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1.
Darko Vucicevic Janis E. Blair Matthew J. Binnicker Ann E. McCullough Shimon Kusne Holenarasipur R. Vikram James M. Parish Nancy L. Wengenack 《Mycopathologia》2010,170(5):345-351
Coccidioidomycosis, the fungal infection caused by dimorphic Coccidioides sp., is typically diagnosed by histopathologic identification of spherules in affected secretions and tissues or by culture.
These tests are reliable but time-intensive, delaying diagnosis and treatment. To evaluate a polymerase chain reaction (PCR)
test developed to detect Coccidioides sp. in clinical specimens, we conducted a retrospective chart review of all patients (N = 145) who underwent Coccidioides PCR at our institution between April 27, 2007, and May 6, 2008, abstracting clinical, microbiologic, serologic, radiographic,
treatment, and follow-up data. One hundred fifty-eight PCR tests (153 respiratory; 5 cerebrospinal fluid) produced 5 positive
and 153 negative findings. Five of nine patients (56%) with confirmed or highly probable pulmonary coccidioidomycosis had
a positive PCR on respiratory specimens, and four of nine (44%) had a positive culture. Among two patients with coccidioidal
meningitis, none had a positive PCR, whereas Coccidioides sp. in fungal culture grew for one of two. Among six asymptomatic patients with probable coccidioidomycosis, none had a positive
culture or PCR. Compared with culture of respiratory specimens, PCR demonstrated a sensitivity, specificity, positive predictive
value, and negative predictive value of 75, 99, 60, and 99%, respectively. Coccidioides PCR appears accurate in identifying negative results, and its sensitivity is similar to that of fungal culture. 相似文献
2.
Neil M. Ampel Sara O. Dionne Andrea Giblin Abigail B. Podany John Galgiani 《Mycopathologia》2009,167(4):173-180
Background Mannose-binding lectin (MBL) is a circulating collectin that is part of the innate immune response. We explored the serum
levels of MBL in persons with different forms of coccidioidomycosis.
Methods Serum MBL was measured by ELISA from samples obtained from healthy donors with immunity to Coccidioides, and those with various forms of active coccidioidomycosis. Blood cell specimens from a subgroup of subjects with active
coccidioidomycosis were examined for single nucleotide polymorphisms of the MBL gene and promoter regions.
Results The control group comprised 29 healthy immune subjects. Patient groups with active coccidioidomycosis consisted of 20 patients
with symptomatic primary pulmonary coccidioidomycosis, 26 with non-meningeal disseminated coccidioidomycosis, and nine with
coccidioidal meningitis. The group with active coccidioidomycosis was significantly older and more likely to be male than
the control group (for both, P < 0.001). The mean ± SEM level of serum MBL in the healthy controls was 169.4 ± 28.6 ng/ml, significantly higher than the
79.2 ± 10.9 ng/ml for all active groups (P < 0.001). Moreover, the active coccidioidomycosis group was significantly more likely to have serum MBL level ≤70 ng/ml compared
to the control group (P = 0.001). Genetic analysis in 27 subjects with active coccidioidomycosis revealed marked variation based on race and ethnicity.
Among a subgroup of 10 white, non-hispanic men with active coccidioidomycosis, there was a significant association between
the H and P haplotypes and MBL levels ≤70 ng/ml (P < 0.036 and P < 0.035, respectively).
Conclusions These data suggest that there is an association between low serum MBL levels and symptomatic coccidioidomycosis. 相似文献
3.
4.
Cunwei Cao Glenn Bulmer Jushang Li Ling Liang Youkun Lin Yongjia Xu Qinghua Luo 《Mycopathologia》2010,170(1):47-50
This is the first indigenous case of disseminated histoplasmosis reported from the Penicillium marneffei endemic area in southern China. It was diagnosed by histopathology of tissue, gross and microscopic morphology of the culture
and PCR assay of the isolated fungus. Successful antifungal treatment was with itraconazole 400 mg/day for 5 months. This
case suggests that histoplasmosis should be an important differential diagnosis in immunocompromised patients in southern
China and South East Asia (the only endemic area for P. marneffei). 相似文献
5.
Coccidioidomycosis is a systemic infection caused by Coccidioides spp. The disease is endemic in Brazil but its incidence is underreported as it is not a notifiable disease. This article
presents the results of a serologic survey carried out with 229 volunteers in northeast Brazil by the immunodiffusion (ID)
test with commercial Coccidioides spp. antigens. The commercial ID test detected 15 individuals without clinical diagnosis of the disease and two individuals
in treatment for coccidioidomycosis. Regarding the epidemiological data, most of the positive individuals were male, between
18 and 65 years of age and were engaged in armadillo hunting. Three women who had never participated in armadillo hunts also
displayed positive results for coccidioidal antibodies. Besides armadillo hunts, exposure to environmental dust in endemic
areas may account for the serologic response detected in the study. The data from this study suggest the importance of performing
epidemiological surveys for coccidioidomycosis in order to understand the prevalence of this disease in Brazil. 相似文献
6.
The pathogenicity of Trichosporon dermatis isolated from skin lesions of a patient has been examined in mice. Balb/c mice were treated with two intraperitoneal injections
of 100 mg/kg cyclophosphamide on days 4 and 1 and one subcutaneous injection of 10 mg/kg dexamethasone on day 1 pre-inoculation,
and then challenged with 0.2 ml T. dermatis inoculum (1 × 108 CFU/ml) by topical application on an abrasive wound in the dermabrasive group and by hypodermic injection in the subcutaneous
group. In the intravenous group, 0.2 ml of high (1 × 108 CFU/ml) or low (1 × 107 CFU/ml) inoculum was injected into the tail vein. Histopathology and inverse fungal culture were performed on the skin lesion
and viscera, and renal fungal burden was also determined. Inoculated sites developed localized infections after dermabrasive
and subcutaneous challenge in all mice, but the maximum area of skin lesions, and number of positive cultures from the lesions,
were higher for immunocompromised mice. In the intravenous group, all immunocompetent animals survived during the four-week
period, whereas 100 and 70% of immunocompromised animals died by 3 and 5 days in the high and low-inoculum groups, respectively.
The incidence of disseminated infection and the renal fungal burden of immunocompromised mice were higher than those of immunocompetent
mice. Our results demonstrate that subcutaneous and intravenous injection of T. dermatis can successfully establish cutaneous and systemic infection models in immunocompromised mice, with the kidney and lung being
most susceptible. 相似文献
7.
Kumar J Fish D Burger H Weiser B Ross JS Jones D Robstad K Li X Chaturvedi V 《Mycopathologia》2011,172(4):287-292
Candida parapsilosis is an uncommon cause of invasive endocarditis. This pathogen induces severe complications and carries a high mortality rate.
We describe a case of C. parapsilosis endocarditis in a 54-year-old man with a history of HIV and Hepatitis C infection who previously underwent prosthetic valve
replacement due to bacterial endocarditis. The patient presented with prolonged febrile episodes and fungemia with repeat
blood cultures positive for C. parapsilosis. The patient failed multiple regimens of antifungal therapy and the C. parapsilosis isolate progressively acquired resistance to a number of drugs. Due to the multidrug resistant nature of the isolate, replacement
of the infected valve was required to resolve his fungemia, and the patient remained asymptomatic for two years. This case
is unusual due to the multidrug resistant nature of the isolate requiring both combined medical and surgical intervention.
A review of published reports indicates that endocarditis due to C. parapsilosis responds well to a combination of medical and surgical interventions; the latter is particularly suitable for immunocompromised
hosts. 相似文献
8.
Background
Bordetella holmesii is a human pathogen closely related to B. pertussis, the etiological agent of whooping cough. It is able to cause disease in immunocompromised patients, but also whooping cough-like symptoms in otherwise healthy individuals. However, virtually nothing was known so far about the underlying virulence mechanisms and previous attempts to identify virulence factors related to those of B. pertussis were not successful. 相似文献9.
Coccidioidomycosis is common in the southwestern United States, northern Mexico, and areas of South America. Coccidioides immitis and Coccidioides
posadasii form arthroconidia that, if inhaled, can cause respiratory infection. Rarely, the organism disseminates throughout the body,
causing disease in bones, lymph nodes, skin, joints, and brain in most severe cases. Certain populations are at higher risk
for dissemination, including persons with compromised cellular immunity. This group includes patients with human immunodeficiency
virus, patients undergoing immunosuppression for rheumatologic disorders, and patients receiving antirejection therapy after
organ transplant. For patients undergoing a solid organ transplant in endemic areas, screening for past or present coccidioidal
disease is completed pretransplantation. Those with known disease are given triazole therapy to prevent reactivation of disease
posttransplantation. Usually, transplantation is postponed if the disease is active. We present a patient with known, active
coccidioidomycosis who underwent successful liver transplant and later had subclinical posttransplantation peritoneal dissemination. 相似文献
10.
Anti‐Helicobacter pylori therapy in localized gastric mucosa‐associated lymphoid tissue lymphoma: A prospective,nationwide, multicenter study in Japan
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Katsuya Sugizaki Akira Tari Yasuhiko Kitadai Ichiro Oda Shotaro Nakamura Tadashi Yoshino Toshiro Sugiyama 《Helicobacter》2018,23(2)
Background
Helicobacter pylori eradication therapy was approved in Japan for the first‐line, standard treatment of H. pylori‐positive gastric mucosa‐associated lymphoid tissue (MALT) lymphoma. Although several retrospective studies or small‐scale single‐center studies have been reported, a prospective, large‐scale, nationwide, multicenter study has not been reported from Japan.Materials and Methods
We conducted a prospective, nationwide, multicenter study to evaluate the clinical efficacy of rabeprazole‐based triple H. pylori eradication therapy for patients with localized gastric MALT lymphoma in practice‐based clinical trial. A total of 108 H. pylori‐positive patients with stage I/II1 gastric MALT lymphoma underwent H. pylori eradication therapy. The primary endpoints were complete remission (CR) rate and the rate of transfer to secondary treatment. The secondary endpoints were CR maintenance duration and overall survival (OS).Results
CR of lymphoma was achieved in 84 of 97 patients (86.6%), during the period 2.0‐44.7 months (median, 5.3 months) after starting H. pylori eradication treatment. CR was maintained in 77 of 81 patients (95.1%) for 0.4‐53.2 months (median, 33.1 months). Secondary treatments (radiotherapy, rituximab, or gastrectomy) for gastric MALT lymphoma were needed in 10 of the 97 patients (10.31%). During follow‐up, OS rate was 96.9% (94/97) and the causes of 3 deaths were not related to lymphoma.Conclusions
Rabeprazole‐based H. pylori eradication therapy demonstrated a high CR rate, long CR maintenance, and a good OS for patients with localized gastric MALT lymphoma in this prospective, practice‐based, multicenter study. 相似文献11.
《Cancer epidemiology》2014,38(1):56-61
Introduction: Antigenic stimulation is a proposed aetiologic mechanism for many haematological malignancies. Limited evidence suggests that community-acquired infections may increase the risk of acute myeloid leukaemia (AML) and myelodysplastic syndrome (MDS). However, associations with other myeloid malignancies including chronic myeloid leukaemia (CML) and myeloproliferative neoplasms (MPNs) are unknown. Materials and methods: Using the Surveillance, Epidemiology and End Result (SEER)-Medicare database, fourteen community-acquired infections were compared between myeloid malignancy patients [AML (n = 8489), CML (n = 3626) diagnosed 1992–2005; MDS (n = 3072) and MPNs (n = 2001) diagnosed 2001–2005; and controls (200,000 for AML/CML and 97,681 for MDS/MPN]. Odds ratios (ORs) and 95% confidence intervals were adjusted for gender, age and year of selection excluding infections diagnosed in the 13-month period prior to selection to reduce reverse causality. Results: Risk of AML and MDS respectively, were significantly associated with respiratory tract infections, bronchitis (ORs 1.20 [95% CI: 1.14–1.26], 1.25 [95% CI: 1.16–1.36]), influenza (ORs 1.16 [95% CI: 1.07–1.25], 1.29 [95% CI: 1.16–1.44]), pharyngitis (ORs 1.13 [95% CI: 1.06–1.21], 1.22 [95% CI: 1.11–1.35]), pneumonia (ORs 1.28 [95% CI: 1.21–1.36], 1.52 [95% CI: 1.40–1.66]), sinusitis (ORs 1.23 [95% CI: 1.16–1.30], 1.25 [95% CI: 1.15–1.36]) as was cystitis (ORs 1.13 [95% CI: 1.07–1.18], 1.26 [95% CI: 1.17–1.36]). Cellulitis (OR 1.51 [95% CI: 1.39–1.64]), herpes zoster (OR 1.31 [95% CI: 1.14–1.50]) and gastroenteritis (OR 1.38 [95% CI: 1.17–1.64]) were more common in MDS patients than controls. For CML, associations were limited to bronchitis (OR 1.21 [95% CI: 1.12–1.31]), pneumonia (OR 1.49 [95% CI: 1.37–1.62]), sinusitis (OR 1.19 [95% CI: 1.09–1.29]) and cellulitis (OR 1.43 [95% CI: 1.32–1.55]) following Bonferroni correction. Only cellulitis (OR 1.34 [95% CI: 1.21–1.49]) remained significant in MPN patients. Many infections remained elevated when more than 6 years of preceding claims data were excluded. Discussion: Common community-acquired infections may be important in the malignant transformation of the myeloid lineage. Differences in the aetiology of classic MPNs and other myeloid malignancies require further exploration. 相似文献
12.
Hanxiang Zeng Xiqing Li Xiejie Chen Junmin Zhang Jiufeng Sun Zhi Xie Liyan Xi 《Mycopathologia》2009,168(1):31-35
Penicillium marneffei is one of the unique thermally dimorphic fungi in Penicillium species that causes a disseminated, progressive and life threatening
infection in immunocompromised patients. The diagnosis of Penicilliosis marneffei depends on culture that may delay the treatment due to the time-consuming process. In the present study, we evaluated the
specificity and sensitivity of nested PCR to identify Penicillium marneffei from paraffin-embedded tissue. Two sets of oligonucleotide primers were derived from the sequence of 18S rRNA of Penicillium marneffei. The outer primers (RRF1 and RRH1) were specific to fungi. The inner primers (Pm1 and Pm2) were specific to Penicillium marneffei. The specific fragment of approximately 400 bp was amplified from all paraffin-embedded tissues from 14 patients with Penicilliosis
marneffei and 10 bamboo rats. The detectable DNA concentration of single PCR and nested PCR were 14 pg/μl and 14 fg/μl, respectively.
Further studies are required in order to use nested PCR for early diagnosis of the disease. 相似文献
13.
Kourkoumpetis TK Velmahos GC Ziakas PD Tampakakis E Manolakaki D Coleman JJ Mylonakis E 《Mycopathologia》2011,171(2):85-91
Fluconazole is the first line of therapy for the management of candidiasis. However, fluconazole-resistant strains pose an
emerging challenge in everyday clinical practice. In this study, we sought to determine whether cumulative length of hospital
stay (CLOS) is a predictive factor for the acquisition of non-susceptible Candida strains to fluconazole. Thirty-three critically ill emergency surgery patients with 56 Candida isolates were enrolled in this prospective study. We divided our isolates according to their minimum inhibitory concentration
(MIC) to fluconazole using 8 mcg/ml as a cutoff. We then compared the two groups with respect to basic demographics, antifungal
agents prescribed, number of wide-spectrum antibiotics, duration of central venous catheter placement, elapsed time to positive
culture, duration of prior hospital stay, and length of hospital stay. Non-susceptible fluconazole samples belonged to patients
with a significantly longer prior hospital stay and a longer CLOS (P = 0.02 and 0.01, respectively). The difference between the 2 groups regarding non-albicans strains was statistically significant (P < 0.001). By fitting a non-parametric receiver-operating characteristics (ROC) curve into our analysis, a CLOS ≥ 29 days
predicted the occurrence of non-susceptible strains with 90% sensitivity and 79.6% specificity (correct classification 81.5%).
A CLOS ≥ 29 days is a strong predictor for the isolation of non-susceptible Candida isolates to fluconazole among critically ill emergency surgery patients. Clinicians should consider the duration of previous
hospital stay when deciding on empiric antifungal therapy. 相似文献
14.
Krystyna Konopka Barbara Dorocka-Bobkowska Senait Gebremedhin Nejat Düzgüneş 《Antonie van Leeuwenhoek》2010,97(4):413-417
Candida-associated denture stomatitis has a high rate of recurrence. Candida biofilms formed on denture acrylic are more resistant to antifungals than planktonic yeasts. Histatins, a family of basic
peptides secreted by the major salivary glands in humans, especially histatin 5, possess significant antifungal properties.
We examined antifungal activities of histatin 5 against planktonic or biofilm Candida albicans and Candida glabrata. Candida biofilms were developed on poly(methyl methacrylate) discs and treated with histatin 5 (0.01–100 μM) or fluconazole (1–200 μM).
The metabolic activity of the biofilms was measured by the XTT reduction assay. The fungicidal activity of histatin 5 against
planktonic Candida was tested by microdilution plate assay. Biofilm and planktonic C. albicans GDH18, UTR-14 and 6122/06 were highly susceptible to histatin 5, with 50% RMA (concentration of the agent causing 50% reduction
in the metabolic activity; biofilm) of 4.6 ± 2.2, 6.9 ± 3.7 and 1.7 ± 1.5 μM, and IC50 (planktonic cells) of 3.0 ± 0.5, 2.6 ± 0.1 and 4.8 ± 0.5, respectively. Biofilms of C. glabrata GDH1407 and 6115/06 were less susceptible to histatin 5, with 50% RMA of 31.2 ± 4.8 and 62.5 ± 0.7 μM, respectively. Planktonic
C. glabrata was insensitive to histatin 5 (IC50 > 100 μM). Biofilm-associated Candida was highly resistant to fluconazole in the range 1–200 μM; e.g. at 100 μM only ~20% inhibition was observed for C. albicans, and ~30% inhibition for C. glabrata. These results indicate that histatin 5 exhibits antifungal activity against biofilms of C. albicans and C. glabrata developed on denture acrylic. C. glabrata is significantly less sensitive to histatin 5 than C. albicans. 相似文献
15.
Jin-Ha Jeong Young-Dong Jeon O-Mi Lee Jeong-Do Kim Na-Ri Lee Geun-Tae Park Hong-Joo Son 《Biodegradation》2010,21(6):1029-1040
In this study, we isolated and characterized a novel feather-degrading bacterium that shows keratinolytic, antifungal and
plant growth-promoting activities. A bacterium S8 was isolated from forest soil and confirmed to belong to Bacillus subtilis by BIOLOG system and 16S rRNA gene analysis. The improved culture conditions for the production of keratinolytic protease
were 0.1% (w/v) sorbitol, 0.3% (w/v) KNO3, 0.1% (w/v) K2HPO4, 0.06% (w/v) KH2PO4 and 0.04% (w/v) MgCl2·6H2O (pH 8.0 and 30°C), respectively. In the improved medium containing 0.1% (w/v) feather, keratinolytic protease production
was around 53.3 ± 0.3 U/ml at 4 day; this value was 10-fold higher than the yield in the basal feather medium (5.3 ± 0.1 U/ml).
After cultivation for 5 days in the improved medium, intact feather was completely degraded. Feather degradation resulted
in free –SH group, soluble protein and amino acids production. The concentration of free –SH group in the culture medium was
15.5 ± 0.2 μM at 4 days. Nineteen amino acids including all essential amino acids were produced in the culture medium; the
concentration of total amino acid produced was 3360.4 μM. Proline (2809.9 μM), histidine (371.3 μM) and phenylalanine (172.0 μM)
were the major amino acids released in the culture medium. B. subtilis S8 showed the properties related to plant growth promotion: hydrolytic enzymes, ammonification, indoleacetic acid (IAA),
phosphate solubilization, and broad-spectrum antimicrobial activity. Interestingly, the strain S8 grown in the improved medium
produced IAA and antifungal activity, indicating simultaneous production of keratinolytic and antifungal activities and IAA
by B. subtilis S8. These results suggest that B. subtilis S8 could be not only used to improve the nutritional value of feather wastes but also is useful in situ biodegradation of
feather wastes. Furthermore, it could also be a potential biofertilizer or biocontrol agent applicable to crop plant soil. 相似文献
16.
Design,Synthesis, and Antifungal Activities of Novel 1,2,4‐Triazole Schiff Base Derivatives
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With the aim to find new compounds with high antifungal activity, 21 4‐amino‐5‐substituted‐1,2,4‐triazole Schiff bases ( 2a – 2g , 3a – 3g , and 4a – 4g ) were designed and synthesized. Their antifungal activities against Pythium solani, Gibberlla nicotiancola, Fusarium oxysporium f. sp. niveum, Gibberlla saubinetii, Alternaria iycopersici, Phytophthora capsici, Physalospora piricola, Cercospora arachidicola hori, and Fusarium oxysporium f. sp. cucumber were tested, parts of the compounds exhibited excellent antifungal activity. This research provides useful information for further study of antifungal agents. 相似文献
17.
18.
Chemical Composition and in vitro Biological Activities of Essential Oils from Conchocarpus fontanesianus (A. St.‐Hil.) Kallunki & Pirani (Rutaceae)
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This study aimed at assessing the chemical composition of the essential oils from leaves and fruits of Conchocarpus fontanesianus, an endemic Brazilian species of Rutaceae. The plant material was harvested from two regions of the Atlantic rainforest in the State of São Paulo. The volatile compounds in the essential oils were extracted by hydrodistillation (HD), and analyzed by GC/FID and GC/MS, allowing the quantification and identification of 54 components in total, which comprise about 97% of the total oil composition. From the leaves collected in Caraguatatuba and Juréia‐Itatins, the major volatile compounds identified were as follows: spathulenol (22.32% and 16.67%) and α‐cadinol (9.7% and 14.76%). However, β‐myrcene (34.56%), (+)‐epi‐bicyclosesquiphellandrene (8.71%), and bicyclogermacrene (5.80%) were dominant in the fruits collected only in Juréia‐Itatins. The in vitro biological activities were tested to evaluate the cytotoxic, antifungal, and antioxidant potential of essential oils from leaves and fruits. 相似文献
19.
Rhodotorula species are commensal yeasts that have emerged as a cause of life-threatening fungemia in severely immunocompromised patients. A case of Rhodotorula mucilaginosa fungemia in a 48-year-old woman that had undergone consecutive abdominal surgeries due to ovarian cancer and bowel necrosis while she was receiving fluconazole prophylaxis is presented. Several risk factors were identified such as presence of central venous catheters, solid organ neoplasm, abdominal surgery and administration of antibiotics. Identification was performed using commercial systems. The yeast was resistant to fluconazole, posaconazole and voriconazole and to echinocandins, whereas MIC to amphotericin B was 1.5?mg/L. Furthermore, published cases of Rhodotorula spp fungemia during the last decade are reviewed. In conclusion, Rhodotorula spp must be considered a potential pathogen in patients with immunosupression and central venous catheters. Correct identification is mandatory for appropriate management, as Rhodotorula spp are resistant to antifungal agents, such as fluconazole and echinocandins. 相似文献
20.
Objectiveto asses the characteristics and factors associated with falls during hospitalisation among elderly stroke patients.Material and methodswe studied 1,410 subjects (60.1% female), aged 65 years and older (80.6 ± 6.9 years), admitted to a geriatric stroke unit between 2000 and 2003. We recorded demographic, clinical and functional variables and evaluated the characteristics and management of falls. The variables showing an association with falls in bivariate analyses were subsequently included in a multivariate logistic regression analysis.Resultsthe incidence rate of falls was 10.49% in 115 patients. The variables showing statistical association (p < 0.05) with falls were age (78.7 vs 80.8) and gender (10.5% male vs 6.6% female), arm strength (2.8 vs 2.3), leg strength (3.2 vs 2.6) and being classified in the group with moderate stroke (47.8%) compared with patients without falls (29.3%). Falls were more frequent in patients with depression (13% vs 7%) and delirium (27% vs 6%). The variables that remained significant in the multivariate logistic regression model for falls were: delirium (OR = 4.691 [2.930-7.511]), mild stroke (OR: 0.347 [0.154-0.782]), age (OR = 0.958 [0.929-0.987]), depression (OR = 1.760[1.095-2.828]), arm strength (OR = 1.233 [1.058-1.438]), and Barthel Index prior to the fall (OR = 1.013 [1.002-1.024]).Conclusionspatients with falls are younger, with a higher previous functional status and with lesser neurological severity on admission. The presence of depression and delirium are frequently associated. 相似文献