Anna B. Macura

The influence of some antifungal drugs on in vitro adherence of Candida albicans to human buccal epithelial cells

Summary:  An in vitro adherence test with 10 Candida albicans strains to buccal epithelial cells (BEC) was performed in a medium with the following antifungal drugs: nystatin, amphotericin B, 5‐fluorocytosine, clotrimazole and ketoconazole. Simultaneously, an in vitro adherence test was made without drugs added, but the fungal cells had been previously treated with the same drugs. All antifungal drugs applied significantly inhibited the adherence of C. albicans to BEC (p < 0.01). Pretreatment of the fungi with drugs inhibited their adherence to BEC stronger than the addition of the drugs to the test medium. Subinhibitory doses of the drugs were less effective than therapeutic ones. The most effective inhibition of the adherence was obtained with 5‐fluorocytosine and ketoconazole, while nystatin turned out to be the least effective.

Fungal Species Isolated from Skin and Nail Lesions of Hands and Feet of Patients Suspected of Mycotic Infection./Das Pilzartenspektrum an Haut- und Nagelläsionen der Hande und Füße von Patienten mit Mykoseverdacht

Summary: A mycological study of patients attending the dermatological departments in the district of Kraków was undertaken during a period of five years, from 1980 to 1984. The investigations were carried out on 1561 women and 946 men. A total of 3626 specimens (skin scrapings and nails) were investigated. Dermatophytes were isolated from 824 specimens, Candida albicans from 256 and Scopulariopsis brevicaulis from 233. The growth of dermatophytes was observed in 363 samples with negative result of direct microscopic examination. The incidence of mixed fungal cultures from specimens was observed in different combinations. In 8 cases mixed dermatophytes infection took place. Frequently, dermatophytes were isolated accompanied by yeast‐like fungi. It should be noted that in 30 samples with positive result of direct microscopic examination, Aspergillus was isolated in 11 cases and S. brevicaulis in 19. Among isolated dermatophytes, T. rubrum was dominant.

Susceptibility to fungal infections of nails in patients with primary antibody deficiency

Primary antibody deficiencies are rare diseases, which require early treatment with intravenous immunoglobulins to prevent fatal infections. The cell mediated immunity in patients with those immunodeficiencies remains unimpaired and usually they do not develop fungal infections. The aim of the study was to determine the susceptibility to fungal infections of nails in children with X-linked agammaglobulinaemia (XLA) and common variable immunodeficiency (CVID). Nail plate fragments collected from five patients with XLA and five with CVID were experimentally infected with a Candida albicans and Trichophyton mentagrophytes strains. The same procedures were carried out with the nails from a control group of 10 healthy volunteers. The intensity of the infection was evaluated on the basis of hyphae ingrown into the nail fragments. The main finding of the study was the increased susceptibility of antibody deficient patients to experimental nail infection with C. albicans and T. mentagrophytes.

Mycotic sinusitis in children

Zusammenfassung: Bei 414 Kindern im Alter von 3 bis 15 Jahren, die an rezidivierender schleimig‐eitriger Sinusitis maxillaris und in der Mehrzahl der Fälle auch an anderen Erkrankungen der Atmungsorgane litten, wurden mykologische und bakteriologische Untersuchungen durchgeführt.

Candida adherence to mucosal epithelial cells with regard to its pathogenicity.

Twelve Candida strains were tested to compare their ability to adhere to human buccal and vaginal mucosa epithelial cells in vitro. The tests were performed in 0.9% saline and in phosphate buffer with both kinds of cells and additionally in saliva with buccal cells. The time of incubation was either 30 or 90 min. The pathogenicity of all of the fungal strains had been evaluated previously using viability test in mice. Eight strains were found to be pathogenic while four strains were considered to be not pathogenic. Out of the pathogenic ones, 5 strains of C. albicans, two strains of C. guilliermondi and one strain of C. stellatoidea were found. Non-pathogenic single strains were identified as C. krusei, C. parapsilosis, C. pseudotropicalis and C. tropicalis. The adherence tests with the pathogenic strains revealed significantly higher values for vaginal epithelial cells after 30 as well as after 90 min of incubation both in phosphate buffer and in saline in comparison to non-pathogenic ones (p less than 0.01). The adherence of the pathogenic strains to the buccal cells was significantly greater only after incubation in saline (p less than 0.05 after 30 min and p less than 0.01 after 90 min). The above findings suggest that adherence may be of importance in fungal colonization on mucous membrane surface resulting in development of fungal infection.

Case report: onychomycosis due to Trichophyton schoenleinii.

Trichophyton schoenleinii is an antropophilic dermatophyte transmitted by contact between humans. This genus is an aetiological agent of mycosis of the scalp – tinea favosa. Infections with T. schoenleinii were the most frequent dermatomycoses in Poland before the Second World War. Improvements in living conditions and hygiene after the Second World War have led to considerable decrease of infection with this fungus. We describe a patient who had a toenails involvement due to T. schoenleinii.

Dermatophyte species in superficial mycoses in the Krakow district, Poland in the years 1972-2007

Considerable changes in the dermatophyte spectrum have been observed in the past century. Hence, many authors point out the necessity of performing periodical overviews of the mycological flora producing mycoses in humans in a given area. Analysis of dermatophyte species was performed, which were isolated from the lesions in patients suspected of superficial mycosis and referred to the Department of Mycology. The materials were isolated from patients suspected of superficial mycosis from Kraków region from January 1, 1972 through December 31, 2007. A total of 4983 dermatophyte strains were isolated from 23 124 specimens, which amounts to 21.5%. The percentage of dermatophytes isolated in the past decade decreased to 13.1% in the year 2007. Trichophyton rubrum outnumbered Trichophyton mentagrophytes during the entire survey period: 62.4 vs. 33.5%. The participation of Microsporum canis amounted to 1.71% and that of Epidermophyton floccosum to 1.32%. The species M. canis appeared by the end of the 1980s. The remaining dermatophyte species comprised 1% of the isolates. A considerable decrease in dermatophyte isolations has been observed since 2000. Trichophyton rubrum outnumbered T. mentagrophytes during the entire period of study. The percentages of T. rubrum and T. mentagrophytes are decreasing while the percentages of other dermatophytes are slowly increasing.

In vitro antifungal susceptibility of Scopulariopsis brevicaulis isolates

In humans, Scopulariopsis is mainly associated with onychomycoses, rarely with cutaneous infections or with invasive mycoses. However, during the last two decades, deep infections caused by members of this genus have been increasing. Scopulariopsis brevicaulis is the most common species described as an etiologic agent of human disease. Previous antifungal susceptibility studies indicate that this species is resistant in vitro to the broad-spectrum antifungal agents that are available today. Here, we describe the antifungal activity of amphotericin B, terbinafine, ciclopirox, itraconazole, ketoconazole, and voriconazole against 40 S. brevicaulis isolates. Antifungal susceptibility tests were performed using a modified Clinical and Laboratory Standards Institute M38-A2 procedure. The results showed that itraconazole had the highest minimal inhibitory concentration (MIC) of >16 mg/l; amphotericin B, voriconazole, and ketoconazole MICs were ranging from 4 to >16 mg/l, 8 to >16 mg/l, and 8 to >16 mg/l, respectively; and the best activity was found with terbinafine and ciclopirox with MICs ranging from 0.5 to 16 mg/l and 1 to 8 mg/l, respectively.

Efficacy of Topical Antifungal Treatment in Denture Stomatitis

Summary: The report presents results of treatment of 90 patients with denture stomatitis, comprising cases with mycologically controlled yeast‐like fungal infections. Pimafucin drops were applied in form of a suspension dropped onto the adjacent denture surface. After a 3‐week treatment, 85 per cent of the cases revealed complete recovery, while 11 per cent demonstrated significantly improved clinical state. The results of control mycological examinations after treatment were negative in 80 per cent of the cases.

The incidence of yeast-like fungi in denture wearers' oral cavities.

Summary: A total of 500 patients examined clinically amd mycologically were divided into three groups: toothless patients before application of dentures, denture‐wearers with healthy mucous membranes and denture‐wearers with clinical signs of denture stomatitis. The incidence of yeast‐like fungi was found to be more frequent in denture‐wearers (40 per cent) than in toothless patients with no dentures (8 per cent). Most frequently i. e. in 94.5 per cent of the cases, yeast‐like fungi occurred in denture‐wearers suffering from denture stomatitis.