Aksel Stenderup

White piedra and Trichosporon beigelii carriage in homosexual men

Trichosporon beigelii was isolated from the anal region in 45 (13%) of 343 Danish homosexual men. T. beigelii was also present on the scrotal skin of six anal carriers who were accessible for re-examination, and white piedra of the genital hair was observed in two cases. Because T. beigelii may cause systemic infections in compromised hosts it may pose a threat to homosexuals infected by HTLVIII/LAV virus.

Clinical-mycologic diagnosis of oral yeast infections.

Conventional oral specimens for recovery of yeasts are swabs and smears. Oral rinses and imprint/impression cultures can also be used. Yeasts grow well at room temperature and may multiply in specimens under transport. Direct smears examined for blastospores, hyphae, and inflammatory cells ensure rapid presumptive diagnosis. Fungal identification requires culture, preferably on different media and at different temperatures to ensure recognition of all species present. YM agar supplemented with 0.01% aniline enables detection of Candida albicans and C. parapsilosis on primary plates through fluorescence. Microstix-Candida or Oricult-N slides can be read after culture at room temperature. Histologic sections for demonstration of yeasts require periodic acid-Schiff, Gridley, or Gomoris methenamine silver staining. Fungiqual staining enables non-specific diagnosis, also of rare oral mycoses, within 30 min, through fluorescence. Calcofluor white is even faster (less than 30 sec). Specific antibodies labeled with fluorescent stain enable more precise mycologic diagnosis. Mycologic findings should be interpreted together with clinical findings.

Oral Yeast Flora and Antibodies to Candida albicans in Homosexual Men: Orale Hefeflora und Antikörper gegen Candida albicans bei homosexuellen Männern

Summary: The oral yeast flora and circulating IgG and IgA antibodies to Candida albicans were investigated in 76 Danish homosexual men C.albicans was isolated from 45 (65%) of 69 subjects by enrichment broth culture, but primary plate cultures were positive in 11 (16%). The frequency of yeast recovery on primary plates increased with decreasing T‐lymphocyte helper‐to‐suppressor ratio (ratio ≤1.0: 33%; 1.1–1.4: 19%; and >1.4: 8%), whereas the frequency of positive enrichment broth cultures did not change (range 64–67%). Demographic or lifestyle parameters did not correlate significantly with oral yeast colonization as did neither IgG nor IgA antibodies to C. albicans. High levels of IgA antibodies to C. albicans were found to be associated with a Th/Ts ratio >1.0 whereas IgG candida antibody levels correlated inversely with the number of sexual partners in the past year.

IgA and IgG serum antibodies to Candida albicans in women of child-bearing age

IgA and IgG antibodies against Candida albicans culture filtrate were determined by enzyme-linked immunosorbent assay (ELISA) in sera from 84 pregnant and 21 non-pregnant women. IgA Candida antibody levels were found not to change significantly with age, whereas IgG Candida antibody levels were significantly higher in women aged 27 to 35 years than in women less than 24 years of age. Neither IgA nor IgG Candida antibody levels were related to the number of pregnancies. In a subgroup of 45 pregnant women examined for yeasts in the oral, anal and vaginal flora IgA Candida antibody levels were significantly higher in 13 women with negative cultures than in 19 women with recovery of C. albicans on plates. Intermediate levels of IgA Candida antibodies were found in 9 women with negative plate cultures, but positive enrichment broth cultures of C. albicans. All of 15 women with IgA ELISA values less than or equal to 0.51 had yeast-positive cultures compared with 17 of 30 women with IgA ELISA values greater than 0.51. This may suggest a role of IgA antibodies in the clearance of C. albicans from mucosal surfaces in healthy individuals.

Circular DNA Molecules Controlling Synthesis and Transfer of the Surface Antigen (K88) in Escherichia coli

SUMMARY: Studies have been carried out on the molecular nature of the plasmid DNA in four strains of Escherichia coli carrying different mutants of the K88 factor. The factor was derepressed in three of the strains, one of which had kept the K88 antigen determinant, while the antigen was no longer demonstrable in the two other strains. The fourth strain possessed the K88 antigen but was transfer defective. The purified plasmid DNA was studied by electron microscopy and analytical CsCl density gradient centrifugation. All the plasmid DNA from the four strains formed a single band in the neutral CsCl gradient at a density of 1.709 g/cm3. The distributions of the contour lengths of the circular DNA molecules indicate three principal size classes of about 5, 20 and 25 µm. The small, 5 µm circles presumably contain the K88 determinant. The results seem to support the theory of a dissociation of composite plasmids.

Isolation of Cryptococcus neoformans from pigeon manure on two media inducing pigment formation

A newly described medium with esculin for identification of Cryptococcus neoformans was compared with Staibs Guizotia abyssinica extract-creatinine medium (GAEC) with and without diphenyl (DF). Twenty-seven samples of pigeon manure were examined. Cr. neoformans was found in 6 samples (22%) on GAEC plates (-DF); ESC medium (-DF) and malt extract agar allowed isolation from 2 and 3 samples respectively. Cr. neoformans was found in 0 to 2 samples when DF was added. Colonies of Cr. neoformans found on ESC plates had no distinctive pigmentation although inocula of pure cultures produced brown colonies. On GAEC plates some colonies of Cr. neoformans turned brown not until after 2 weeks of incubation. At 1 month the presence of pigmented colonies on GAEC plates (-DF) allowed the identification of 5 of the 6 samples from which Cr. neoformans was isolated. Other yeasts were grown from 26 samples (96%) and Torulopsis candida was found to be more frequent than Cr. neoformans.

Serum antibodies to Aspergillus fumigatus in Danish farmers

182 Danish farmers and 105 city-dwelling control subjects were investigated for serum IgG antibodies to three purified Aspergillus fumigatus antigen fractions and unfractionated culture filtrate by enzyme-linked immunosorbent assay (ELISA). Farmers had higher levels of antibodies to all four ELISA antigens than non-farming controls. In farmers and controls high antibody activity was recorded with an antigen fraction of approximate molecular weight 470 000 daltons. Antibody levels to this fraction were higher in non-smokers than smokers in both study groups. Cattle farmers had higher antibody levels to the 470 000 daltons fraction than farmers with no animals on the farm. Farmers with higher antibody activity to any of the three fractionated ELISA antigens tended to have fewer respiratory symptoms than farmers with lower antibody activity. It was concluded that occupational exposure and smoking habits are the main determinants of the immune response to A. fumigatus in man.

CHLAMYDIA, MYCOPLASMAS, UREAPLASMAS, AND YEASTS IN THE LOWER GENITAL TRACT OF FEMALES

Abstract. 162 women were investigated. Group I consisted of 85 women, who were partners to men with non‐gonococ‐cal urethritis (NGU) or presented macroscopic signs of cer‐vicitis; patients who had harbored Neisseria gonorrhoeae were excluded from the study. Group II was a control group of 77 women without any complaints from the urogenital tract and with normal findings at pelvic examination. All the women were tested for infection with Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma urealy‐ticum, and Candida albicans. In group I, chlamydiae and mycoplasmas were recovered in 44% and 36%, respectively, the corresponding figures for the control group (group II) being 5% and 19%. The difference is highly significant. No such difference between the two groups was found for ureaplasmas. Sixteen percent of the patients in group I were positive for C. albicans; 12% were positive in group II. Fifty per cent of asymptomatic NGU‐partners were chlamydia‐positive, and about one‐third of patients with either dysuria or vaginal discharge harbored the organism. No difference in the isolation frequency of mycoplasmas was observed between asymptomatic partners to male NGU carriers and women with increased vaginal discharge, whereas the organism was isolated more frequently from patients with dysuria. Fifty‐nine per cent of patients with cervicitis were chla‐mydia‐positive, compared with 30% of patients with normal cervical appearance and normal vaginal discharge. Samples obtained from the cervix were more often positive than samples from the urethra. In conclusion, if samples can be taken from only one of the two sites in patients with lower genital tract infection, the cervix is the optimal sampling site.

The influence of long-term treatment with mecillinam on fecal Escherichia coli.

The influence of long-term treatment with a low dose of pivmecillinam on the fecal flora was investigated. Before treatment Escherichia coli was detected in about 88% of 30 outpatients with chronic recurrent urinary tract infections, but after 1-2 months only about 55% had detectable E. coli in the intestinal flora. E. coli resistant to mecillinam were not selected during the therapy. A similar group of patients treated with nitrofurantoin showed neither changes in the E. coli flora nor in the resistance pattern.

The Serological Response to Candida albicans in Leukemic Patients Prophylactically Treated with Ketoconazole/Die Candida‐Serologie bei Leukämie‐Patienten unter Ketoconazol‐Prophylaxe

Summary: The mucosal yeast flora and the serum levels of IgG and IgA antibodies to Candida albicans were studied weekly in 38 patients with malignant haematological disorders prophylactically treated with 400 mg ketoconazole daily during induction chemotherapy. All patients developed granulocytopenia and 30 (79%) were colonized by yeasts. IgG C. albicans antibody levels were higher in carriers of C. albicans, or other yeast species, than in non‐carriers throughout the survey, and a statistically significant increase was observed in the first 4 weeks (p < 0.05). IgA C. albicans antibodies followed the same trend. It appears that even severely immunocompromized patients receiving ketoconazole retain a serological response to yeast colonization.