and other sophisticated tests are reliable for the identification of many rare and newly emerging Candida species. Their implementation in routine laboratories is limited due to trained personnel, high costs, and specialized laboratory equipments. As a result, conventional methods and automated systems such as VITEK-2 and MALDI-TOF MS are still widely used in routine laboratories. This study evaluates and compares the identification capabilities of these commonly used tests for rare Candida species and provides guidance for rapid identification. A total of 201 isolates consist of 16 rare Candida species from various clinical samples were analyzed. Identification was performed using VITEK MS (as a gold standard) and results compared with VITEK-2, API ID 32 C, CHROMagar Candida, CHROMagar Candida Plus, and cornmeal agar with 1% Tween 80. VITEK MS identified all isolates and among them, the three most common species were Candida inconspicua (n:34; 16.9%), Candida lusitaniae (n:33; 16.4%), and Candida kefyr (n:31; 15.4%). Among these, a total of 107 isolates (53.2%) were correctly identified at the species level using the VITEK-2 system, whereas only 51 isolates (25.37%) were accurately identified with the API ID 32C system. However, when additional conventional methods (colony morphology and colour on chromogenic agar medium, Dalmau plate method, esculin hydrolysis test, growth at different temperatures) were applied, these identification rates increased to 81.5% (n = 164) and 54.7% (n = 110), respectively. Notably, even when used alone, the VITEK-2 system demonstrated a high identification success rate for Candida auris (83.3%), Candida lipolytica (85.7%), Candida lusitaniae (78.7%), Candida guilliermondii (83.8%), and Candida dubliniensis (86.4%). One of the primary reasons for misidentification was the absence of these microorganisms in the databases of the identification systems used. Additionally, all C. auris strains were correctly identified using CHROMagar Candida Plus medium, with no false-positive results observed for other Candida species. None of the identification methods, when applied alone, were able to correctly identify all 201 rare Candida species. Both VITEK-2 and API ID 32 C demonstrated limited accuracy for some rare species. However, evaluating microscopic and colony morphology on cornmeal agar and chromogenic media improved the accuracy of identification, especially for C. auris. In laboratories with limited access to MALDI-TOF MS or molecular methods, these tests should be used in combination to improve identification accuracy and provide alternative approaches for species differentiation. Also laboratories should update regular databases of their systems constantly. These organisms may be considered “rare” because they remain unidentified due to limitations in current identification methods and databases.

Invasive infections due to Magnusiomyces / Saprochaete species are an emerging problem in immunocompromised patients and are often underrecognized because of misidentification and intrinsic resistance to some antifungals. This multicenter study investigated the species distribution, antifungal susceptibility patterns, and key virulence traits of clinical isolates from Türkiye. A total of 133 clinical isolates collected between 2010 and 2024 from 18 hospitals in 10 cities were identified by MALDI-TOF MS and ITS/LSU sequencing. MICs of amphotericin B, fluconazole, voriconazole, itraconazole, posaconazole, and flucytosine were determined using the EUCAST broth microdilution method. Biofilm formation and esterase, caseinase, secreted aspartyl proteinase, phospholipase, and hemolysin activities were assessed phenotypically. Sequencing identified 107 isolates (80.4%) as Magnusiomyces capitatus and 26 (19.6%) as Magnusiomyces clavatus , MALDI-TOF MS identified 106 (79.7%) as M. capitatus and 27 isolates (20.3%) as M. clavatus . There was 99.2% agreement between MALDI-TOF MS and sequencing results. Voriconazole, amphotericin B, and posaconazole showed the lowest MICs, whereas fluconazole displayed wide MIC ranges and limited activity. Overall, 97.7% of isolates were strong biofilm producers, with significantly higher biofilm production in M. capitatus . In contrast, M. clavatus showed higher caseinase and esterase activity. This study provides the most extensive multicenter dataset on Magnusiomyces / Saprochaete in Türkiye and underscores their considerable pathogenic potential through strong biofilm formation and tissue-degrading enzyme activities. Accurate species-level identification using MALDI-TOF MS supported by molecular methods is essential, and limited fluconazole activity suggests that voriconazole and amphotericin B should be prioritized in species-guided treatment strategies.

PurposeAutosomal recessive (AR) CARD9 deficiency is an inherited immune disorder which results in impaired innate immunity against various fungi. Superficial and invasive fungal infections, mainly caused by Candida or Trichophyton species, are the hallmark of CARD9 deficiency. Together with the increasing number of CARD9-deficient patients reported, different pathogenic fungal species have been described such as Phialophora, Exophiala, Corynespora, Aureobasidium, and Ochroconis. Saprochaete capitata is an opportunistic infectious agent in immunocompromised patients and is a common cause of invasive fungal disease in patients with hematological malignancies. In this study, we investigated the causative genetic defect in a patient with S. capitata fungal infection which disseminated to lymph nodes and common bile duct.MethodsThe identification of the isolated yeast strain was made by direct microscopic examination and confirmed by internal transcribed spacer (ITS) sequencing. We applied whole exome sequencing to search for the disease-causing mutation. Sanger sequencing was used to validate the mutation in the patient and his parents.ResultsS. capitata was isolated from the biopsy specimen as the causative microorganism responsible for the invasive fungal disease in the patient. Whole exome sequencing revealed a homozygous c.883C > T, (p.Q295*) mutation in CARD9, confirmed by Sanger sequencing.ConclusionsThis is the first report of invasive Saprochaete infection associated with autosomal recessive (AR) CARD9 deficiency in the literature and thereby further extends the spectrum of fungal diseases seen in these patients.

Candida auris has emerged as a significant fungal threat due to its rapid worldwide spread since its first appearance, along with its potential for antimicrobial resistance and virulence properties. This study was designed to examine virulence characteristics, the efficacy of ceragenins, and biofilm-derived drug resistance in seven C. auris strains isolated from Turkish intensive care patients. It was observed that none of the tested strains exhibited proteinase or hemolysis activity; however, they demonstrated weak phospholipase and esterase activity. In addition, all strains were identified as having moderate to strong biofilm formation characteristics. Upon determining the minimum inhibitory concentrations (MIC) of ceragenins, it was discovered that CSA-138 exhibited the highest effectiveness with a MIC range of 1–0.5 µg/mL, followed by CSA-131 with a MIC of 1 µg/mL. Also, antimicrobial agents destroyed mature biofilms at high concentrations (40–1280 µg/mL). The investigation revealed that the strains isolated from Türkiye displayed weak exoenzyme activities. Notably, the ceragenins exhibited effectiveness against these strains, suggesting their potential as a viable treatment option.

Background: Ankaferd Blood Stopper® (ABS) is a hemostatic product comprising a standardized mixture of Thymus vulgaris, Glycyrrhiza glabra, Vitis vinifera, Alpinia officinarum, and Urtica dioica. It is used to control bleeding after extracorporeal injuries, traumatic cuts, dental operations, and surgical intervention. ABS was reported to exhibit antibacterial and germicidal activities. Objectives: This in vitro study aimed to determine the antifungal activity of ABS. Methods: In total, 114 Candida strains; 65 Candida albicans and 49 non-albicans isolated from the oral cavity of patients with oral stomatitis, as well as three reference strains of C. albicans ATCC 90028, C.parapsilosis ATCC 22019, and C.krusei ATCC 6258, were tested by agar well diffusion, disk diffusion, and time-kill curve methods in this study. The results obtained for ABS were compared with those obtained for amphotericin B (AMB). Results: ABS and AMB exhibited inhibitory zones with mean diameters of 18.2 ± 1.4 (12-20) mm, 20.6 ± 1.2 (18 - 23) mm by disk diffusion and 18.3 ± 1.3 (15 - 20) mm, 19.9 ± 2.6 (18 - 22) mm, respectively, by agar well diffusion methods for C. albicans. On the other hand, ABS and AMB showed inhibition zones with mean diameters of 19.4 ± 1.5 (18 - 24) mm, 19.1 ± 2.8 (13 - 30) mm by disk diffusion and 19.8 ± 2.1 (18 - 25) mm, 18.7 ± 2.3 (13 - 23) mm by agar well diffusion methods for non-albicans Candida isolates. ABS exhibited higher activity against non-albicans Candida species compared to C. albicans (P < 0.001). By the time kill-curve method, ABS achieved a 4 log10 cfu/mL decrease in C. albicans ATCC 90028, C. parapsilosis ATCC 22019, and C. krusei ATCC 6258, as well as seven different Candida spp. isolates of C. albicans, C. glabrata, C. tropicalis, C. guilliermondii, C. kefyr, C. krusei, and C. parapsilosis, respectively. Conclusions: ABS can be an alternative for treating superficial infections

Over the past decades, different mycobacteriosis agents have become important fish pathogens. The present study describes a different mycobacteriosis in farmed sea bream ( ) caused by in Turkey. Affected 15 fish, weighing 15 to 20 g, showed lethargy, stunted growth, pale skin, dorsal fin necrosis, and a significant level of mortality (40 %) in fish stocks. Internally, no multifocal white-colored granulomas in the visceral organs were observed. Inoculation of the visceral organs onto Löwenstein-Jensen medium and Tryptic Soy Agar (1.5% NaCl) slants produced only fast-growing (2-3 weeks), orange to yellow-colored, photochromogenic acid-fast colonies. Ziehl-Nielsen positive bacterial isolates were identified using a commercially available line probe assay (Genotype Mycobacterium CM/AS assay) and with 16S rRNA gene sequencing analysis based on 16S rRNA gene sequencing, fifteen isolates were identified as . Histopathologically, epithelioid cell granulomas were not observed in any vicseral organs but acid-fast bacteria were detected in the liver, kidney, spleen, and heart tissue. This study shows that asystemic mycobacteriosis is observed in sea bream with high mortality.

A series of indole-based spirothiazolidinones have been designed, synthesized and evaluated, in vitro, for their antitubercular, antiviral, antibacterial, and antifungal activities. The structures of the new compounds were established by IR, H NMR, C NMR (proton decoupled, APT, and DEPT), electrospray ionization mass spectrometry, and microanalysis. Compounds bearing a phenyl substituent at position 8 of the spiro ring, exhibited significant antitubercular activity against H37Rv ATCC 27294 at concentrations of 3.9 and 7.8 µM. Still, some of the tested compounds displayed activity on mycobacteria with MIC values of 16 and 31 µM. Four of the indole-spirothiazolidinone derivatives were found to be moderately active against Punta Toro virus, yellow fever virus or Sindbis virus in Vero cells. The antiviral EC values were in the range of 1.9-12 µM and the selectivity index (ratio of cytotoxic to antivirally effective concentration) was above 10 in some cases. The most potent effect was seen with the compound that is methylated at positions 2 and 8 of the spirothiazolidinone system.