[Interspecies differentiation of Candida albicans (Robin, 1853) Berkhout, 1923 strains from multifocal invasions--their identity or similarity parameters]. / Róznicowanie wewnatrzgatunkowe szczepów Candida albicans (Robin, 1853) Berkhout, 1923 z inwazji wieloogni- skowych--parametry ich identycznosci lub podobienstwa.

The subject of analysis is a pathogenic species of fungi that has the highest prevalence in the word--Candida albicans. The aim of this study was to determine the identity and similarity of strains for the diagnosis of multifocal (concerning two or more organs) invasions. The material was comprised of 210 strains isolated from 83 women from 6 various ontocenoses: in group I--from the vagina, oral cavity and rectum, in group II--from the vagina and oral cavity, in group III--from the oral cavity, oesophagus, stomach, duodenum and rectum. Three tests were used in this study; API 20 C and API 20 AUX tests were used to differentiate interspecies biochemical features, and identify the codes of individual strains, while the API ZYM test was used to evaluate extracellular hydrolase activity and compare their enzymograms. Strain biotyping was also conducted with the use of binomial distribution 1:4:6:4:1. Comparing the codes of strains from successive sections of the alimentary tract identified pentafocal, tetrafocal, trifocal and bifocal invasions. The analysis of the enzymograms from all strains allowed the diagnosis of trifocal and bifocal candidosis. Consecutive hydrolase activity and biotyping evaluation demonstrated the similarity of strains from various ontocenoses. Interspecies differentiation of Candida albicans strains is relevant for the determination of the identity and similarity of strains, leading to multifocal infection diagnosis and localization, as well as choosing appropriate treatment.

[The diagnostic methods applied in mycology]. / Metody diagnostyki laboratoryjnej stosowane w mikologii.

The systemic fungal invasions are recognized with increasing frequency and constitute a primary cause of morbidity and mortality, especially in immunocompromised patients. Early diagnosis improves prognosis, but remains a problem because there is lack of sensitive tests to aid in the diagnosis of systemic mycoses on the one hand, and on the other the patients only present unspecific signs and symptoms, thus delaying early diagnosis. The diagnosis depends upon a combination of clinical observation and laboratory investigation. The successful laboratory diagnosis of fungal infection depends in major part on the collection of appropriate clinical specimens for investigations and on the selection of appropriate microbiological test procedures. So these problems (collection of specimens, direct techniques, staining methods, cultures on different media and non-culture-based methods) are presented in article.

Activity of hydrolytic enzymes in fungi isolated from diabetic pregnant women: is there any relationship between fungal alkaline and acid phosphatase activity and glycemic control?

Ability to respond to environmental changes and secretion of hydrolases are considered to be important for Candida virulence. In this study we determined and compared the activities of 19 different hydrolases of the fungal strains isolated from diabetic and non-diabetic pregnant women. We also looked for the presence of a relationship between hydrolase activities and glycemic control, and, furthermore, evaluated the influence of gestational age on the activity of hydrolases. Mycological examinations were performed for 119 diabetic pregnant women: 47 with diabetes mellitus type I (DM), 72 with gestational diabetes (GDM), and for 132 healthy women (CON). Samples were collected from the vagina, rectum and oral cavity and cultured on Sabouraud media. The fungal hydrolase activities were evaluated using the API ZYM test (bioMerieux). For the 19 different fungal hydrolases tested, 13 activities were present in the isolated fungal strains. The activity of alkaline phosphatase (ALP) in vaginal strains (p=0.028) and acid phosphatase (ACP) in strains from the vagina (p=0.006) and rectum (p=0.049) was significantly lower in DM than in GDM and CON women. In conclusion, we describe for the first time that fungi isolated from pregnant diabetic women have lower activity of both phosphatases compared to fungi isolated from healthy women. Furthermore, similar differences of mean ALP and ACP activities were observed in the course of pregnancy in strains from the vagina and rectum of DM and CON women. However, strains from DM had lower activity at each stage of pregnancy. The highest activity of ALP and ACP was detected at the beginning, then declined, and had the lowest values between the 24(th) and 33(rd) week of gestation. After that period the activity of both phosphatases increased.

Species distribution and influence of glycemic control on fungal infections in pregnant women with diabetes.

OBJECTIVES: (1) To find the distribution of species among fungal strains isolated from pregnant women with diabetes mellitus (DM), gestational diabetes (GDM) and healthy controls (CON); (2) to analyse the influence of glycemia on the prevalence of fungi in different body sites. METHODS: Mycological examinations were performed in 251 pregnant women: 119 diabetic (47 DM, and 72 GDM) and 132 controls. Samples were collected from vagina, rectum and oral cavity of all women and cultured on Sabouraud media. RESULTS: A total of 212 fungal strains were isolated, 12 fungal species were identified: 89.6% of the strains belonged to Candida gender, 10.4% to Saccharomyces, Geotrichum, Rhodotorula and Trichosporon genera. The prevalence of fungi, respectively, in vagina and rectum, was significantly higher in diabetics with poor glycemic control when stratified (<100 mg/dl, 100-120 mg/dl and >120 mg/dl) both the mean week glucose levels (MWGL) levels (p = 0.03, p = 0.03) and glycemia 90 min after breakfast (p = 0.04, 0.03). No difference was found in the prevalence of fungi and glycolised hemoglobin (HbA1). CONCLUSIONS: MWGL showed an association between glycemia and prevalence of fungi. However, no relation was found between HbA1 and fungal infections in well controlled diabetic pregnancies.

Prevalence of fungi in the vagina, rectum and oral cavity in pregnant diabetic women: relation to gestational age and symptoms.

OBJECTIVES: To estimate the prevalence of fungi in the vagina, rectum and oral cavity in pregnant women with diabetes mellitus (DM) type I or gestational diabetes mellitus (GDM) and in healthy controls; to assess the influence of gestational age on the prevalence of fungi; to compare the vaginal symptoms within the groups; and to analyze the multifocality of fungal invasions. METHODS: A total of 251 women were examined: 47 with DM, 72 with GDM and 132 controls. Samples were collected from the vagina, rectum and oral cavity of all women and cultured on Sabouraud media. RESULTS: Fungi were found in 59.8% in at least one of the three locations in all women. Vaginal mycosis was diagnosed more often (p < 0.001) in pregnancies with DM [40.4%, odds ratio (OR) 4.3, confidence interval (CI) 2.41-4.85] than with GDM (22.2%, OR 1.84, CI 0.99-2.12) and nondiabetics (13.6%, OR 1.0). The risk of trifocal mycosis was higher in DM women (OR 2.7, CI 1.72-4.45), than in the controls. Only in 27.6% of symptomatic women were fungi detected in vagina. However, 60.4% of women with vaginal mycosis had symptoms. Among women without mycosis, 42.4% were symptomatic, and discharge was more common in the DM group (50%) than in the GDM group (21.4%) and the controls (28.1%; p < 0.002). The prevalence of fungi in the groups was not influenced by gestational age. CONCLUSIONS: The risk of vaginal mycoses in DM women is more that four times higher and in pregnancies with GDM nearly two times higher than in controls. The risk of trifocal mycosis in DM women is nearly three times higher than in nondiabetics. There is a poor correlation between symptoms of vaginitis and fungal infection. We did not confirm the influence of the gestational age on the prevalence of fungi.

[Multifocal mycoses in women: prevalence, species characteristics, and some intraspecific features]. / Wieloogniskowe zarazenia grzybami u kobiet: prewalencja, charakterystyka gatunkow i niektórych cech wewnatrzgatunkowych.

The aim of this study was to detect fungi in three ontocenoses of 947 women (aged 20-45). The prevalence of multifocal fungal infections in women varied from 62.2 +/- 2.99% to 81.0 +/- 3.92% in different ontocenoses. They assumed the following mean values: 38.4 +/- 1.77% for the vagina, 42.2 +/- 1.80% for the oral cavity, and 25.0 +/- 1.58% for the anus. The clinical manifestations of sexual organs inflammations were statistically significantly (p < 0.01) more frequent in women infected with fungi than in those without fungi in the vaginal ontocenosis. The highest convergence of the fungi presence with subjective and objective symptoms (assessed using the Yule Q index value) concerned: pruritus of the vulva or/and vaginal walls, burning sensation or painful urethra, as well as oedema of the external opening of the urethra, vulva or/and the vagina (Q from +0.808 to +0.970). However, there was no statistically significant convergence between occurrence of the fungi and vaginal discharge and painful hypogastrium. Based on more than 40 phenotypical features (morphological, biochemical) of the axenic strains originating from vaginal, oral, and anal ontocenoses, a total of 12 species of fungi were identified: Candida albicans, C. guilliermondii, C. krusei, C. tropicalis, C. kefyr, C. utilis, C. humicola, C. viswanathii, C. glabrata, C. parapsilosis, Rhodotorula mucilaginosa, and Geotrichum candidum. For intraspecific features, depending on the profile of the compounds used for auxanogram, 9 codes were read for Candida albicans and only one code for each of other species was detected. In API ZYM test based on assessment of 19 hydrolase activities the enzymograms of species included from 6 to 11 enzymes.

[Activity of the azole drugs in vitro against strains of Candida albicans with different codes isolated from the digestive tract in children]. / Aktywnosc leków azolowych in vitro wobec szczepów Candida albicans o róznych kodach wyodrebnionych z przewodu pokarmowego dzieci.

The activity of ketoconazole (K, R04 1400 molecular weight 531.44), miconazole (M, R01 4889, molecular weight 479.15) and itraconazole (I, R05 1211, molecular weight 705.64) obtained from Janssen Pharmaceutica NV, against Candida albicans strains was studied. The axenic fungal strains were isolated from the faecal samples of children--not previously treated with antifungal drugs--with clinical symptoms suggesting the inflammation of the mucous membrane in the stomach and/or duodenum. The strains were assessed by own methods and unified tests (bioMérieux: API 20 C, API 20 C AUX). Five codes of Candida albicans Berkhout were found. The minimal inhibitory concentration (MIC) values were calculated from 448 dose-response curves according to the agar diffusion--Kadlubowski's method. MICs were also examined by analyzing the variation (min-max, x mean +/- standard error, mode Mo, median Me). It was demonstrated that all the strains used in the study were susceptible to the azoles drugs.

[Multifocal fungal infections in patients after renal transplantation undergoing immunosuppression]. / Wieloogniskowe zarazenia grzybami u poddawanych immunosupresji osób po przeszczepach narek.

The aim of the study was to estimate the prevalence of fungi in monofocal and multifocal infections in renal transplant recipients and the characteristics of 60 species and intraspecies features of fungal strains isolated from the organ ontocenoses: oral cavity, rectum and genital organs in 32 patients undergoing permanent immunosuppression after renal transplantation. Fungal strains were recovered in 66 out of 96 samples (68.2% off all renal transplant recipients). There were in ontocenoses: oral cavity (65.6%), rectum (37.5%) and genital organs (25.0%). Monofocals mycosis were found only in 21.9% of the patients. Multifocal infections occurred in 68.2% and contained ontocenoses of oral cavity and rectum (34.4%) the most frequently. Trifocal infection occurred in 12.5% of all examined renal transplant recipients. Fungal strains identified using API 20 C and API 20 C AUX (bioMérieux). The activity of 19 hydrolases was investigated using API ZYM. From among 41 strains of fungi the following were found: Candida albicans (31 strains), Candida glabrata (5), Candida guilliermondii (2), Candida krusei (2) and Saccharomyces cerevisiae (1). The enzymograms were described for all strains and the highest activity was noted in case of: leucine arylamidase, acid phosphatase, esterase, naphtol-AS-BI-phosphohydrolase. The presence high mean of activity of this enzymes means high pathogenicity of C. albicans strains.

[Current data about fungi prevalence in various ontocenoses in women during procreation period]. / Aktualne dane o prewalencji grzybów w róznych ontocenozach u kobiet w okresie prokreacji.

The aim of study was to analyse fungi prevalence in three ontocenoses (vagina, oral cavity and anus) in women during procreation period, which should be helpful in developing prophylactic programmes for pregnant womem, newborns and infants infected with fungi. In 716 examined women (age 20-45 years), 1411 samples of appropriate biological materials were taken and inoculated in the fluid Sabouraud medium and then axenic fungi strains were isolated in Sabouraud agar. High fungi prevalence in three ontocenoses of examined women was noted. Mean percentage for ontocenosis was: 39% +/- 1.8% for vagina, 42.18% +/- 1.8% for oral cavity and 25.03 +/- 1.6% for anus. These data indicate the necessity for further examinations of multifocal fungal infection in women during procreation period.

[Relationship between activity of hydrolases in fungi isolated from vagina of pregnant women and selected symptoms]. / Zwiazek miedzy aktywnoscia hydrolaz grzybów wyizolowanych z pochwy kobiet ciezarnych i wybranymi objawami klinicznymi.

Pregnancy is considered a factor of vulvovaginal mycosis. Secretion of hydrolases is an important determinant of Candida virulence. Thus, the aim of the study was to found the relationship between activity of 19 hydrolases in fungi isolated from vagina of pregnant women and symptoms of mycosis. 251 pregnant women were examined. Samples were collected from vagina and cultured on Sabouraud media. Activity of hydrolytic enzymes was evaluated using API ZYM (bioMerieux) test Fungi were found in 20.1% of vaginal samples. Symptoms were detected in 45.8% of women. Only 32.1% of women with discharge and 26.4% with pruritus had mycosis. Out of the 19 examined hydrolazes, 13 active enzymes were detected in fungal strains. We found for the first time the relationship between activity of fungal esterase lipase and the presence of vaginal discharge in pregnant women.

[Analysis of sIgA concentrations in the contents of the cervical canal of the uterus and of the oral cavity in women with Candida or without fungi in ontocenoses of these organs]. / Analiza stezen sIgA w tresci kanalu szyjki macicy i jamy ustnej u kobiet z Candida lub bez grzybów w ontocenozach pochwy i jamy ustnej.

The aim of the study was to search for fungi in ontocenoses of genital organs and oral cavity (the fungal reservoir for multifocal infections) in women; evaluation of the concentration of sIgA in the contents of the cervical canal of the uterus and of the oral cavity. 102 women (age: 18-35 years) were examined. Fungi were isolated from ontocenoses of the vagina and the oral cavity; axenic strains were differentiated with API 20 C and API 20 C AUX tests (bioMérieux). The concentrations of sIgA in the content of the cervical canal of the uterus and from the oral cavity were evaluated by LC-Partigen IgA (Behring) tests. Candida occurence in the oral cavity was significant (p < 0.02) higher than in the vagina. Candida albicans (6 codes) was the predominat species; there were also C. tropicalis, C. kefyr, C. krusei, C. guilliermondii and C. glabrata. There were no significant differences between sIgA concentrations and the presence or absence of fungi in the vagina or oral cavity.

[Prevalence of multifocal fungal infections in patients undergoing permanent immunosuppresion after renal transplantation]. / Prewalencja wieloogniskowych zarazen grzybami u chorych z przeszczepami nerek poddawanych stalej immunosupresji.

Prevalence of multifocal fungal infections in patients undergoing permanent immunosuppresion after renal transplantation. The aim of the study was to estimate the prevalence of fungi in monofocal and multifocal infections in renal transplant recipients. 32 renal transplant recipients were examined for presence of fungi in genital organs, oral cavity and rectum. Fungal strains were recovered in 66 out of 96 samples (68.2% off all renal transplant recipients) in oral cavity (65.6%), rectum (37.5%) and genital organs (25.0%) Monofocal mycosis was found only in 21.9% of the patients. Multifocal infections occurred in 68.2% and contained ontocenoses of oral cavity and rectum (34.4%) the most frequently. Trifocal infection (genital organs - oral cavity - rectum) occurred in 12.5% of all examined renal transplant recipients. The following fungi were found: Candida albicans (31 strains), C. glabrata (5), C. guilliermondii (2), C. krusei (2), Saccharomyces cerevisiae (1).

[Characteristics of phenotypic specific and intraspecific features of fungal strains isolated from the organ ontocenoses in patients after renal transplantation]. / Charakterystyka cech fenotypowych gatunkowych i wewnatrzgatunkowych szczepów grzybów wyodrebnionych z wybranych ontocenoz narzadowych osób po przeszczepach nerek.

Characteristics of phenotypic specific and intraspecific features of fungal strains isolated from the organ ontocenoses in patients after renal transplantation. The aim of present study was to describe 60 specific and intraspecific features of fungal strains isolated from the organ ontocenoses: oral cavity, rectum and genital organs in 32 patients undergoing permanent immunosupression after renal transplantation. Fungal strains identified using API 20 C and API 20 C AUX (bioMérieux). The activity of 19 hydrolases was investigated using API ZYM. Among 41 strains of fungi the following were found: Candida albicans (31 strains), C. glabrata (5), C. guilliermondii (2), C. krusei (2) and Saccharomyces cerevisiae (1). The number of fungal strains isolated from the oral cavity was the highest (21), less numerous from rectum (12) and the least from the genital organs (8). The enzymograms were described for all strains and the highest activity was noted in case of: e6 - leucine arylamidase, e11 - phosphatase acid, e3 - esterase (C4), e12 - naphtol-AS-BI-phosphohydrolase. The activity of these enzymes is connected with higher pathogenicity of C. albicans strains.

[Analyse of fungi prevalence and their species in the digestive tract of adult persons and children]. / Analiza prewalencji grzybów i ich gatunków w przewodzie pokarmowym osób doroslych i dzieci.

Analyse of fungi prevalence and their species in the digestive tract of adult persons and children. 1081 faecal sample were examined, 723 from adult persons and 358 from children. Fungal strains were recovered in 67.9% samples from adult persons and in 69.8% from children. There were found 8 species of fungi: Candida albicans, C. famata, C. tropicalis, C. krusei, C. glabrata, C. guilliermondii, C. kefyr, Saccharomyces cerevisiae.

Candida albicans Berthout, 1923: hydrolases activity and own method of digestive tract strains biotyping.

112 strains of Candida albicans were isolated from oral cavity and ontocenoses of the upper digestive tract (endoscopy) of children (age: 5-17) with gastrointestinal disorders. Axenic strains were differentiated with API 20C AUX and API ZYM tests (bioMérieux). Then enzymograms and biotypes were determined for all the strains based on the activity of 19 hydrolases. The highest activity was noted for: e2 - phosphatase alcaline, e6 - leucine arylamidase, e11 - phosphatase acid, e5 - lipase (c14); e7 - valine arylamidase, e12 - naphtol-AS-BI-phosphohydrolase, e16 - alpha-glucosidase and e18 - N-acetyl-beta-glucosamidase, and the latter four were used for biotyping procedures. Our own system was based on the mathematical binominal distribution formula (1 : 4 : 6 : 4 : 1): all "+"; one "-", three "+"; two "-", two "+"; three "-", one "+"; all "-". We have found the following biotypes: A (16.1 +/- 3.5%), B1 (2.7 +/- 2.53%), B3 (8.0 +/- 2.5%), B4 (22.3 +/- 3.9%), C2 (1.8 +/- 1.3%), C3 (7.1 +/- 2.4%), C6 (30.4 +/- 4.3%), D, (11.6 +/- 3.0%).