INTRODUCTION: Monoclonal gammopathy is the abnormal proliferation of a single clone of B cell lineages, producing monoclonal immunoglobulin (M-protein). Serum protein electrophoresis (SPE) and immunofixation electrophoresis (IFE) are commonly used to detect M-protein. IFE is mainly used to detect M-protein types and clonality. The results of urine and serum immunofixation electrophoresis (IFE) tests performed in the laboratory of our newly established hospital were retrospectively evaluated.

METHODS: The study included 962 serum immunofixation electrophoresis results analyzed with Hydrasis 2 (Sebia, France) between November 1, 2022, and May 1, 2023, in our laboratory. In addition, the results of 51 samples from patients who had paraprotein bands in serum immunofixation electrophoresis and who requested urine immunofixation electrophoresis were included.
RESULTS: Paraprotein band was detected in 220 (22.9%) of 962 serum immunofixation electrophoresis results. A paraprotein band was detected in the urine immunofixation electrophoresis of 18 (34.6%) of 52 patients with paraprotein bands in serum immunofixation electrophoresis. In serum immunofixation electrophoresis, IgG kappa monoclonal band in 66 (30%) patients, IgG lambda monoclonal band in 50 (22.7%) patients, IgA kappa monoclonal band in 19 (8.6%) patients, IgA lambda monoclonal band in 14 (6.4%) patients, free light chain band in 22 (%10) patients were detected.
DISCUSSION AND CONCLUSION: We detected IgG kappa as the most common paraprotein band and IgG lambda as the second most common paraprotein band. Our study provided an opportunity to predict the frequency and type of monoclonal gammopathy detected in our newly established hospital laboratory and to compare it with literature data. Moreover, the data obtained in the study has enabled opportunities for comparison with hospital laboratories to be established in the future.

INTRODUCTION: Hepatitis C virus (HCV) is one of the most important causes of chronic hepatitis. Genotype determination before HCV treatment is recommended for patient management. The aim of this study is to determine the HCV genotype distribution in HCV RNA positive samples sent to Kırşehir Training and Research Hospital Medical Microbiology Laboratory.

METHODS: Blood samples of HCV-RNA positive chronic hepatitis C patients sent for HCV genotype determination between July 1, 2014 and July 1, 2023 were included in our study. Demographic data of the patients were obtained from the hospital electronic information system. HCV-RNA levels were investigated with the real-time PCR method Cobas TaqMan (Roche Diagnostics, Germany) device between 2014 and 2022, and with the Montania 4896 (Anatolia Geneworks, Turkey) device in 2022 and 2023.
RESULTS: It was determined that 84 (59%) of the samples were genotype 1, 15 (11%) were genotype 2, 21 (15%) were genotype 3 and 19 (13%) were genotype 4. Additionally, mixed genotype was detected in 3 (2%) patients. Of the samples detected as genotype 1, 14 (10%) were found to be genotype 1a, 58 (41%) were genotype 1b and 12 (8%) were genotype 1. While 123 (87%) of the samples consisted of Turkish patients, 19 (13%) of them consisted of foreign patients. Of these 19 patients, 6 (31.5%) had genotype 1, 2 (10.5%) had genotype 2, 7 (37%) had genotype 3, 3 (16%) had genotype 4 and 1 (%5) It was determined that were in mixed genotype.
DISCUSSION AND CONCLUSION: The distribution of HCV genotypes constantly changes with migration and changing living standards. Determination and follow-up of HCV genotypes allowed regular recording of epidemiological data. In this way, it contribute to more systematic patient follow-up and management. In this study, although HCV genotype 1b was seen at the highest rate, similar to studies conducted throughout our country, genotypes other than genotype 1 were also detected in our patients.

INTRODUCTION: The aim of this study is to reveal the level of use of preventive health services (blood pressure measurement, cholesterol measurement and blood sugar measurement) in Türkiye and to determine individual, sociodemographic, social and systemic factors that are thought to be effective in individuals’ use of preventive health services.

METHODS: In the study, the Türkiye Health Survey 2019 data set, which is regularly conducted at the national level by the Turkish Statistical Institute, was used. Data obtained from a total of 16.253 individuals aged 18 and over who participated in the Türkiye Health Survey were analyzed using the SPSS 23.0 (Statistical Package for the Social Sciences) program.

RESULTS: According to the results obtained as a result of the analyzes carried out in the research, 88.6% of the participants had their blood pressure measured, 83.7% had their cholesterol measured and 88.9% had their blood sugar measured. It has been determined that among the participants, women, older individuals, those with higher education levels, those who engage in physical activity, those with poorer health status, those who can receive social support from their surroundings, and those with social security coverage use preventive health services more.
DISCUSSION AND CONCLUSION: The regular and effective use of preventive health services is an important method for improving public health and reducing healthcare costs. This study enables international comparisons by revealing the blood pressure, cholesterol and blood sugar measurement levels of individuals living in Türkiye and the factors that affect them. In addition, the study is important in terms of reviewing the policies implemented to increase and encourage the use of these services by raising awareness of preventive health services. In this context, it is thought that facilitating access to provided healthcare services and improving their quality; increasing the quality and quantity of education; providing information on which age groups and how often preventive services should be received; and effectively monitoring the process will support the use of these services in the early stages.

INTRODUCTION: Pseudomonas aeruginosa is naturally resistant to many antimicrobial drugs, and resistance rates against currently available antimicrobials may vary according to different geographical regions, hospitals and years. The ability to develop resistance to antimicrobials during the treatment of infections causes treatment difficulties and requires constant monitoring of the resistance profile. This study aimed to retrospectively determine the resistance rates of P. aeruginosa strains isolated from different culture samples sent to the microbiology laboratory from hospitalized patients to various antimicrobials and to examine their changes over the years.

METHODS: 1746 P. aeruginosa isolates grown in inpatient culture samples sent to the microbiology laboratory from all clinics between January 2016 and December 2022 were evaluated retrospectively. Vitek 2 Compact automated system (BioMérieux, France) was used for antimicrobial susceptibility testing (AST). AST results were evaluated according to Minimum Inhibitory Concentration (MIC) values according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines. EUCAST and Clinical and Laboratory Standards Institute (CLSI) guidelines only approve the broth microdilution method for colistin resistance, so colistin resistance rates were not included in our study.
RESULTS: P. aeruginosa strains were isolated most frequently from respiratory tract samples (57.2%) and urine samples (24.5%), and most frequently from samples sent from Intensive Care Units (ICU) (60.4%). The lowest antimicrobial resistance rates for all strains isolated in seven years were amikacin (16.3%) and ceftazidime (22.3%), while meropenem resistance was 33.6% and imipenem resistance was 44.3%. Ciprofloxacin (47.9%) and piperacillin-tazobactam (51.1%) were found to be the antimicrobials with the highest resistance rates. Resistance rates for all other antimicrobials, except amikacin and aztreonam, increased significantly from 2016 to 2022 (p<0,001- p: 0,002).
DISCUSSION AND CONCLUSION: In our study, amikacin and ceftazidime were determined to be the most effective antibiotics for P. aeruginosa strains, and there are increasing resistance rates against antimicrobials over the years. Continuous monitoring of antimicrobial resistance rates for each hospital will contribute to the determination of empirical treatment options and appropriate treatment approaches.

INTRODUCTION: Blood culture is the gold standard in the diagnosis of bloodstream infections and allows the isolation of microorganisms and antibiotic susceptibility tests. The aim of this study is to determine the distribution and antibiotic resistance profile of microorganisms isolated from blood cultures and to guide empirical treatment.

METHODS: Blood culture results of Bayburt State Hospital Microbiology Laboratory between May 2019 and May 2022 were retrospectively reviewed and included in the study. Blood cultures were incubated in the BacT/ALERT (BioMérieux, Marcy l’Etoile, France) automated system. Vials with positive signals were inoculated on chocolate agar, 5% sheep blood agar and eosin methylene blue (EMB) agar and incubated at 37°C for 24-48 hours. Bacterial identification was performed by conventional methods and antibiotic susceptibility was determined by disk diffusion method.

RESULTS: There was no growth in 3,778 (77.1%) of 4,902 blood cultures accepted to the laboratory. Of the 1,124 (22.9%) blood cultures that grew, 860 (76.5%) grew gram positive bacteria, 244 (21.7%) grew gram negative bacteria and 20 (1.8%) grew yeast type fungi. The skin flora elements were analyzed for contamination and the contamination rate was 9.9% (n: 488/4,902). The gram positive bacteria detected were coagulase-negative staphylococci, Staphylococcus aureus and Enterococcus spp in order of frequency. Gram-negative bacteria were Escherichia coli, Klebsiella spp, Enterobacter spp, Brucella spp, Acinetobacter spp, Proteus spp, Pseudomonas spp and Citrobacter spp. While susceptibility rates to penicillin, cephalosporin, quinolone group antibiotics and trimethoprim-sulfamethoxazole were below 50% in Enterobacteriaceae family, susceptibility rates to carbapenem and aminoglycoside group antibiotics imipenem and amikacin were above 50%. Sixty percent of coagulase-negative staphylococci and 20% of S. aureus isolates were methicillin resistant. All Enterococcus spp isolates were susceptible to vancomycin, teicoplanin and linezolid.

DISCUSSION AND CONCLUSION: In Bayburt province, vancomycin is a reliable option for empirical treatment of gram-positive bacteria due to the presence of methicillin-resistant staphylococcal isolates and the susceptibility of enterococcal isolates to vancomycin. In addition, aminoglycoside and carbapenem group antibiotics would be better choices than penicillin and cephalosporin group antibiotics for gram negative agents. Such cumulative antibiotic susceptibility data are instructive for empirical treatment and lead to rational antibiotic use.

INTRODUCTION: Since stress has become an inseparable aspect of human existence, the interplay between stress and the immune system is a primary focus of research. Despite serotonin being a crucial regulator of the immune and stress systems, its potential involvement in the stress-induced immunological response remains unexamined. This study employed two serotonin receptor antagonists to assess the modulatory influence of serotonin on the immunological response to acute stress.
METHODS: Fifty-four Wistar albino rats (n=9/group) were allocated into six groups: control (C), acute stress (AS), ondansetron (O), methiothepin (M), acute stress + ondansetron (ASO), and acute stress + methiothepin (ASM). Rats were administered intraperitoneal injections of ondansetron or methiothepin at doses of 2 mg/kg and 0.2 mg/kg, respectively, prior to the introduction of acute stress. Acute stress was induced by a cold-immobilization procedure. Immediately following the stress procedure, the animals were euthanized using exsanguination. A complete blood count was taken, and plasma levels of serotonin, IL-6, and IL-17 were quantified by ELISA.
RESULTS: Acute stress significantly decreased leukocyte counts and IL-17 levels relative to the control group (p = 0.003 and 0.002, respectively). Methiothepin had comparable effects on both parameters. On the other hand, neither acute stress nor serotonin receptor antagonists significantly altered IL-6 levels. Nonetheless, when rats were administered a serotonin receptor antagonist and subjected to acute stress (the ASO and ASM groups), the differences in IL6 levels reached statistical significance (p<0.0001). Despite both serotonin antagonists exhibiting comparable effects on immunological response under acute stress, we were unable to observe any alterations in plasma serotonin levels across all groups.
DISCUSSION AND CONCLUSION: These results suggest that the serotonergic system may play a modulatory role in the acute stress-induced immune response and that this modulation is more likely occurring at the receptor level. This phenomenon might be related to desensitization or downregulation of serotonin receptors.

INTRODUCTION: The endocannabinoid system (ECB) is present throughout the human body and has been extensively studied, particularly in the nervous system. Cannabinoid 1 (CB1) ligands and receptors are primarily found in the central nervous system and its cells. Neuroglioma is an aggressive and life-threatening cancer that accounts for approximately 50% of primary central nervous system (CNS) tumors. The treatment protocol for gliomas typically includes surgery, radiation therapy or chemotherapy. In this study, we evaluated the antiproliferative effects of Arachidonoylcyclopropylamide (ACPA), a CB1 receptor agonist, on H4 human neuroglioma cell line.

METHODS: In this study, we investigated the antiproliferative, pro-apoptotic, antimigratory and organelle-stress-related effects of ACPA on H4 neuroglioma cells. xCELLigence cell impedance assay (n=6) was performed on untreated H4 cells exposed to ACPA at half the maximum inhibitory concentration (IC50) dose. Annexin V/PI labeling was performed by flow cytometry on IC50 ACPA-exposed and untreated H4 cells. In addition, immunofluorescence labeling of anti-GRP78, anti-LC3B and anti-beta tubulin antibodies were analyzed to evaluate the effects on organelle-stress relationship (n=3).
RESULTS: The IC50 dose (2.1X10-7 M) of ACPA on H4 cells was determined by xCELLigence cell impedance assay and this dose reduced the proliferation capacity of H4 neuroglioma cells in a dose-time dependent manner (p < 0.05). Flow cytometry analysis showed that cells treated with IC50 ACPA had a higher late apoptotic rate (n=3). Immunofluorescence analysis showed a significant increase in GRP78 and LC3B labeling. Furthermore, a significant decrease in beta tubulin immunolabeling was observed compared to the untreated group (p < 0.05).
DISCUSSION AND CONCLUSION: ACPA induced apoptosis, suppressed proliferation and was able to induce endoplasmic reticulum stress and autophagy in neuroglioma cells. These findings highlight the potential of ACPA as a therapeutic agent for neuroglioma refractory to clinical treatment and warrant further functional validation.

INTRODUCTION: Poisoning due to snake bites, scorpion stings is important public health problem. Determining the current situation very important for future planning. This study aims to make a descriptive epidemiological assessment of snake bites, scorpion stings and the amount of antivenom used in Turkey between 2015-2021 by province.
METHODS: The data on snake bites, scorpion stings for 2015-2020 were requested from the Provincial Health Directorates of the Ministry of Health, Public Health Presidencies, and responses were received from 75 provinces. Data from 38 provinces that met the required standards were evaluated. The antivenom use data for 2016-2021 were obtained from the Ministry of Health, General Directorate of Public Health, Department of Vaccine Preventable Diseases (AOHDB), Logistics Unit. The frequency of use for the provinces was calculated using the Turkish Statistical Institute's Address-Based Population Registration System population. The number and frequency of antivenom use in the provinces were visualized with the mapping program.
RESULTS: According to data collected from 38 provinces in Turkey, 2,486 snake bites, 30,769 scorpion stings occurred between 2015-2020. Among the 38 provinces evaluated, the provinces with the highest number of snake bites were Adana, Mersin, Hatay, respectively, while the top three in scorpion bites were Adana, Malatya, Mersin. The three provinces with the highest bite frequencies were Iğdır, Elazığ, Sinop, for scorpion bites, Iğdır, Van, Niğde, respectively. 22.7% of snake bite cases occurred in 2019, 20.3% of scorpion sting cases occurred in 2019. Antivenom application frequency was found to be 79.0% for snake bites and 49.2% for scorpion bites. The provinces with the highest number of snake, scorpion antivenom use are located in the Southeastern Anatolia and Mediterranean regions. More than 50% of snake and scorpion antivenom use occurred in the summer season. The three provinces with the highest antivenom use frequencies are Kilis, Muğla, Diyarbakır for snakes and Kırıkkale, Aydın, Çankırı for scorpions, respectively. The highest number of scorpion stings and serum use is seen in August, and in snake bites in July. Lack of data and non-standard data entries are striking, especially in bite data collected from provinces.
DISCUSSION AND CONCLUSION: Snake bite, scorpion sting cases are concentrated in the Southeast, Mediterranean, Aegean Regions, especially during the summer months. In order to closely monitor and regularly evaluate all snake bites, scorpion stings, a case registration system should be developed that includes descriptive characteristics of the cases as well as information on the application of antivenom, antiserum, and the location of exposure.

INTRODUCTION: Background and objective: In immunocompromised populations, such as patients living with HIV, parasitic infections and Helicobacter pylori (H. pylori) are a major public health concern. Each of them infects the gastrointestinal tract and causes symptoms that are similar. The goal of this study was to establish the prevalence of H. pylori and its relationship with opportunistic parasites in patients living with HIV, as well as to estimate co-infection risk and predictors.
METHODS: Methodology: In Tehran, Iran, single fecal samples were collected from 70 patients living with HIV ranging in age from 13 to 60 years. To detect ova, cysts, and coccidian, all stool samples were analyzed microscopically with Iodine and acid-fast stain. Using nested-PCR tests, H. pylori and Cryptosporidium copro-DNAs were detected.
RESULTS: Results: Molecularly, H. pylori was detected in 21.4 % of patients living with HIV; opportunistic and intestinal parasites were found in 74.3 %, with Cryptosporidium spp, Entameba. histolytica, and Giardia duodinalis predominating (28.5 %, 27.1 %, and 22.8 % respectively). H. pylori co-infection with Cryptosporidium spp. was detected in (53.85%) and Isospora spp (15, 38 %). The co-infection of Cryptosporidium spp., Isospora belli, various parasites, and H.pylori was reported to be linked with abdominal pain and diarrhoea.
DISCUSSION AND CONCLUSION: Conclusion: Our findings shed light on the prevalence of H. pylori infection in patients living with HIV who also have opportunistic and intestinal parasites. The co-occurrence of H. pylori and Cryptosporidium could support the theory of co-infection. More research is needed to confirm the link between gut microbiomes and opportunistic and intestinal parasites, whether H. pylori provides appropriate conditions for them or vice versa.

INTRODUCTION: Autoimmune hepatitis (AIH) is a chronic liver disease characterized by increased inflammation formation in hepatocytes, which can progress to liver failure if not treated. The aim of this study was to compare patients with and without anti-F-actin staining pattern in the anti-smooth muscle antibodies (ASMA) positive population in terms of the presence of type 1 AIH using clinical and laboratory data.
METHODS: The study included 240 ASMA positive patients, 120 of whom had anti-F-actin staining and 120 without. After treating HEp-20-10 cells with samples from the patients, tests were done to check for anti-filamentous-actin (F-actin) staining and ASMA positivity using indirect immunofluorescence.

RESULTS: Antinuclear antibody (ANA) positivity was 45.8% in patients with an anti-F-actin staining pattern and 29.2% in those without (p=0.008). ASMA titers were higher in the anti-F-actin staining group than in the group without anti-F-actin staining (p<0.001). Laboratory findings showed higher AST, ALT, and immunoglobulin G values in the anti-F-actin group (p values <0.001, 0.002, and 0.006, respectively). Among type 1 50 AIH patients, 60% of those with an anti-F-actin staining pattern tested positive for ANA, while only 40% of those without this pattern did (p=0.123). In type 1 AIH patients, the anti-F-actin staining pattern associated with greater AST, ALT, GGT, total bilirubin, and CRP (p values <0.001, <0.001, <0.001, 0.015, 0.015, respectively), but albumin was lower (p=0.009). The research focused on young females aged 15 to 25 who had high levels of anti-F-actin antibodies, making up 48.7% of type 1 AIH cases. 25% of anti-F-actin-like staining patients were 15–25-year-old women. 66.6% of 15–25-year-old women had type 1 AIH. The group with anti-F-actin staining showed no link between actin titer and ANA positivity (p = 0.210), whereas type 1 AIH was considerably higher with a higher titer (p<0.001). As the ASMA titer grew, the number of patients with type 1 AIH dramatically increased (p<0.001). As actin titer increased, ASMA titer also considerably increased (p<0.001). A diagnosis of type 1 AIH was found in 20.2% of patients with anti-F-actin titers of 1/160, while 56.5% of patients with titers of 1/320 and higher had a diagnosis (p<0.001).
DISCUSSION AND CONCLUSION: Anti-F-actin antibodies can be found in various diseases, including both liver and non-liver diseases, usually at low levels, but they are of great importance for the diagnosis of type 1 AIH, especially in young women.

INTRODUCTION: The purpose of this study is to measure the attitudes of nurses working at the Health Care Services Directorate of a public hospital in Ankara towards ageism, to determine which sociodemographic variables influence these attitudes, and to map the perceptions, values, and biases that nurses hold in care processes for elderly individuals. Based on the findings, the study aims to provide a basis for awareness, training, and policy development studies against ageism.

METHODS: This descriptive and cross-sectional study was conducted with nurses providing patient care services in a public hospital in Ankara. According to a 95% confidence level and 5% margin of error, the minimum sample size was determined to be 322 participants. Data were collected online via Google Forms between January 30 and February 28, 2025. Data collection tools included a sociodemographic information form and the Ageism Attitude Scale developed by Vefikuluçay (2008). The scale consists of three sub-dimensions, and high scores indicate positive attitudes towards elderly individuals. Data were analyzed using SPSS 26.0; normal distribution was evaluated with the Shapiro–Wilk test, and appropriate parametric and non-parametric tests were applied.
RESULTS: The findings of the study show that nurses generally display a positive attitude towards elderly individuals. Perceptions regarding care processes for the elderly differed depending on demographic variables such as education level, years of experience, and age. These findings indicate that sensitivity to ageism in health services still has room for improvement.

DISCUSSION AND CONCLUSION: The study revealed that nurses’ attitudes towards elderly individuals play a critical role in providing health services in a manner that respects human dignity. It was concluded that ageism is not limited to individual attitudes but is also influenced by institutional culture and administrative structures. Therefore, it is important that ageing-related content should be strengthened in nursing education, in-service training should be restructured on the basis of ethical awareness, and social policies centred on elderly rights should be implemented.

INTRODUCTION: As digital platforms are increasingly used to share health information, evaluating the quality of these contents is of critical importance for public health. This study aims to scientifically examine the most watched videos on hand hygiene on YouTube during the COVID-19 pandemic.

METHODS: By searching with the keyword “COVID-19 hand hygiene” in January 2025, the 100 most watched videos published during the COVID-19 pandemic period (March 11, 2020 – May 5, 2023) were evaluated. Videos that were shorter than 30 seconds, advertising/propaganda, repetitive, or had poor image quality were excluded. Content was evaluated by two independent researchers using the DISCERN scale and JAMA criteria.
RESULTS: The total number of views of the videos was over 200 million; the average duration was 6.8±4.2 minutes. 76.4% of the content was general information, 11.8% was hands-on demonstration, 8.2% was misinformation correction, and 4.6% was product promotion. The mean DISCERN score was 45.8±10.6; 20% of the videos were categorized as “excellent”, 18% as “good”, 34% as “fair”, 20% as “poor” and 8% as “very poor”. The DISCERN score of health professional videos (52.4±8.2) was significantly higher than that of individual user videos (39.6±7.8) (p<0.001). The mean JAMA score was 2.6±0.7, and the citation criterion had the lowest fulfillment rate (28.0%). Additionally, a weak positive correlation was found between video duration and quality (p=0.41; p<0.001). However, there was no significant relationship between the number of views, likes or comments and video quality.
DISCUSSION AND CONCLUSION: During the COVID-19 pandemic, the overall scientific quality of YouTube videos on “COVID-19 pandemic and hand hygiene” is insufficient. Content produced by healthcare professionals and official institutions is more reliable. To protect public health, the visibility of reliable videos should be increased, digital health literacy should be strengthened, and users should be guided correctly in accessing information.

The incidence of invasive fungal infections has increased significantly in recent years. There are hundreds of Candida species that cause invasive candidiasis. The most common species causing infections include C. albicans, Nakaseomyces glabrata (C. glabrata), C. parapsilosis, C. tropicalis and Pichia kudriavzevii (C. krusei). Candida albicans is the most frequently detected microorganism that causes candidiasis. Detection of the microorganism that poses a risk for invasive fungal infections and application of antifungal sensitivity tests are of great importance for the treatment of patients. The study demonstrates the effective use of the clinical microbiology laboratory in terms of laboratory diagnosis of invasive fungal infection and directing treatment. A 49-year-old male patient, who underwent femoral popliteal bypass surgery at an external center due to peripheral vascular artery disease, was admitted to Ağrı Training and Research Hospital due to discharge and increased temperature in the left popliteal region. The tissue biopsy sample of the patient, who was re-operated by Cardiovascular Surgery, was sent to the Medical Microbiology Laboratory. Gram-stained microscopic examination was performed on the tissue biopsy sample. For culture, cultivation was done on %5 sheep blood agar, EMB agar, chocolate agar, Saboraud dextrose agar and chromogenic Candida agar. Gram staining and germ tube testing were performed on pure colonies. Species level identification and antifungal susceptibility testing were performed with the VITEK-2 Compact (Biomerioux, France) device. Gram-stained microscopic examination of the tissue biopsy sample revealed pseudohyphae and budding yeast fungi. Green and well-circumscribed colonies were detected on chromogenic Candida agar and the germ tube test was positive. It was identified as Candida albicans at species level with the VITEK-2 Compact (Biomerioux, France) device. Fluconazole was added to the patient’s treatment. He was discharged after two weeks of treatment. In invasive fungal infections identification of the infective pathogen and performing antifungal susceptibility tests guide the clinician in applying effective antifungal therapy in treatment. As a result, microbiological diagnostic methods were used effectively in the study and the treatment was implemented as quickly as possible.

Toxoplasma gondii (T. gondii) is an obligate intracellular zoonotic protozoan that can be transmitted to humans through consumption of infected food, blood or organ transplantation, and vertical transmission to the fetus. While infections in healthy individuals are usually asymptomatic, they can be serious and life-threatening in immunocompromised patients, congenitally infected fetus and newborns. Infections in immunocompetent individuals are usually self-limiting, after the acute period, the parasite has the ability to persist in the bradyzoite form in the tissue cyst for years. In immunocompetent hosts, tissue cysts can persist for years and current treatments or the immune system cannot eliminate tissue cysts. Intact tissue cysts do not cause an immune response and an inflammatory response in the host. The immune response to Toxoplasma infection is complex. In immunocompetent hosts, infection is controlled by a strong innate and adaptive immune response that leads to elimination of the majority of parasites. Innate immunity is the first line of defence. Macrophages, neutrophils, dendritic cells (DC) and NK cells produce proinflammatory cytokines, particularly IL-12, to limit infection. IL-12-producing dendritic cells play an important role not only in stimulating the innate response but also in shaping adaptive immunity. IL-12 stimulates the proliferation of NK cells, CD4+ T and cytotoxic CD8+ T cells, leading to IFN-γ production. IFN-γ is the major cytokine involved in the protection of the infected host as it limits tachyzoite growth. IFN-γ mediates host protection through multiple mechanisms, including induction of the antimicrobial molecules nitric oxide and reactive oxygen species. Although CD4+ and CD8+ T lymphocytes play a synergistic role in the immune response to chronic toxoplasmosis, CD8+ T lymphocytes are critical in immunity against chronic T. gondii infection by producing IFN-γ and exhibiting perforin-dependent cytolytic activity against infected cells. Although the role of humoral immunity in host protection is often underestimated, immunoglobulins are important in high levels of cytotoxicity and parasite lysis by activating the complement system and triggering agglutination. Progress has been made in the development of effective vaccines against toxoplasmosis, but developing an ideal vaccine remains a significant challenge due to the complexity of the T. gondii genome, life cycle and strain diversity. In this review, we aimed to analyze the current research on the intracellular survival strategies of the parasite, the immune mechanisms triggered in the host, and the complex relationship between host and parasite during T. gondii infection.