Post-mortem analysis of Candida albicans breakthrough infection during echinocandin treatment in haematopoietic stem cell transplant recipient.

We present case of a girl deceased due to Candida albicans breakthrough invasive infection during the echinocandin treatment after undergoing allogeneic haematopoietic stem cell transplant for relaps of acute myeloid leukaemia. Candida albicans generally susceptible to all antifungal drugs wasn't considered for potential resistance and conventional blood culture positivity was too late to reveal the resistance to echinocandins. Due to severe organ toxicities (liver, kidneys) she received echinocandin as an antifungal prophylaxis, no change was made for the treatment of Candida albicans infection. Later, the molecular analysis proved the mutation S645P known as being responsible for the echinocandin resistance. The post mortem analysis of fungal burden in autopsy samples showed very high levels of Candida DNA in gut, liver, spleen and kidneys.

[Microbiological identification of coagulase-negative staphylococci and the present status of their sensitivity to antibiotics]. / Mikrobiologická identifikace koaguláza-negativních stafylokoku a soucasný stav jejich citlivosti k antibiotikum.

Reliable laboratory diagnosis of coagulase-negative staphylococci and subsequent assessment of the MIC of these strains is part of the essential routine work of clinical laboratories with regard to the rising incidence of nosocomial coagulase-negative staphylococci infections, in particular in specialized departments concerned with important clinical issues.

[Actinomyces viscosus in subdural empyema]. / Actinomyces viscosus v subdurálním empyému.

The authors describe the finding of Actinomyces viscosus in pus from a subdural empyema in a child patient. When searching for the probable primary source of this uncommon infection of the central nervous system the authors identified by cultivation the same bacterial strain in a periapical dental granuloma. Bacterial diagnosis and radical surgical and antimicrobial therapy led to normalization of a clinical condition with an initially unfavourable prognosis.

[Immunologic cross reactivity of beta-lactam antibiotics]. / K otázce zkrízené imunologické reaktivity betalaktamových antibiotik.

The authors investigated the antibody response against beta-lactam antibiotics (penicillins, cephalosporins, monolactams, carbapenes) in conjugation with allergic reactions after penicillin administration. The results revealed a high percentage of positive antibody responses against penicillin and high percentage of crossed immunological reactivity between penicillin and the other investigated preparations.

[Immunologic reactivity of tylosin and erythromycin]. / K otázce imunologické reaktivity tylozinu a erytromycinu.

The authors investigated the antibody response to erythromycin and tylosine in experiments and in a clinical investigation. The results proved in 90-100% a crossed immunological reactivity of the two macrolid antimicrobial preparations. In view of the wide use of tylosine in veterinary practice and its presence in residues of slaughter animals as well as in serological tests, it is very probable that this preparation participates in a major way in the increased incidence of allergic reactions against erythromycin in humans. Clinical results confirmed this assumption.

[Immunologic aspects of macrolide antibiotics]. / Imunologické aspekty nekterých makrolidových antibiotik.

The authors investigated in an experimental and clinical study the part played by the macrolide antibiotic, tylosine, in the elevated immunological reactivity of the present population to Erythromycin. The first assembled results justify the statement that tylosine used in veterinary practice (sometimes without control) may indice acrossed immunological reactivity against Erythromycin. The authors discuss also other undesirable manifestations after Erythromycin administration. The assembled data confirm the need of an aimed and controllable administration of antimicrobial preparations in human as well as in veterinary medicine.