Pathogenesis of a newly isolated rat virus in newborn and juvenile rats.

The pathogenesis of the UT-1 strain, a newly isolated rat virus (RV), in juvenile and newborn rats was examined. Intracerebrally (ic) inoculated newborns developed severe pantropic infections resulting in emaciation, stunted growth, diarrhea, dehydration and icterus, and died 13 to 15 days after the inoculation. Newborns inoculated intraperitoneally (ip) developed similar, but milder diseases. The virus replicated in all the organs tested, which was followed by severe viremia. Histopathologically, diffuse vacuolation and necrosis of the hepatocytes were observed in the liver. Juvenile rats inoculated with the virus showed neither clinical signs nor histopathologic lesions, although viral recovery and antibody production were observed. Thus, we conclude that the UT-1 strain of RV caused asymptomatic infections in juvenile rats, and fatal infections with hepatic lesions in newborn rats.     

Critical roles of amino acids Ser231, His107 and Asp156 of Staphylococcus sciuri exfoliative toxin C (ExhC) in the induction of skin exfoliations in neonate mice

Staphylococcus sciuri is a rare pathogen in humans, but it can cause a wide array of human infections. Recently a strain of S. sciuri (HBXX06) carrying exfoliative toxin C (ExhC) was reported to cause fatal exudative epidermitis in piglets and might be considered as a potential zoonotic agent. However, little is known regarding the pathogenicity of this bacterium. In this study, we predicted the three-dimensional structure of S. sciuri HBXX06 ExhC and replaced Ser231 or His107 or Asp156 in the active site of ExhC by site-directed mutagenesis, and examined the effects of mutant ExhC on BHK-21 cells and newborn mice as models. Interestingly, we found that mutant ExhC lost its exfoliative effects on newborn mice but could still induce necrosis in cultured cells if any one of the three amino acid residues in the active site was replaced. These results suggest that Ser231, His107 and Asp156 of ExhC play a critical role in the induction of skin exfoliation in neonate mice, which may help to further understand the mechanisms underlying the actions of exfoliative toxins.     

Immunoglobulin Levels in Newborn Infants with Hepatosplenomegaly

Serum IgM and IgA levels were measured in 97 newborn infants with and 141 without hepatosplenomegaly. All were considered normal at birth and had no apparent disease on clinical examination. Thirty per cent. of the infants with hepatosplenomegaly were found to have IgM levels of 20 mg/100 ml or greater, a level established as abnormal when compared with the control group. The number of infants with raised IgM level and the geometric mean level were significantly different (P < 0·001) from those in the control group. No difference, however, was found in serum IgA levels between the two groups of infants. The results suggest that intrauterine infections may sometimes be the cause of hepatosplenomegaly in newborn infants without apparent disease.     

Host defense deficiency in newborn nonhuman primate lungs

We have investigated two major aspects of the pulmonary host defense mechanism--alveolar macrophage function as a "first line of bacterial defense" and induced neutrophil migration into the lung as a "back-up defense." Chemotactic and phagocytic/killing assays revealed a functional deficiency in the alveolar macrophages of newborn primates. Serial bronchoalveolar lavage investigations revealed diminished neutrophil migration into the newborn primate lung. The overall pulmonary host defense capability in newborn primates was deficient. The results of this investigation may have direct clinical relevance to the susceptibility of newborns to infections and pneumonia.     

Effect of Candida albicans dsDNA in Gastrointestinal Candida Infection

Neonates are highly sensitive to infections because they are biased to develop Th2 immune responses. When exposed to certain agents, such as DNA vaccines or CpG DNA motifs, neonates are capable to mount adult-like Th1 protective responses. This study investigates the capacity of Candida albicans (C. albicans) dsDNA to induce host resistance in newborn mice against gastrointestinal C. albicans infection. The protective properties of dsDNA are related to an increased number of spleen CD4+ T cells secreting IFN-γ. In infected DNA-treated mice, an enhanced production of IFN-γ by Peyer’s patch cells was observed together with reduced colonization and histopathological changes in the stomach. Our results indicated that C. albicans dsDNA administration in neonates elicited the protective immune response against gastrointestinal Candida infection.     

Treatment options in emerging mold infections

Although Zygomycetes, Fusarium spp, and Scedosporium spp are far less frequent causes of invasive fungal disease than Aspergillus and Candida, they are emerging. These types of infections in severely immunocompromised patients have a common feature: a poor clinical response to antifungal therapy. Infection is usually airborne, although local infections in cases of skin trauma are also possible. These fungi are resistant to some common antifungal agents; therefore, surgical debridement of the necrotic tissue, when possible, should be combined with specific systemic antifungal treatment in immunocompromised patients. In the absence of randomized clinical trials, most experience in the treatment of these infections is with amphotericin B. Experience with new antifungal agents is still limited, and recovery from neutropenia remains the main predictor of a favorable outcome.     

Mechanisms of triazole resistance in Aspergillus fumigatus

The ubiquitous fungal pathogen Aspergillus fumigatus is the primary cause of opportunistic mould infections in humans. Aspergilli disseminate via asexual conidia passively travelling through air currents to germinate within a broad range of environs, wherever suitable nutrients are found. Though the average human inhales hundreds of conidia daily, A. fumigatus invasive infections primarily affect the immunocompromised. At-risk individuals can develop often fatal invasive disease for which therapeutic options are limited. Regrettably, the global insurgence of isolates resistant to the triazoles, the frontline antifungal class used in medicine and agriculture to control A. fumigatus, is complicating the treatment of patients. Triazole antifungal resistance in A. fumigatus has become recognized as a global, yet poorly comprehended, problem. Due to a multitude of factors, the magnitude of resistant infections and their contribution to treatment outcomes are likely underestimated. Current studies suggest that human drug-resistant infections can be either environmentally acquired or de novo host selected during patient therapy. While much concerning development of resistance is yet unknown, recent investigations have revealed assorted underlying mechanisms enabling triazole resistance within individual clinical and environmental isolates. This review will provide an overview of triazole resistance as it is currently understood, as well as highlight some of the prominent biological mechanisms associated with clinical and environmental resistance to triazoles in A. fumigatus.     

Aerosolized Delivery of Antifungal Agents

Pulmonary infections caused by Aspergillus species are associated with significant morbidity and mortality in immunocompromised patients. Although the treatment of pulmonary fungal infections requires the use of systemic agents, aerosolized delivery is an attractive option in prevention because the drug can concentrate locally at the site of infection with minimal systemic exposure. Current clinical evidence for the use of aerosolized delivery in preventing fungal infections is limited to amphotericin B products, although itraconazole, voriconazole, and caspofungin are under investigation. Based on conflicting results from clinical trials that evaluated various amphotericin B formulations, the routine use of aerosolized delivery cannot be recommended. Further research with well-designed clinical trials is necessary to elucidate the therapeutic role and risks associated with aerosolized delivery of antifungal agents. This article provides an overview of aerosolized delivery systems, the intrapulmonary pharmacokinetic properties of aerosolized antifungal agents, and key findings from clinical studies.     

Fungal infections of the nails in Western Australia

Between 1963 and 1972, 986 fungi were isolated from the nails of patients in Western Australia. Three clinical types of infections in both finger and toe nails were studied. All 3 types occurred more commonly in adults over the age of 20. Multiple infections were relatively frequent. Two hundred and fourteen of the nail infections were caused by dermatophyte fungi.Trichophyton rubrum was the predominant aetiologic agent isolated from both finger and toe nails,T. mentagrophytes and other dermatophytes were involved to a lesser degree. Paronychia of the finger nails was common and mainly caused byC. albicans. Aspergillus species were the most frequent fungi grown from superficial white onychomycosis.     

Value of anti-infective chemoprophylaxis in primary systemic vasculitis: what is the evidence?

Although infections are a major concern in patients with primary systemic vasculitis, actual knowledge about risk factors and evidence concerning the use of anti-infective prophylaxis from clinical trials are scarce. The use of high dose glucocorticoids and cyclophosphamide pose a definite risk for infections. Bacterial infections are among the most frequent causes of death, with Staphylococcus aureus being the most common isolate. Concerning viral infections, cytomegalovirus and varicella-zoster virus reactivation represent the most frequent complications. The only prophylactic measure that is widely accepted is trimethoprim/sulfamethoxazole to avoid Pneumocystis jiroveci pneumonia in small vessel vasculitis patients with generalised disease receiving therapy for induction of remission.     

Risk factors for helminth infections in a rural and a peri-urban setting of the Dongting Lake area, People's Republic of China

Schistosomiasis japonica and soil-transmitted helminthiasis are endemic parasitic diseases in the People’s Republic of China (PR China). As very few studies have reported on the distribution and interaction of multiple species helminth infections, we carried out a comparative study of households in a rural village and a peri-urban setting in the Dongting Lake area of Hunan province in November and December 2006 to determine the extent of single and multiple species infections, the underlying risk factors for infection, and the relationships with clinical manifestations and self-reported morbidity. In each household, stool samples were collected and subjected to the Kato-Katz method for identifying Schistosoma japonicum, Ascaris lumbricoides, hookworm and Trichuris trichiura infections. Clinical examinations were performed and questionnaire surveys conducted at both household and individual subject levels. Complete parasitological, clinical and questionnaire data were obtained for 1,298 inhabitants of the two settings. The overall prevalences of single infections of S. japonicum, A. lumbricoides, hookworm and T. trichiura were 6.5%, 5.5%, 3.0% and 0.8%, respectively; the majority of the infections were of light intensity. We found significant negative associations between wealth and infections with S. japonicum and A. lumbricoides. Clinical manifestations of splenomegaly, hepatomegaly and anaemia were prevalent (9.0%, 3.7% and 10.9%, respectively), the latter two being significantly (P < 0.05) associated with schistosomiasis. Self-reported symptoms were more common among females but there was considerable under-reporting in both sexes when relying only on spontaneous recall. Our findings may guide the design and targeting of a more equitable, comprehensive and integrated parasitic disease control programme in Hunan province and in other areas of PR China.     

构建冻干无细胞生物传感器快速检测临床铜绿假单胞菌感染北大核心

【目的】铜绿假单胞菌(Pseudomonas aeruginosa)是常见于医院感染的条件致病革兰氏阴性细菌,其群体感应信号3-氧代十二烷酰基高丝氨酸内酯(3-oxo-dodecanoyl-homoserine lactone,3OC12-HSL)可作为铜绿假单胞菌感染的生物标志物。本研究期望开发针对3OC12-HSL的冻干无细胞生物传感器,以实现临床铜绿假单胞菌感染的快速诊断。【方法】首先构建报告质粒以重建3OC12-HSL的应答过程,而后将该质粒加入冻干无细胞表达系统中以实现生物传感器的制备;接着利用梯度浓度的3OC12-HSL表征该传感器的灵敏度与动力学特征,并测试其底物特异性;最后通过临床样本测试验证其效果,并优化临床样本的预处理方法。【结果】本研究构建的冻干无细胞生物传感器能够在60 min内实现对临床呼吸道样本中铜绿假单胞菌感染的诊断,具有高灵敏度和高特异性。【结论】本研究构建了针对3OC12-HSL的冻干无细胞生物传感器,并借助RNase抑制蛋白预表达的策略提升了其对体液样本的耐受性,最终证明其具备开发成临床铜绿假单胞菌感染的快速检测方法的潜力。     

Immunogenetic Variability Associated with Different Susceptibility Patterns to Candida and Aspergillus Infections

Fungal infections remain a serious clinical problem with a high disease and financial burden, especially among immunocompromised and critically ill patients. Numerous efforts have not fully identified clinical and laboratory risk factors for increased susceptibility to fungal infections. The recent acquisition of knowledge about innate immune responses to fungi and genetic alterations in immunologic mechanisms has revealed additional genetic risk factors and has shed more light on the predisposition of individuals to fungal infections. The aim of this review is to address the findings of recent studies associating genetic factors with susceptibility to fungal infections, focusing on the most common opportunistic fungi, Candida and Aspergillus species.     

<Emphasis Type="Italic">Acr</Emphasis><Emphasis Type="Italic">emonium</Emphasis> Species: A Review of the Etiological Agents of Emerging Hyalohyphomycosis

Unusual fungal agents that exist environmentally as saprophytes can often lead to opportunistic infections. Hyalohyphomycosis is a group of fungal infections caused by fungi characterized by hyaline septate hyphae and can infect both immunocompetent as well as immunocompromised patients. Many a times it becomes difficult to distinguish a pathogenic and a contaminant fungus, because many such agents can assume clinical significance depending on circumstances. Subcutaneous and invasive fungal infection due to the emerging hyalohyphomycotic fungus, Acremonium, has drawn the attention of clinicians and microbiologists, as a potential pathogen in patients with and without underlying risk factors. Generally considered to be minimally invasive in the past, genus Acremonium has been responsible for eumycotic mycetomas and focal infections in otherwise healthy individuals. It has also been increasingly implicated in systemic fungal diseases. The management with different antifungals in various clinical situations has been very conflicting and hence needs to be carefully evaluated. This overview is an endeavor to consolidate the available clinical infections due to Acremonium and the recommendations on treatment.     

Some Problems of Host and Parasite Interactions in the Coccidia*

SYNOPSIS. The current status of some concepts of host and parasite interactions in the coccidia are discussed and evaluated. It is suggested that winter coccidiosis of cattle caused by Eimeria zuernii results from activation of arrested endogenous stages in the tissues of the host. A second aspect of clinical coccidiosis is that infections are seldom monospecific, but little work has been done on infections in animals with multiple species of coccidia. Information in the literature indicates that there are interactions between species of Eimeria in concurrent infections, and it is hoped that investigators will undertake studies to define more clearly what interactions there may be. Finally, the finding that there is a genetic basis for successful transmission of Eimeria separata from rats to mice provides a tool for studying the basis of host-specificity in the coccidia.     

The main characteristics of outbreaks of hospital infections in the USSR in 1986-1988

The analysis of 69 outbreaks of hospital infections in different regions of the USSR in 1986-1989 (the number of patients affected by these infections was 1,517) showed that most of these outbreaks (41) occurred at hospital wards for newborn infants. Acute enteric infections prevailed in the total structure of the outbreaks (73.7%). Purulent septic infections among newborns constituted a quarter of all outbreaks. Opportunistic microbes, and mainly Klebsiella, were the dominating element in the etiology of outbreaks in hospital wards for newborn infants. In pediatric wards in among adult hospital patients the etiology of outbreaks was completely, or almost completely, determined by pathogenic microorganisms, mainly salmonellae and shigellae. Outbreaks among hospital patients of three above-mentioned groups were characterized by differences in sources, routes and factors of the transmission of infection.     

Role of type 1 and type 3 fimbriae in <Emphasis Type="Italic">Klebsiella pneumoniae</Emphasis> biofilm formation

Background  

Klebsiella pneumoniae is an important gram-negative opportunistic pathogen causing primarily urinary tract infections, respiratory infections, and bacteraemia. The ability of bacteria to form biofilms on medical devices, e.g. catheters, has a major role in development of many nosocomial infections. Most clinical K. pneumoniae isolates express two types of fimbrial adhesins, type 1 fimbriae and type 3 fimbriae. In this study, we characterized the role of type 1 and type 3 fimbriae in K. pneumoniae biofilm formation.     

The pathological activity of metabolic products of candida albicans on newborn mice

Summary Concentrated filtrates ofCandida albicans have an inhibiting effect on the growth of newborn mice. Occasionally, this inhibition of growth is very distinct and the clinical picture corresponds to human progeria.Increased dosages of subcutaneous injections of filtrates did not increase the frequency of appearance of distinctly retarded growth in mice, but the mice showed a great area of baldness.In the number of mice, which did not show progeria, there were degenerative changes in liver and kidneys morphologically suggesting glycogenosis. The same type of changes were also observed when contents of disruptedC. albicans cells were injected into newborn mice. In the later case there was positive histochemical staining for the deposits of glycogen.The induction of pathological changes through fungus filtrates is a newly described biological phenomenon, which may play a greater role in pathology.     

Fetal hemoglobin in newborn baboons, Papio cynocephalus

Hemoglobins from a newborn baboon, Papio cynocephalus, and from a 15-day-old baboon of the same species were examined for electrophoretic properties of polypeptide chains and were tested for alkali resistance. Hemoglobin of newborn P. cynocephalus appears to be analogous to human fetal hemoglobin. Hemoglobin of newborn P. cynocephalus is composed of α-like and γ-like chains and hemoglobin of adult P. cynocephalus is composed of α-like and β-like chains.     

Clinical Relevance of In Vitro Resistance of Echinocandins: a Focus on <Emphasis Type="Italic">Candida parapsilosis</Emphasis>

Invasive infections due to Candida species are a major cause of healthcare-associated infections and are associated with a high mortality rate. Candida parapsilosis (C. parapsilosis) is associated with higher minimum inhibitory concentrations (MICs) of echinocandins creating controversy concerning their role in therapy for invasive disease. Despite the higher MICs observed in vitro, clinical resistance is rare and clinical success may occur with higher MICs against this species. A large number of non-comparative studies have demonstrated echinocandins efficacy against C. parapsilosis in invasive candidiasis and candidemia. In addition, pooled data from prospective studies have demonstrated in a meta-analysis that echinocandins are non-inferior to comparator anti-fungal drugs in the treatment of C. parapsilosis. Adverse events reported in the trials were similar in both echinocandin and comparator groups. Based on available data from randomized and non-randomized trials, echinocandins appear to be effective alternative agents for the treatment of invasive C. parapsilosis infections.