INTRODUCTION: There are two widely used standards for antimicrobial susceptibility testing (AST) in the world. One of these standards is the "Clinical Laboratory Standards Institute" (CLSI) which has been used for many years in our country and the other one is the "European Committee on Antimicrobial Susceptibility Testing" (EUCAST) standard which has been used in many countries of the European Union and since 2015 being used in our country. There may be some possible changes in resistance profiles after the EUCAST standards will be begun to use in our country.
METHODS: Blood cultures sent to Ankara Numune Training and Research Hospital Medical Microbiology Laboratory between 01.03.2014 - 22.06.2015 were examined retrospectively. The blood culture bottles were monitored on the BACTEC FX automated system (Becton Dickinson, USA). All samples with positive signal were cultured simultaneously on bloody agar, chocolate agar and eosin methylene blue agar media. Identification of the microorganisms on the plates where growth was observed was performed with Maldi Biotyper (Bruker, Germany). Antibiotic susceptibility tests of bacteria that are thought to be causative were made by BD Phoenix ™ (Becton Dickinson, USA). The minimum inhibitor concentration (MIC) values of antibiotics were interpreted separately according to CLSI 2015 and EUCAST 2015 and results were compared.
In order to investigate the relation of antimicrobial resistance, the data were analyzed by SPSS 15 and the statistical analysis was done by Pearson Chi-square test.

RESULTS: When all antibiotic susceptibility tests of our study were evaluated according to the CLSI and EUCAST guidelines, amikacin, ceftazidime and ticarcillin-clavulanic acid resistance rates of 254 Esherichiae coli, strains were found to be significantly more resistant according to EUCAST (p<0.05). In our study, the resistance rate of aztreonam in 107 Pseudomonas spp. was 56.1% according to CLSI and 98.1% according to EUCAST (p<0.05). In our study 97.8% of 92 Enterococcus faecium, strains were resistant to ampicillin according to CLSI and 89.1% resistant according to EUCAST (p<0.05). In our study, the clindamycin resistance of 160 Staphylococcus aureus, strains was determined as 4.4% according to CLSI and 88.8% according to EUCAST (p<0.05).
DISCUSSION AND CONCLUSION: In this study, comparing antibiotic susceptibilities of microorganisms from blood cultures according to the guidelines of CLSI and EUCAST, no significant difference was found in general between the resistance rates for many antibiotics in both gram-negative and gram-positive bacteria.

INTRODUCTION: In this study, the aim was to investigate the clonal relationship between carbapenem resistant Acinetobacter baumannii isolates and carbapenem resistance genes isolated from blood samples of patients followed in intensive care units by molecular methods.
METHODS: Bactec 9240 system (Becton Dickinson, USA) was used for the isolation of bacteria from blood culture flasks. Identification of 112 strains included in the study were performed by conventional tests, API 20NE (bioMèrieux, France) and Phoenix TM 100 system (Becton Dickinson, USA) and confirmed by the presence of blaOXA-51 gene. Antimicrobial susceptibility tests were performed by Kirby-Bauer disk diffusion method and Phoenix TM 100 system. Carbapenem resistance genes; blaOXA-23, blaOXA-48, blaOXA-58, blaIMP, blaVIM and blaNDM-1 were investigated by Multiplex Polymerase Chain Reaction (PCR) method. Pulsed Field Gel Electrophoresis (PFGE) was used to determine the clonal relationship between Acinetobacter baumannii strains.
RESULTS: The antibiotic resistance percentages of strains for gentamicin, amikacin, tobramycin, netilmicin, ceftazidime, trimethoprim/sulfamethoxazole, piperacillin, ciprofloxacin, ampicillin/sulbactam, piperacillin/tazobactam and cefoperazone/sulbactam, were 88%; 81%; 78%; 36%; 98.5%; 96%; 89%; 100%; 100%; 93%; 91% respectively. MIC values of imipenem and meropenem were determined above ≥8 µg/ml in the whole group. blaOXA-51 and blaOXA-23 genes were detected in all isolates included in the study. By PFGE method, 62 different pulsotypes were detected. Among the pulsotypes, 19 of them contained ³2 strains. It was observed that 108 (96.4%) strains were clustered in 11 clonally related groups when the similarity between pulsotypes for grouping was limited to 85% or more.
DISCUSSION AND CONCLUSION: In this study, it was observed that carbapenem-resistant A.baumanii strains were resistant for all tested antibiotics at high levels except netilmicin and spread in the hospital via cross contamination. These strains posed a risk for hospital infections, however, clonal-related strains were not limited to a specific unit and time period.

INTRODUCTION: Urinary tract infection is the second most common infection. The presence of bacteriuria and/or pyuria with clinical signs such as costovertebral angle sensitivity, fever, suprapubic tenderness, dysuria, pollakuria and urinary incontinence is defined as urinary tract infection..The most commonly isolated bacterium in acute infections is Escherichia coli. The aim of this study was to determine the bacteria isolated from urine cultures of patients with urinary tract infection and to investigate the sensitivity and resistance of these bacteria to the antibiotics commonly used in treatment by examining the antibiogram results.
METHODS: In this study, urine cultures were analyzed retrospectively between 1 December 2014 and 1 October 2016. The pyuria in full automatic urine test and cultures with 10⁵colony mL growth in patients with urinary tract infections were included in the study. Identification of the causative agents and antibiotic susceptibility tests were performed according to the recommendations of the European Committee on Antimicrobial Susceptibility Testing (EUCAST). The data are expressed as numbers and percentages.
RESULTS: The urine culture results of 76 patients were evaluated. Forty eight strains were isolated from urine cultures and antibiogram results of these strains were examined. The most common microorganism isolated from urine cultures was E. coli (69%). Thirty three E. coli strains were isolated. Twenty (42%) extended spectrum beta-lactamase (ESBL)-positive E. coli, 13 (27%) ESBL-negative E. coli, 5 (10%) ESBL-positive K. pneumoniae and 2 (4%) ESBL-negative K. pneumoniae, 8 (17%) other gram negative and gram positive bacteria strains were determined in 48 (100%) isolated strains.
The other bacteria were Proteus mirabilis, Enterococcus faecalis, Enterococcus faecium, Pseudomonas aeruginosa, Streptococcus agalactiae, Stenotrophomonas maltophilia and Acinetobacter lwoffii. The sensitivity of imipenem, meropenem, cefoperazone-sulbactam, piperacillin-tazobactam, cefepim, ciprofloxacin, amikacin and nitrofurantoin was 100% and sensitivity of tobramycin was 92.31% in ESBL-negative E. coli.

DISCUSSION AND CONCLUSION: ESBL-positive E. coli was found to be 42%. This rate supports the increasing antibiotic resistance results over the years. Resistance to frequently preferred ciprofloxacin, trimethoprim-sulfamethoxazole and cefuroxime has been increasing for empirical antibiotic treatment. Therefore, the choice of empirical antibiotic therapy should be revised in patients with urinary tract infection.

INTRODUCTION: Cervical cancer is the second most common cancer type among women all over the world. Human papilloma virus (HPV) is the major etiologic agent associated with cervical cancer. More than 200 species of HPV have been identified so far and 40 of them are known to infect the genital system. The aim of this study was to determine the presence of HPV DNA and HPV genotypes in the cervical samples sent to our laboratory for HPV DNA investigation and to investigate the cytopathological changes in HPV positive patients.
METHODS: A sample of 1068 cervical swabs taken from patients between the ages of 20 and 66 who applied to the Obstetrics and Gynecology Clinic between January 2015 and January 2018 were included in the study. HPVsign® Q24 complate kit (Qiagen, Germany) was used for HPV typing with QIAamp® DNA Mini Kit PCR (Diatech Pharmocogenetics, İtaly) and pyrosequencing for DNA isolation.
RESULTS: HPV DNA was detected as positive in 226 (21.1%) samples of 1068 samples. In 141(62.3%) of the HPV DNA positive specimens, high-risk types were detected alone. Among HPV DNA positive samples, HPV type 16 was found in 73(32.3%) patients alone, multiple types were found in 37 (16.3%) patients and other types were found in 116 patients. HPV DNA positivity was highest in the 20-30 age group (26.3%). Cytology positivity was found in 20 (8.8%) of the patients with HPV DNA positivity. Of these patients, 13 had LSIL (65%), 4 (20%) had HGSIL, 1 (5%) had ASCUS, 2 (10%) had HGSIL / seviks CA.
DISCUSSION AND CONCLUSION: This is the first comprehensive study conducted in our region. The rate of HPV DNA positivity detected in cervical swab specimens and the frequency of HPV type 16 were found to be somewhat higher than the rates found in other studies in our country.
More extensive work is needed to determine the type of HPV DNA and HPV type prevalence and the types of HPV that should be used in our country.

INTRODUCTION: Enhancer elements in the genome take a role in establishment of proper gene expression patterns via bringing transcription factors together with the promoter regions of the genes. Acetylation of lysine K27 on histone H3 (H3K27ac) marks the enhancer regions in the genome. Super-enhancers are regulatory regions which have unusual high signal of H3K27ac and consist of several enhancer elements. Super-enhancers play a critical role in setting of correct cell-type specific gene expression programs. The aim of this study is to identify the super-enhancers characterizing normal bladder and associate these super-enhancers with the genes via analyzing bladder H3K27ac chromatin immunoprecipitation sequencing (ChIP-seq) data generated within Roadmap Epigenomics Project.
METHODS: Bladder H3K27ac ChIP-seq data was downloaded from Roadmap Epigenomics server. The data was analyzed on Homer ChIP-seq analysis platform. Super-enhancers were called using ‘findPeaks’ function of the platform in ‘super’ mode. The identified super-enhancers were associated with the genes using ‘annotatePeaks’ function of Homer platform. The visualization of H3K27ac ChIP-seq signal and identified super-enhancers was performed using UCSC GenomeBrowser. The protein-protein interaction networks of super-enhancer regulated genes and the pathways involved were determined using STRING protein interaction database.
RESULTS: 602 super-enhancers were called. Among the genes which were associated with super-enhancers having the top 100 highest H3K27ac signal were TBX3, RARA, RXRA, RASSF1, DAB2IP. Super-enhancer regulated (max distance of the super-enhancer to transcriptional start site of gene is 10 kb) genes (n=386) were identified to be involved in organ development, epithelial cell differentiation, and retinoic acid metabolism. In addition, it was determined that transcription factors were significantly (False Discovery Rate (FDR) =1.49e-07) enriched among the genes regulated by super-enhancers and those genes had a significant protein-protein interaction.
DISCUSSION AND CONCLUSION: With this study, the super-enhancers regulating normal bladder were determined. Given the fact that associated genes are involved in the maintenance of normal bladder homeostasis and the misregulation same set of genes take a role in bladder cancer, it is estimated that the results obtained with this study will largely contribute to a better understanding of bladder biology.

INTRODUCTION: Oxidative stress is one of the major causes of embryonal developmental disorders. In addition, melatonin reduces oxidative stress in the body and is known as a potential treatment for adverse effects of caffeine on fetal development. In this study, we aimed to investigate the teratogenic effect of caffeine on fetal kidney development and the protection of melatonin against the teratogenicity in terms of biochemical parameters.
METHODS: 5-7 months old Wistar-Albino rats (n=24) weighing 180-220 gr were divided into 7 groups for control, caffeine, melatonin, and caffeine+melatonin (co-injection). Control group: Serum physiological (SF) as 1 ml/kg intraperitoneal (i.p.), Sham group: 0.1 ml hanks as i.p., Low dose caffeine group: 30 mg/kg caffeine as gavage, Low dose caffeine+melatonin group: 30 mg/kg dose gavage with 10 mg/kg melatonin as i.p., High dose caffeine group: 60 mg/kg caffeine as gavage, High dose caffeine+melatonin group: 60 mg/kg dose gavage with 10 mg/kg melatonin as i.p., and Melatonin group: 10 mg/kg melatonin as i.p.
RESULTS: Total antioxidant status (TAS) values were 0.49±0.02 in the control group and 0.14±0.00 in the high dose caffeine group. In addition, total oxidant status (TOS), oxidative stress index (OSI), glutathione (GSH), glutathione disulfide (GSSG), superoxide dismutase (SOD), thiobarbituric acid reactive substances (TBARS), calcium (Ca), vitamin D and GSH/GSSG levels were examined (p<0.001).
DISCUSSION AND CONCLUSION: Melatonin has shown that caffeine has an essential role in reducing teratogenic effects and also reducing oxidative stress. Therefore, melatonin is a potential treatment for oxidative stress and caffeine teratogenicity in embryonic development.

INTRODUCTION: In this study, it was aimed to investigate the effect of medium composition on the ability of producing L-asparaginase enzyme and the activity of L-asparaginase enzyme isolated from soil samples collected from Van Lake Basin. In addition, it was aimed to determine the location of L-asparaginase positive isolates in bacterial taxonomy based on phenotypic and 16S rDNA sequencing analysis.
METHODS: Luria-Bertani (LB) Agar was used to isolate and cultivate bacteria from soil samples. L-asparaginase-producing isolates were screened for M9 minimal salt medium with 0.5% L-asparagine and 0.001% phenol red. The activity of the enzyme produced by positive isolates was determined by spectrophotometric method at 436 nm. The identification of the L-asparaginase producing isolate was performed according to standard microbiological methods and 16S rDNA sequencing analysis.
RESULTS: Of the 10 isolates, only one was clearly positive for L-asparaginase in the M9 minimal salt medium containing L-asparagine and phenol red. The L-asparaginase enzyme produced by this isolate was incubated at a temperature of 35 ºC (16.02 IU/ml) at a pH of 8.0 (15.25 IU/ml) for a 48 hour incubation period (16.02 IU / ml), in the presence of mannitol as a carbon source (15.69 IU/ml), in the presence of yeast extract (14.55 IU/ml) and arginine amino acid (17.63 IU/ml) as a source of organic nitrogen. Morphological, physiological and biochemical properties of this isolate were determined. In addition, L-asparaginase positive isolate was found to belong to Enterobacter cloacae complex strain according to 16S rDNA sequencing analysis and its status in bacterial taxonomy was determined.
DISCUSSION AND CONCLUSION: This research; In our country, it is one of the first studies about screening of L-asparaginase producing bacteria isolated from nature. In the treatment of ALL, L-asparaginase Enterobacter cloacae complex sp. V1 strain, positive for the antineoplastic L-asparaginase enzyme is extremely important for our national gene sources. This strain has been found to have an activity that could potentially be used in the industrial production of the enzyme L-asparaginase.

INTRODUCTION: Nosocomial infection is an infection if it becomes positive 48 hours or more after admission to the hospital or within 30 days of discharge. Nosocomial infection in healthcare facilities is a major public health problem in most developing countries. Basic infection control measures in any healthcare students setup can reduce the rates of healthcare-associated infections. Thus, it is important to identify the level of their knowledge, by correcting their deficiencies. The current study aimed to evaluate the level of knowledge regarding nosocomial infection among healthcare students.
METHODS: A descriptive study was conducted among 565 healthcare students. A structured self-administered questionnaire was used to collect data. The questionnaire included two parts: demographic characteristic, level of knowledge among the healthcare students. Data was analyzed using IBM SPSS Statistics version 22 and the associations were tested with Kruskal Wallis and Mann Whitney U test with a p-value of <0.05.
RESULTS: Five hundred and sixty-five students were included in the study. Students mean age was 20,99±2,64 (range, 17–37 years). The majority of the students (58.1%) were ≤20 year-old, (69.7%) were female, (57.7%) were attended occupational training program, 11.1% of them have working experience. The percentage of students' knowledge of hospital infections is between 10 and 100, with a mean knowledge level of 73.0 ± 17.23 and a median of 80.
DISCUSSION AND CONCLUSION: The overall knowledge level for infection control indicated that instruction was effective; however, knowledge levels were different. A periodically check of heatlhcare students’ knowledge would be advisable in order to fill any gaps, improve training, reduce nosocomial infections and increase prevention measures compliance. For this purpose continuing education programs and seminars should be arranged on regular basis.

INTRODUCTION: The aim of this study was to determine the prevalence of salmonella, shigella and parasites in the gaita and the prevalence of staphylococcus in the nose and to prevent the spread of diseases by treating the identified carriers the food factory workers in Diyarbakır.
METHODS: This descriptive study was carried out between 15 November and 30 December 2009. According to the records of the Provincial Directorate of Agriculture in Diyarbakir province, there are 15 food factories and 568 personnel work in these food factories. 50% of the employees working in the food factories in the province were aimed to be sampled. A questionnaire was applied to 252 individuals who agreed to participate in the study. Nasal and stool samples were taken from all the food workers who were surveyed and written consent was obtained from the participants. However, since 9 people did not have laboratory results due to lack of samples or sampling, 243 people (85.6% of thesample) were included in the study. Nasal specimens were collected from 237 subjects and stool specimens were taken from 217 subjects. Stool samples of the employees were evaluated by a microbiologist within half an hour. The data obtained were calculated frequency, percentage and mean values by using SPSS program. Chi-square, Fisher’s Exact tests were used for statistical analysis. P<0.05 was considered statistically significant.
RESULTS: The mean age of the study group was 30.9 ± 8.9 years and 93.4% of them were male. The incidence of parasites in stool was found to be higher in the workers whose toilet was not connected to the sewer system or whose toilet was outside the house (p <0.05). Staphylococcus aureus carriage was found to be 5.49 times higher in the cooks than in the other employees. On the nose s. aureus carriage rate was 7.6% and parasite carriage in the intestine was 7.4%. In the Gaita culture, salmonella and shigella were observed but no growth was observed.
DISCUSSION AND CONCLUSION: The high level of parasitic carriage and s.aureus carriage in the food factory workers indicate the lack of personal hygiene in employees.The s. aureus carriage was found to be higher in the nose of the cooks than the other workers. In the porter examination, the patients who were found to be carriers or patients were treated and hygiene training was provided to the employees.

INTRODUCTION: In this descriptive study, it was aimed to examine the personal hygiene habits of university students from Isparta Vocational School of Health Services, Suleyman Demirel University in Isparta and from School of Physical Education and Sports, Mehmet Akif Ersoy University in Burdur according to their departments, economic status (income) and sex variables.
METHODS: While evaluating, respective scores were assigned to some hygiene behaviors and then “the total hygiene score” was calculated by adding up these scores in order to analyze how the students’ hygiene behaviors changed with their descriptive qualities. The data obtained from research were analyzed using SPSS package program. In the statistical analysis of the data frequency (f), percentage (%) and chi-square (X2) analysis were applied in order to test the differences and p<0,05 was accepted significant.
RESULTS: It was determined that the personal hygiene habits of the students who participated in the study did not differ according to the department variable and economic status (income) (p>0.05). It was found that the personal hygiene habits of the students significantly differed according to sex; compared to the male students, the female students had significantly higher personal hygiene scores (p<0.05). Consequently, it was found that the female students were more sensitive with regard to the personal hygienic practices and attached more importance to personal hygiene.

DISCUSSION AND CONCLUSION: In the light of these results, it can be said that the personal hygiene behaviors of the male students should be improved and both families and teachers be responsible as regards this issue. In order to develop positive behavioral changes among students with regard to personal hygiene, seminars and conferences may be held by experts, various educative sources (posters, brochures, booklets etc.) involving practical hints may be provided for students, school staff and families; school counselling services may hold educative activities for students with regard to personal hygiene. Educative public service ads on personal hygiene may be broadcast on mass media especially on television.

INTRODUCTION: It is not known whether the infection control nursing trainees who completed both the theoretical trainings with distance education technique and the practical trainings in training centers successfully have reached the validity and reliability and the purpose of the final exam that they have taken with the ‘online’ test technique. The aim of this cross-sectional screening study is to determine whether the infection control nursing certification ‘online’ exam which held on 12 April 2019 has reached its goal.
METHODS: For this purpose, the reliability of the test, test statistics and item analysis were evaluated. Out of a total of 318 trainees admitted to the training program, 266 trainees who successfully passed the theoretical and practical training successfully took the exam and participated in the study.
RESULTS: The mean raw score from the test was 56.85 ± 9.45 and 120(45%) of trainees were successful and 146(55%) were unsuccessful. The percentage of success is lower than the previous exams. The standard error of the test raw scores was 3.35 and the reliability of the test was found 0.874. After adding the standard error as 4.0 to the raw scores, 62%(n=165) of the trainees were successful and 38% (n = 101) of them were found to be unsuccessful. The mean power of the items is 0.71± 0.23. The test consists mainly of easy and very easy items (n = 55, 69%). The mean of the item discriminative index of the test was found to be 0.31(± 0.10). It was found that case items (n = 13) were answered correctly less than other items (p <0.001).
DISCUSSION AND CONCLUSION: Since the high reliability of the test, the mean of the item discrimination index is > 0.30 and the mean power of the items is 0.71, it is concluded that the exam is appropriate for its purpose. In order to increase the reliability of the test to > 0.90 and increase the discriminative index, medium difficulty items should be selected rather than very easy and very difficult items. The evaluation of the test should be done by adding the standard error of the test to the raw scores to reduce the effect of the random errors that are expected to occur due to the fact that the exam is online. The low test success requires the re-evaluation of the training and achievement criterion by the experts. The training should be developed to increase the ability of trainees to identify cases.

INTRODUCTION: The p21-activated kinase 4 (PAK4) overexpression is sufficient to initiate the tumorigenesis process in normal breast epithelial cells. Recent studies suggested that PAK4 could be an important oncogenic factor in breast cancer.
The aim of this study was to investigate the migration ability of cells due to protein kinase C activation and inhibition and the expression levels of E-cadherin which provides cell-cell contact in MCF-7 breast cancer cells that PAK4 overexpressing and non-overexpressing cells.
METHODS: MCF7 cell line was used as a breast cancer model. Ectopic expression of the wild-type human PAK4 gene was achieved using PAK4 plasmid in MCF7 cells. Plasmid p3XFLAG-CMV-10 was used as control vector. RO318220 was used as PKC inhibitor and Phorbol 12-myristate-13-acetate (PMA / TPA) was used as PKC activator. Cells in both groups transfected with PAK4 plasmid and control vector were cultured for 0.2 h FBS, 10% FBS, RO318220 (5μM) and TPA (200 nM) for 48 hours. Cell migration in breast cancer cells was evaluated by Oris cell migration assay. Western blot method was used to evaluate the expression of E-cadherin.
RESULTS: It was determined that mesenchymal-like phenotype was formed and the number and length of podosomal structures were increased in these PAK4 overexpressed cells. In addition, PKC activation via TPA treatment increased cell migration due to PAK4 overexpression. However, PKC-induced invasive effects were blocked by the PKC kinase inhibitor RO318220. In addition, PAK4 overexpression leads to downregulation of E-cadherin compared to control.
DISCUSSION AND CONCLUSION: E-cadherin is one of the basic structures that provide cell-cell contacts and prevent cell migration. Taken together, these findings suggest that PKC-activated PAK4 signalling contributes to breast cancer progression. Therefore, our results show that inhibition of the PKC-PAK4 signaling pathway may be a potential therapeutic approach for the treatment of breast cancer.

Infections of viral rashes occurring frequently in pediatric patients even so it can be rarely seen in adult patients. Hand-foot-mouthdisease (EAAH) is a viral infectious disease that is usually seen in children under the age of five. Typically ıt was characterized by maculopapular or vesical eruptions around the hands, feet, oral cavity and mouth. The disease could be transmitted to humans via fecal-oral, oral-oral, droplet and contact. The causative agents are the Coxaciviruses, Echoviruses and Enteroviruses which are found in the enterovirüs genus.
An adults two brothers (aged 18 and 22) applied to the out patient clinic after one day of fever, headache, sorethroat, fatigue, loss of appetite, rash complaints and common muscle pain. They reported that similar findings were present in their younger sisters and that were treated with a diagnosis of hand-foot-mouth disease in the pediatric outpatient clinic one week before. There were subfebril fever, oropharyngeal hyperemia and maculovesicular rashes to perioral, palm and foot in the examinations of two brothers. Paracetamol, antiseptic mouthwash, bed rest, antihistaminic and hydration were suggested for symptoms to diagnosis of hand-foot-mouth disease. Although there were active lesions in the follow-up examinations, there was no complication or severe disease.Therefore they were followed by symptomatic treatment, hospitalization not considered. Diagnosis in our patients were based on the disease history and skin lesions, typical appearance. We couldn’t studied distribution of histopathology, viral serology or PCR. Larger patient numbers and studies with a defined viral factor are thought to be more useful.
Although it is not common in adult patients, EAAH can be seen. Early symptomatic and supportive therapies should be initiated to avoid complications or severe disease. It is important to inform patients about the measures to be taken to minimize the risk of social transmission. EAAH in two adult brothers who diagnosed with clinical findings were shared so purpose of the study to ensure that the early diagnosis is made in similar rash diseases, prevent complications by early diagnosis and treatment, reduce the risk of social transmission with necessary hygiene measures, update this disease again. EAAH cases were prescribed in two adult brothers diagnosed with history of family contact, typical rashes and clinical findings.

Candida auris is a new type of Candida that has been reported in several countries and has been resistant to multiple drugs in a short time since its identification. This fungus, whose natural reservoir cannot be found, is almost exclusively isolated in hospital settings. The actual prevalence of mushroom misidentifiable by conventional methods is therefore not known. As with other candida species, C.auris causes various invasive infections such as bloodstream infections, urinary tract infection, otitis, surgical wound infections, catheter-associated skin abscesses, myocarditis, meningitis, bone infections and wound infections, and is responsible for many hospital outbreaks. Use of broad-spectrum antibiotics and antifungal agents, diabetes mellitus, abdominal and vascular surgery, presence of central venous catheters, urinary catheterization, post-operative drain placement, chronic kidney disease, chemotherapy, blood transfusions, hemodialysis, total parenteral nutrition, duration of intensive care unit, the immunosuppressive condition also constitutes risk factors for C.auris as in other infections. C.auris; Adherence has various virulence factors such as biofilm formation, phospholipase and proteinase enzymes, and infections may result in high mortality. Survival of external surfaces and partial resistance to disinfectants facilitate colonization with fungi and subsequent infection. Most isolates show high MIC fluconazole and amphotericin B values. Resistance to echinocandins has been reported to differ. Some isolates are resistant to three major antifungal classes and cause persistent infection. In the first-line treatment of C.auris, echinocandin class antifungals are used. In case of resistance to echinocandins, combination therapies are recommended. The general misconfiguration of laboratory diagnoses, resistance to antifungal agents and rapid spread in the global sense arouses concern for this pathogen.
The aim of this review is to describe C. auris, a newly described species; Microbiological characteristics, virulence factors, antifungal resistance mechanisms and global dissemination are examined to create a clinical awareness.