Value of measuring serum procalcitonin, C-reactive protein, and mannan antigens to distinguish fungal from bacterial infections.

The study presented here was conducted to determine the diagnostic value of measuring procalcitonin, C-reactive protein, and mannan antigens to distinguish fungal from bacterial infections. The sensitivity and specificity of these measurements ranged from 35% to 97%. On days 1 and 3 following the onset of fever, both serum procalcitonin and C-reactive protein levels were lower in patients with fungal infections than in those with bacterial infections (p<0.0001). The presence of mannan antigens combined with a procalcitonin level <0.5 ng/ml provided higher specificity for distinguishing fungal from bacterial infections than each result alone.

Antimicrobial activity of argon fluoride (ArF) excimer laser on gram-negative bacteria.

The objective of this study was to evaluate the antibacterial activity of argon fluoride (ArF) excimer laser radiation on clinically important strains of gram-negative bacteria. The antibacterial activity of ArF excimer laser radiation was evaluated on two Acinetobacter baumannii, one Enterobacter cloacae, three Escherichia coli, two Helicobacter pylori, one Klebsiella pneumoniae and two Pseudomonas aeruginosa strains. The strains were isolated from clinical specimens and typed by the usual biochemical procedures. Square agar plates of 12 x 12 cm were divided into rectangular (2 x 3 cm) regions and spread with 0.5x 10(4) colony forming units (CFU)/ml of bacterial suspension. The excess liquid was removed and the plates were allowed to dry for 30 min. A total of 96 rectangular (2x3 cm) regions were used for each strain, in order to test an equal number of laser parameters. Each rectangular region was irradiated with different laser parameters, using a 193 nm ArF excimer laser, linked with a simple Galilean afocal system and a rectangular diaphragm of the same dimensions as the original laser beam cross-section, at a distance of 10 cm from the irradiated surface. This system was used in order to keep the laser pulse energy under 80 mJ and to cut-out the non-transverse electromagnetic mode branches of the laser beam. We then studied the bacterial survival ratio versus the number of laser pulses, the repetition frequency and the total laser beam fluence. Our results showed that the total laser beam fluence was the most important parameter to consider in evaluating the bactericidal effect of ArF excimer laser radiation. A critical value of the total fluence was determined for each strain, such that, for laser beam fluences greater than this critical value, no colonies appeared to survive while, for laser fluences less than this critical value, the survival ratio did not exceed 2 x 10(7) CFU (2 x 10(-5)%). These critical values were found to vary between 8 J/cm2 and 16 J/cm2 for the bacterial species studied. Under these conditions, ArF laser irradiation is promising for the sterilisation of hard surfaces and for in situ application.

Controlled release of water-soluble polymeric complexes of sorbic acid with antifungal activities.

We synthesized six water-soluble polymeric complexes of sorbic acid with polyvinylpyrrolidone of different molecular weight (mol wt). As shown by infrared absorption spectrum analysis, the complexes were formed by hydrogen bonding. The complexes (SC1, with mol wt=10 kDa, SC2 with mol wt=25 kDa, SC3 with mol wt=30 kDa, SC4 with mol wt=40 kDa, SC5 with mol wt=90 kDa, and SC6 with mol wt=360 kDa) were characterized as low mol wt (SC1, SC2, and SC3) and high mol wt (SC4, SC5, and SC6). The antifungal potencies of the complexes were tested by the macrodilution susceptibility method against environmental and clinically important fungi. Sorbic acid as well as the complexes exhibited minimum inhibitory concentrations (MICs) lower than potassium sorbate against all the strains tested. MICs of SC1, SC2, and SC3 were shown to be 2- to 4-fold lower for yeast and 1.5- to 3-fold lower than those of sorbic acid for moulds, respectively. The MICs of SC4 and SC5 against both of the Candida species tested ranged from 500 to 800 microg/ml, whereas for SC6 and sorbic acid they were about 1 mg/ml. The potencies of the high mol wt complexes against moulds were decreased by increasing the mol wt. For both of the moulds tested, the MICs of SC4 were slightly lower than those of sorbate. The MICs of sorbic acid and SC5 were equal to 300 microg/ml and 500 microg/ml respectively for Aspergillus parasiticus and for Penicillum viridicatum. The susceptibility to SC6 of all of the hyphomycetes tested was higher than that to sorbic acid. The low mol wt complexes and the sorbic acid exhibited minimal fungicidal concentrations (MFCs) 2 and 3 times higher respectively than the MICs. Sorbic acid and SC3 at a concentration of 2.5 mg/ml in an in vitro time kill curve study of Candida tropicalis were shown to be fungistatic, whereas SC1 and SC2 were fungicidal at the same concentrations. For Aspergillus parasiticus sorbic acid at 2.5 mg/ml was fungistatic for a 24-h period, whereas SC1, SC2, and SC3 were fungicidal.

Evidence for an efflux pump in multidrug-resistant Campylobacter jejuni.

Mechanisms of drug resistance in Campylobacter jejuni were investigated. Mutant strains 34PEFr, which was resistant to pefloxacin (128-fold increase in the MIC), and 34CTXr, which was resistant to cefotaxime (32-fold increase in the MIC) and which was derived from the susceptible parent 34s, were obtained by serial passages on pefloxacin and cefotaxime gradient plates, respectively. Both mutants showed cross-resistance to erythromycin, chloramphenicol, tetracycline, beta-lactams, and quinolones. While the quinolone resistance of strain PEFr could be explained by a mutation at codon 86 of the gyrA gene, the multidrug resistance phenotype of both strains was further investigated. Accumulation of pefloxacin, ciprofloxacin, and minocycline was measured by fluorometry and was found to be lower in the mutant strains than in the parent strain. Preincubation of the cells with carbonyl cyanide m-chlorophenylhydrazone, however, completely abolished this difference. Analysis by sodium dodecyl sulfate-polyacrylamide gel electrophoresis of outer membrane preparations from both mutant strains showed overexpression of two proteins of 55 and 39 kDa which were absent from the outer membranes of the wild-type strain. These results indicate that in C. jejuni 34PEFr and 34CTXr, multidrug resistance is associated with an efflux system with a broad specificity.

Detection of ciprofloxacin resistance mutations in Campylobacter jejuni gyrA by nonradioisotopic single-strand conformation polymorphism and direct DNA sequencing.

A total of 27 strains of Campylobacter jejuni (24 clinical strains and three laboratory strains) were examined for the presence of point mutations in the quinolone resistance determining region (QRDR) of gyrA gene by nonradioisotopic single-strand conformation polymorphism (non-RI SSCP) analysis with silver stain. Direct DNA sequencing of the polymerase chain reaction (PCR)-amplified DNA fragments confirmed the results obtained by non-RI SSCP analysis and revealed that in clinical strains high-level quinolone resistance [minimal inhibitory concentration (MIC) to ciprofloxacin > or = 16 micrograms/ml] was closely associated with one type of single-point mutation at codon 86 (Thr-Ile). Two strains with MICs of 8 and 1 microgram/ml showed point mutations at codons 86 and 70, respectively. Furthermore, transitions at codon 119 of the gyrA QRDR were identified in 17 strains. Six types of bands were separated in a single electrophoretic step with silver stain within 2 hours after PCR amplification of the gyrA QRDR as follows: type I associated to mutation at codon 70 (Ala-Thr), type II to mutation at codon 90 (Asp-Asn), type III to variant with transition at 119, type IV to wild-type, type V to mutation at codon 86 (Thr-Ile), and type VI to mutation at codon 86 (Thr-Ile) and transition at codon 119. Using four DNA extracts from Cambylobacter coli organisms as templates for amplification of the gyrA QRDR, no PCR products were obtained. Non-RI SSCP was proved to be a simple, rapid, and useful screening method for detecting gyrA mutations associated with ciprofloxacin resistance in C. jejuni.

Comparison of in vitro activities of amphotericin, clotrimazole, econazole, miconazole, and nystatin against Fusarium oxysporum.

The inhibitory activity of amphotericin B, clotrimazole, econazole, miconazole and nystatin was compared against Fusarium oxysporum f.sp. radicis-cucumerinum. The most efficient antifungal agent against the growth of Fusarium oxysporum was econazole, followed by clotrimazole, miconazole, amphotericin and nystatin. The ED50 and ED90 values were 0.053 and 1.002 ppm for econazole, 0.088 and 1.100 ppm for clotrimazole, 0.173 and 3.210 ppm for miconazole, 0.713 and greater than 48 ppm for amphotericin and 3.860 and 16.702 ppm for nystatin. The ED50 values of nystatin and amphotericin against spore germination of Fusarium oxysporum were determined at 3.1427 ppm and 8.3990 ppm respectively, nystatin was 2.76 times more effective than amphotericin, while no effect was observed after the addition of econazole, clotrimazole and miconazole. The tested azoles were more effective than amphotericin and nystatin on growth inhibition of Fusarium oxysporum but amphotericin and nystatin acted significantly better on spore germination of Fusarium.

Epidemiological study of brucellosis in eight Greek villages using a computerised mapping programme.

A Computerised Mapping Programme (CMP) was created step by step to cover all the needs of a cross sectional population survey conducted in eight villages of Fokida, a rural area of central Greece. The maps of Greece (boundary) and the topographical maps of the eight villages were created using the CMP. A volunteer sample of 1121 out of 2607 inhabitants of the study area participated in the population survey. The participants were tested for brucellosis using serological tests (ELISA and Rose Bengal) and the intradermal reaction test. A questionnaire was used to obtain information concerning the risk factors for brucellosis. The risk factors found through statistical analysis were occupation (RR: 5.81, p < 0.00001), consumption of raw milk (RR: 1.98, p < 0.001) and unpasteurised fresh cheese (RR: 2.13, p < 0.01). The same factors were indicated by the CMP. The CMP also indicated manure-contaminated playgrounds in residential yards as a potential risk factor for children. The origin and dissemination were delineated using time space association display. The CMP proved to be a useful tool in this epidemiological study.