Concurrent Infection of a Young Tourist by Hookworm and Strongyloides Stercoralis During Low Budget Travel in Southeast Asia.

Strongyloidiasis and hookworm infections are neglected helminth diseases widespread in tropical and subtropical areas. In humans, particularly in immunocompromised patients infections potentially may lead to the life-threatening clinical conditions involving the respiratory as well as gastrointestinal systems. The increased number of tourists travelling to tropical regions is associated with more frequent infection with parasites such as Strongyloides and hookworm. The infection takes place when filariform larvae penetrate the skin exposed to soil, than migrate through the lungs and finally reach the intestine. Travelers are often not aware of how they could get infected. Physicians may suspect strongyloidiasis and hookworm infections in tourists with diarrhea returning from endemic areas, especially when an elevated eosinophilia is observed. In the literature there are many reports about the presence of parasites in indigenous communities, but very few are available regarding travelers. This paper describes a dual infection with hookworm and Strongyloides stercoralis in a young female tourist returning from Southeast Asia. To our knowledge, this is the first report of hookworm and Strongyloides stercoralis infection in a tourist from Europe, acquired in an endemic area.

Hydrogen peroxide-dependent antibacterial action of Melilotus albus honey.

Honey originating from different floral sources exhibits the broad spectrum of antibacterial activity as a result of the presence of hydrogen peroxide as well as nonperoxide bioactive compounds. The mechanisms of antibacterial activity of Polish melilot honey were investigated for the first time. Polish melilot honey samples (Melilotus albus biennial = 3 and annual = 5, Melilotus officinalis = 1) were collected directly from beekeepers and analysed for pollen profile, basic physicochemical parameters, antioxidant capacity, radical scavenging activity, total phenolic contents as well as antibacterial properties against pathogenic bacteria Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Salmonella spp. The physicochemical properties of melilot honey were specific for light-coloured unifloral honey samples and were not dependent on its botanical and geographical origin (P > 0·05). All tested honey samples exhibited inhibitory activity (above 90%) against Gram-positive bacteria at the concentration of 12·5-25%. Above 30-50% of antibacterial activity of melilot honey was connected with glucose oxidase enzyme action and was destroyed in the presence of catalase. Hydrogen peroxide-dependent antibacterial activity of honey was inversely correlated with its radical scavenging activity (r = -0·67) and phenolic compounds (r = -0·61). Antibacterial action of melilot honey depends not only on hydrogen peroxide produced by glucose oxidase, but also on other nonperoxide bioactive components of honey. SIGNIFICANCE AND IMPACT OF THE STUDY: Melilot honey is used in traditional medicine as an anticoagulant agent due to the possibility of the presence of the coumarin compounds which are specific for Melilotus plant. Melilotus albus is rarely used to produce honey, and antibacterial properties of this variety of honey had not been studied yet. Nine samples of melilot honey produced in different regions of Poland were analysed according to their antibacterial activity which was correlated with physiochemical parameters and antioxidant activity. It was shown that antibacterial activity of melilot honey is created by hydrogen peroxide and other bioactive compounds.

Antimicrobial Resistance in Enterobacterales Bacilli Isolated from Bloodstream Infection in Surgical Patients of Polish Hospitals.

BACKGROUND AND AIMS: Bloodstream infections (BSIs) are one of the most frequently observed hospital-acquired infections (HAIs). We sought to describe the epidemiology and drug resistance secondary Enterobacterales BSIs in surgical patients and check for any correlation with the type of hospital ward. MATERIALS AND METHODS: This multicenter (13 hospitals in southern Poland) laboratory-based retrospective study evaluated adults diagnosed with BSI secondary to surgical site infection (SSI) hospitalized in 2015-2018; 121 Enterobacterales strains were collected. The drug resistance was tested according to the EUCAST recommendations. Tests confirming the presence of extended-spectrum ß-lactamases (ESBLs) and bla resistance genes were carried out. The occurrence of possible clonal epidemics among K. pneumoniae strains was examined. RESULTS: The prevalence of Enterobacterales in secondary BSI was 12.1%; the most common strains were E. coli (n = 74, 61.2%) and Klebsiella spp. (n = 33, 27.2%). High resistance involved ampicillin and ampicillin/sulbactam (92, 8-100%), fluoroquinolones (48-73%), and most cephalosporins (29-50%). Carbapenems were the antimicrobials with the susceptibility at 98%. The prevalence of ESBL strains was 37.2% (n = 45). All the ESBL strains had bla CTX-M gene, 26.7% had the bla SHV gene, and 24.4% had bla TEM gene. The diversity of Klebsiella strains was relatively high. Only 4 strains belonged to one clone. CONCLUSIONS: What is particularly worrying is the high prevalence of Enterobacterales in BSI, as well as the high resistance to antimicrobial agents often used in the empirical therapy. To improve the effectiveness of empirical treatment in surgical departments, we need to know the epidemiology of both surgical site infection and BSI, secondary to SSI. We were surprised to note high heterogeneity among K. pneumoniae strains, which was different from our previous experience.

Molecular analysis of meticillin-resistant Staphylococcus aureus strains isolated from different types of infections from patients hospitalized in 12 regional, non-teaching hospitals in southern Poland.

BACKGROUND: Accumulated data indicate that meticillin-resistant Staphylococcus aureus (MRSA) infections are associated with a worse prognosis than methicillin-susceptible S. aureus infections. AIM: To assess the epidemiological profile of S. aureus infections and the genetic diversity of clinical strains of MRSA in 12 hospitals in southern Poland. METHODS: Samples from bloodstream infections, pneumonia, and skin and soft tissue infections from adult patients were examined. S. aureus isolates were tested for MRSA and macrolide-lincosamide-streptogramin B (MLSB) phenotypes. Staphylococcal cassette chromosome mec (SCCmec) typing and S. aureus protein A (spa) typing were performed. Analysis of the genetic similarity was performed by pulsed-field gel electrophoresis. RESULTS: This study included 555 patients. An MRSA phenotype was detected in 15.1% of strains. The prevalence of MRSA infection was higher in patients aged >80 years. An MLSB phenotype was detected in 18.2% of strains. Analysis of SmaI profiles did not reveal a dominant clone. Spa typing showed 25 different spa types, and spa type t003 was the most common (49% of strains). Among MRSA strains, SCCmecII (49%) and SCCmecIV (27.4%) were predominant. CONCLUSION: The characteristics of MRSA showed considerable heterogeneity. The results demonstrate the need for caution when drawing conclusions on direct epidemiological relationships between isolates based on a single typing method. As the cases of infection in this study were not associated with the hospital environment and horizontal transfer, a focus on screening at hospital admission, and appropriate infection control, may help to reduce the risk of MRSA infections.

Carrot infection by Alternaria radicina in field conditions and results of laboratory tests.

Carrot black rot caused by the fungus Alternaria radicina (Meier) Drechsler et Eddy, the economically important disease of carrot (Daucus carota L.). Research was carried out in 2004 and 2005 in order to establish correlation between plant infestation in the field and laboratory experiments. To determine the incidence and severity of the disease in mature crop, a 5-degree scale was used, where 1 meant no visible disease symptoms and 5 meant total foliage infestation. Plants were rated individually and the disease index was calculated. Fungus pathogenicity in laboratory conditions was determined using a petiole assay and a root disc assay. The petiole assay was conducted during the vegetation period; basal parts of petioles detached from fully developed carrot leaves were put in contact with the growing A. radicina mycelium. The root disc assay was conducted during storage of carrot roots; root discs were inoculated with toothpicks overgrown by A. radicina mycelium. The isolate of A. radicina was pathogenic to petioles and carrot discs. Differences in the reaction of the examined cultivars in the field and laboratory experiments were revealed. However, no significant correlation between plant infestation in the field and the results of laboratory experiments were observed.

The clinicopathologic significance of estrogen receptors in human gastric carcinoma.

In most populations, gastric cancer (GC) is approximately two times more prevalent in men than in women, which may suggest the protective role of sex steroid hormones in gastric carcinogenesis. Steroid hormones such as androgens and estrogens can be synthesized not only in the gonads but also in peripheral tissues. Many researchers have conducted studies examining the expression profile of enzymes involved in steroid synthesis, the occurrence of estrogen receptors (ERs) and the influence of ERs in the development, proliferation and progression of gastric cancer. Some studies have also evaluated the relationship between the presence of ERs and survival prognosis. However, the results of these studies are often controversial and divergent. In a recent study, it was indicated that sex steroid hormones and estrogen receptors are partly involved in gastric cancer but their clinicopathological significance still needs further investigation.

Prevalence and molecular characteristics of urinary and intestinal microsporidia infections in renal transplant recipients.

Transplant recipients have been identified as a new risk group for microsporidia infection. We characterize for the first time the prevalence of microsporidia in intestinal and urinary tracts of renal transplant recipients. Molecular examination of 86 patients showed that 25.5% of them were infected; 86% were confirmed to have pathogens in their urine and 45.5% in stool. Among positive patients, 32% had microsporidia confirmed in both urine and stool. Genotyping revealed Encephalitozoon cuniculi (59%) and Enterocytozoon bieneusi (23%) monoinfections as well as coinfections with both species (18%). Moreover, we found diarrhoea and fever as symptoms significantly associated with microsporidia presence. Our results indicate that microsporidial infection should be considered in the assessment of renal transplant recipients, especially in the urinary tract, even if asymptomatic. Molecular identification of microsporidia species is relevant because of their different susceptibility for treatment.

Urinary tract infections caused by Pseudomonas aeruginosa among children in Southern Poland: Virulence factors and antibiotic resistance.

OBJECTIVE: The aim of this study was to analyze antibiotic resistance and virulence patterns in Pseudomonas aeruginosa (PAR) isolates from urinary tract infections among children in Southern Poland. MATERIALS AND METHODS: This study comprised consecutive, non-repetitive PAR isolates sent from two collaborative laboratories. The study group consisted of children aged up to 17 years from Southern Poland with culture-proven PAR UTIs. Relevant information about patients with UTIs, such as age, sex, and type of infection (polymicrobial or monomicrobial), was collected. Isolates were screened for major virulence factors found in uropathogenic PAR strains. Multidrug-resistant (MDR) strains were defined as strains not susceptible to one antimicrobial in at least three different antimicrobial classes. Extensively drug resistant (XDR) strains were defined as strains susceptible to no more than two antimicrobial classes. RESULTS: The total prevalence of PAR UTIs was 2.1%, and in children <5 years of age it was 3.0%. A total of 26 isolates was tested: 21 from outpatients and five from inpatients. Most infections (80.8%) occurred in children ≤ 4 years of age. The most prevalent virulence gene was exoY (96.2%). The prevalence of other effector proteins was 88.5% for exoT, 92.3% for exoS, and 19.2% for exoU. The gene for LasB was present in 80.8% of isolates; the gene for AprA in 61.5%; the gene for PilA in 19.2%; and the gene for PilB was not detected. The PAR isolates were generally susceptible to beta-lactam and aminoglycoside antimicrobials. All isolates were also susceptible to colistin. A large proportion of isolates were resistant to carbapenems and fluoroquinolones (Fig. 1). No significant differences were found in antimicrobial resistance between males and females or inpatients and outpatients (p > 0.05 for all tested antimicrobials), or in antimicrobial resistance between younger (≤ 5 years old, n = 21) and older (> 5 years old, n = 5) children (p > 0.05 for all tested antimicrobials). Two isolates were classified as XDR and none as MDR. The EDTA test yielded one MBL-positive isolate (3.8%), from a 17-year-old patient in home care. No isolates with genes for the KPC, IMP, or VIM were identified. CONCLUSION: As data on UTIs in children with Pseudomonas etiology are scarce, this paper provides useful information for clinicians and allows for comparison between Poland and other countries. Our findings have important implications for clinicians treating UTIs empirically, because the success of empiric treatment is based on knowledge of pathogen antimicrobial susceptibility patterns.

Differential effects of experimental hyperlipidemia on various types of rabbit peripheral blood lymphocyte receptors.

Rabbits fed a high-cholesterol diet for 3 months showed an increase in peripheral blood lymphocytes with membrane receptors for the Fc portion of immunoglobulin G and a decrease in lymphocytes with receptors for the Fc portion of immunoglobulin M and also with receptors for the third component of the complement. Thus our results indicate changes in lymphocyte membrane receptor expression in experimental hyperlipidemia that may supposedly influence some lymphocyte functions.

The effect of ampicillin on skin graft survival and antibody response in B6A F1 mice.

The effect of ampicillin on the immune response to sheep red blood cells (SRBC) and on the survival of BALB/c skin allograft in B6A F1 mice was studied. At the non-toxic doses of 250-500 mg/kg per day, given repeatedly before or after injection of SRBC or skin grafting, there was a marked enhancement of the antibody response and a prolongation of skin graft survival from 12.7 +/- 0.23 days in untreated mice to 13.7 +/- 0.19 days and 15.2 +/- 0.75 days in mice treated before or after skin grafting, respectively.

The immunosuppressive effect of concanvalin A. III. Influence on the survival time of skin allografts in mice.

The influence of Con-A on the survival time of skin grafts in mice was examined. F1 mice (BALB/c X DBA/2) were the skin donors and C57BL X C3H were the recipients. More than a two-fold prolongation in the survival time of the grafted skin was obtained by a single 100 microgram dose of Con-A given intravenously to mice 24 h prior to grafting. Con-A given in a similar manner three days after grafting did not influence the skin graft. The results obtained substantiate our earlier observations which suggested that Con-A administered prior to an antigen may inhibit the immunological response.

Graft-induced polyclonal activation of B cells. I. Alloantigen-induced humoral response in mice.

In recent years evidence has accumulated pointing out that graft rejection may be mediated not only by cellular but also humoral mechanisms. To study this problem in some detail, humoral responses were studied in mice subjected to skin grafting across the H-2 locus. B cell reactivity was measured during the first and second set reactions on consecutive days after transplantation until graft rejection. In vitro B cell activity was assessed by means of the reverse plaque-forming cell assay (PFC) using cells obtained from the lymph nodes and spleens. The results indicate that polyclonal activation of B cells is an integral part of the immune response to skin transplantation in mice. However, no correlation was found between the level of activation as demonstrated by the PFC and the time of graft rejection.

The effect of ATG treatment on LyMIF and LyMSF production in mixed lymphocyte cultures of rabbits after renal allotransplantation.

Rabbit lymphocytes, settled up in microcappillary tubes migrate into culture medium. In the previous communication we have shown that migration of mixture of lymphocytes derived from two blood donors was significantly inferior in 73% of cultures as compared to the corresponding monocultures. 4% of mixed cultures exhibited significant enhancement of migration and in 23% no effects were seen. Use of lymphocytes from rabbits 4-6 days after kidney allotransplantation and their corresponding donors resulted in conversion of this ratio. Percentage of cultures exhibiting enhancement of migration (production LyMSF) rose to 39, 46% of cultures were inhibited (produced LyMIF) and 15% did not show any significant effect. Treatment of kidney recipients with ATG exerted strong inhibitory effect on the appearance of LyMSF and on the appearance of LyMIF in mixed cultures. These results suggested that LyMIF and LyMSF were produced by separate cell populations.

Immunosuppressive effect of concanavalin A. IV. The effect of Con A on the local graft versus host (GvH) reaction in the mouse popliteal lymph node.

In the applied parental F1 hybrid system, the GvH character of the regional lymph node reaction was checked against syngeneic and the absolute control systems. It was found that a cortical B-cell zone of the recipients did not participate in the acute phase of the GvH reaction. Cytologically, the GvH response consisted in a significant increase in large pyroninophilic cells, histologically - in a cellular proliferation and pyroninophilia, as well as in a marked angiogenesis beyond the cortical zone of the lymph node. The injection of Con A into the F1 hybrid mice, 24 hours before the administration of the parental cells, inhibited the earlier (presumably donor origin) cellular reaction and intensified the later (presumably host origin) response.

Lymphatic system of mice born from mothers treated with ampicillin or cloxacillin during gestation.

Ampicillin, an antibiotic, widely used for combating bacterial infections exerts great influence on cells of the immune system of mouse and man. We have studied the effect of ampicillin and cloxacillin treatment of mice in the final week of pregnancy on the development of the lymphatic system of their offsprings. The mice born from antibiotic or saline treated mothers were examined 30 days after delivery. The examination of relative organ weight, cellularity and histopathological picture of lymphatic system (thymus, spleen and lymph nodes) and some other organs was performed. In the group of mice from ampicillin treated mothers we have found decreased relative weight of thymus and spleen and increased weight of lymph nodes with increased cellularity in thymus and lymph nodes. In the group of mice from cloxacillin treated mothers increased cellularity of thymus and lymph nodes was found. The histopathological study of lymphatic organs structure did not reveal any specific changes but the symptoms of focal degeneration and fat necrosis were found in livers of mice born from ampicillin treated mothers. Moreover, in mice born from antibiotic treated mothers the significant lymphocytosis in the peripheral blood was assessed. It was accompanied by an increase of granulocyte number in offsprings from ampicillin treated mothers and increase of monocyte number in those of cloxacillin treated. In conclusion, it could be suggested that ampicillin treatment during pregnancy would exert some effect on the development of lymphopoietic system of fetuses.

Immunomodulatory action of ampicillin.

Ampicillin was found to have an immunoenhancing effect on the expression of FcM human lymphocyte receptors, on the angiogenic potential of human lymphocytes and on the production of anti-SRBC antibody after in vivo administration to low-responder strains of mice. The effect of ampicillin on the graft-versus-host disease in irradiated F1 recipients of spleen cells from presensitized donors was found to be stimulatory when the drug was given to the recipients and suppressive when the drug was administered to the donors which had been preimmunized with a lower dose of antigen.

Differentiation of cellular reaction to alloantigens and bacterial infection in human skin graft--immunosuppressive drugs or antibiotics.

The human hand transplantations prompted revival of interest in evaluation of the rejection process of the grafted skin and its control with the antirejection drugs [1-3]. In case of first hand transplantation a combined immunosuppressive regimen was applied with currently available drugs resulting in acceptance of the entire composite graft. No major untoward systemic effects of antirejection therapy were observed. The most important clinical conclusion was that allogeneic skin can be accepted and function as in a normal extremity, although the attack of host cells on the graft can not be totally eliminated. Chronic perivascular and subepidermal infiltrates with recipient cells could be seen [4]. Another problem connected with skin transplantation is graft infection. Skin is inhabited by a specific spectrum of bacteria [5]. Allografted skin is more sensitive to bacterial penetration than normal skin due to local damage by the host-versus-graft cellular reaction and compromised immune reactivity to bacterial antigens by the immunosuppressive therapy. The histological pictures of rejecting skin represent a mixture of cellular reaction against the graft and penetrating microbes. Alloreaction requires modification of immunosuppressive regimen and infection is an indication for prolonged antibiotic therapy against skin bacterial flora. The question arises how to discriminate the alloreactive and bacterial changes in the skin graft. We studied the histological pictures of rejecting and infected human skin after transplantion to scid mice.

Phenolic compounds in two Solidago L. species from in vitro culture.

The regenerated S. virgaurea and S. graminifolia, obtained previously by micropropagation from shoot tips and the callus tissue of S. virgaurea, were analysed for phenolic compounds. Preliminary used 2D-TLC methods (fingerprinting) showed the presence of phenolic glucoside--leiocarposide (S. virgaurea only), C-glycosyflavones--schaftoside and isoschaftoside (S. graminifolia), flavonoids and caffeoylquinic acids, similar to the ones reported earlier for naturally growing plants with the exception of the callus tissue. The latter contained predominantly caffeoylquinic acids, which were isolated and identified by NMR as 5-O-caffeoylquinic and 3,5-di-O-caffeoylquinic acids. The content of leiocarposide (HPLC) and flavonoids (colorimetry) in S. virgaurea was determined.