[Basic methods for extraction and molecular analysis of micromycetic DNA].

The methods for extraction of nucleic acids from the fungi and clinical materials containing various microorganisms have currently modified and make it possible to extract DNA with its highest yield and to minimize its destruction. In particular, this concerns mycelial fungi that have a rigid cell wall. Addition of glass microbeads to the lysed sample, followed by mixture stirring, gives rise to undamaged DNA from fungi and their spores. Extracted DNA is suitable for the identification of micromycetes by qualitative or quantitative polymerase chain reaction (PCR), real-time PCR-based hybridization, and LightCycler PCR and for the polymorphism analysis of the spacer regions of ribosomal genes by the sequencing technique. A combination of quantitative PCR and sequencing permits co-determination of the number of gene target copies in 9 different micromycetes in the clinical material being examined, which is of great importance for the diagnosis and treatment of patients with higher immunosuppression and, of those after transplantation of organs and tissues in particular.

[Circulating immune complexes in the diagnosis of allergic reactions of the immune-complex type]. / Tsirkuliruiushchie immunnye kompleksy v diagnostike allergicheskoi reaktsii immunokompleksnogo tipa.

The content of intermediate and small circulating immune complexes (iCIC and sCIC), the classical path of compliment activation (CCA), the concentration of C4 and C3 compliment components as well as the levels of IgM, IgG1, IgG2 and IgG3 in blood serum were examined in patients with atopic rhinitis and rhinoconjunctivitis concomitant with hypersensitivity to the Candida albicans allergen of the immediate and mixed (immediate and delayed) types. A significantly reduced concentration of sCIC, sCIC/iCIC(sCIC/iCIC), CCA and of the C4 content as well as a pronouncedly increased IgM concentration was typical of the patients with the mixed allergic reaction, which made them markedly different from the virtually healthy subjects and from patients with the immediate type of hypersensitivity. The most pronounced differences (p < 0.001) between the group of patients with the mixed type of allergic reaction and two other groups were those related with the sCIC/iCIC ratio index. Considering the study results, it can be assumed that the determination of the sCIC/iCIC could be used as an extra criterion in the laboratory diagnosis of the 3d (immunocomplex) types of allergic reaction as made in patients with atopic rhinitis and rhinoconjunctivitis with hypersensitivity to the C. albicans allergen.

[An outbreak of nosocomial candidiasis in a hematology ward]. / Vspyshka vnutribol'nichnogo kandidoza v gematologicheskom otdelenii.

The aim of the present investigation was the study of the epidemic process of hospital candidiasis. The study was carried out from October 1991 to May 1992 in a hematological ward of one of the hospitals of St.-Petersburg on 9 patients with generalized forms of candidiasis: in 4 of them the disease was caused by C. albicans and 5--by C. parapsilosis. Intestinal dysfunction as one of the first manifestations of candidosepsis caused by C. albicans, the isolation of C. albicans from feces, ulcero-necrotic colitis (established by postmortem examination), as well as the incapacity of these patients of immune response (in 2 serologically examined patients the titer of antibodies to fungi of the genus Candida was found to be lower than the diagnostic titer), were indicative of the dissemination of fungi from the gastrointestinal tract. The cases of fungemia caused by C. parapsilosis were due to the fungal contamination of vascular catheters in these patients. This infective agent was also isolated from washings obtained from the hands of nurses carrying out treatment and from medical rubber gloves. Moreover, some violations in the rules of the preparation of disinfecting solutions and the treatment of the hands of the personnel were established.

[The use of immunoenzyme analysis in the diagnosis of candidiasis in patients with different variants of hemoblastosis]. / Primenenie immunofermentnogo analiza v diagnostike kandidoza u bol'nykh razlichnymi variantami gemoblastozov.

A total of 84 blood sera taken from patients with tumors of the hematopoietic system, among them 63 blood sera from patients with candidiasis and 21 blood sera from patients without symptoms of Candida infection have been tested in the enzyme immunoassay (EIA). This assay has been found suitable for the diagnosis of the visceral forms of candidiasis in patients with acute leukemia and hematosarcoma. EIA has proved to be an inadequate method for the detection of Candida infection in chronic lympholeukemia patients, as well as in patients with acute leukemia and hematosarcoma, suffering from such local forms of candidiasis as candidiasis of the oral cavity.

[Diagnosis of mycotic infections in patients with tuberculosis of the respiratory organs]. / Diagnostika mikoticheskoi infektsii u bol'nykh tuberkulezom organov dykhaniia.

The basic clinico-diagnostic criteria are given which detect an intercurrent infection caused by opportunistic fungi of the Candida and Aspergillus genus. The antibacterial drugs of nonspecific action used in patients with destructive forms of respiratory tuberculosis promote the growth and reproduction of fungus flora and aggravate the course of the underlying process in the lung tissue. When there is intercurrent mycotic infection, the antifungal therapy produces a clinical effect in patients with combined pathology.