Evaluation of Genetic Diversity of Candida spp. and Klebsiella spp. Isolated from the Denture Plaque of COPD Patients.

Yeast-like fungi and gram-negative bacilli are the most frequent potential pathogens of the respiratory tract isolated from the denture plaque of patients with chronic obstructive pulmonary disease (COPD). Dominant species among yeast-like fungi are Candida albicans and Candida tropicalis. Significant frequency is also exhibited by Klebsiella pneumoniae and Klebsiella oxytoca. The purpose of this study was to analyze genetic diversity of the strains of C. albicans, C. tropicalis, and Klebsiella spp. present in patients in stable phases of COPD. The analysis was conducted by the random amplified polymorphic DNA (RAPD) method on clinical strains isolated from patients with COPD and control patients in overall good health. Forty one strains of Candida albicans, 12 of Candida tropicalis, as well as 9 strains of K. pneumoniae and 7 of K. oxytoca were scrutinized. The dominant species in clinical material from COPD patients was Candida albicans with a substantial degree of variations of genetic profiles. On the basis of affinity analysis, 19 genetic types were identified within this strain. An analysis of the banding patterns among C. tropicalis strains indicated the existence of 6 genetic types. A considerable diversity of genetic profiles among Klebsiella spp. also was established. The genotype diversity of Klebsiella spp. strains may indicate the endogenic character of the majority of infections, regardless of the therapy applied for the underlying condition.

Diagnosis of Invasive Pulmonary Aspergillosis.

Culturing strains from clinical samples is the main method to diagnose invasive pulmonary aspergillosis. Detecting the galactomannan antigen in serum samples is an auxiliary examination. The goal of this study was to determine the frequency with which Aspergillus fumigatus was cultured in clinical samples taken from patients hospitalized in the the Infant Jesus Teaching Hospital in Warsaw, Poland, in the period of 2013-2014. Specimens from the respiratory tract and blood were cultured for mycological and serological assessments. Strain isolation was performed in chloramphenicol Sabouraud agar. Species identification was based on morphological traits in macro-cultures and on microscopic examination. The galactomannan antigen was detected by ELISA method. Out of 2000 clinical samples with positive mycological results, 200 were obtained from the respiratory tract. A. fumigatus was cultured in 13 cases from the respiratory group. Ten cases were cultured out of tracheal aspirates and three from bronchoalveolar lavage fluid. The galactomannan antigen was detected in a serum sample from only one out of the 13 patients with cultures positive for A. fumigatus. It also was detected in serum samples of three other patients in whom A. fumigatus culture yielded a negative result. We conclude that culture-confirmed invasive pulmonary aspergillosis represents a scarce finding. A. fumigatus cultured from clinical samples may not always be confirmed by ELISA assay and vice versa a positive ELISA result does not attest the successful culture.

Trends in antifungal susceptibility of Candida species--one year observation.

In the past years opportunistic fungal infections have seriously increased, mainly in immunocompromised patients. The aim of the study was to determine the prevalence of yeast-like fungi in invasive candidiasis and to estimate its susceptibility to chosen antifungal agents. One hundred and sixty strains of yeast-like fungi were cultured from various clinical material: samples from lower respiratory tract, blood, the peritoneal cavity and others. The susceptibility tests were established according to the quantitative E-test method. The Candida genus represented the main etiological factor of invasive candidiasis. The predominant species were: C. glabrata (71/160), C. albicans (34/160), C. krusei (17/160), C. tropicalis (14/160). All tested strains were the most resistant to itraconazole. Candida glabrata presented the 100% susceptibility to amphotericin B and caspofungin and was the least susceptible to itraconazole, posaconazole and voriconazole. Candida albicans was the most susceptible species to all antymicotics.

Polymerase chain reaction melting profiles of Candida glabrata clinical isolates in solid organ transplant recipients in comparison to the other group of surgical patients.

The aim of the retrospective study were to estimate the prevalence of Candida glabrata in liver and kidney transplant recipients compared to patients with short bowel syndrome receiving chronic total parenteral nutrition and relevance of the polymerase chain reaction melting profile (PCR MP) method for Candida glabrata strains differentiation. C. glabrata clinical strains isolated from patients were identified by using standard mycological procedures. The analysis of genetic relatedness of the isolated strains was conducted using the PCR MP method. The prevalence of C. glabrata comprised 29% of all episodes of fungal colonization and infection in solid organ transplant recipients, and 54% of those in hospitalized patients receiving long-term total parenteral nutrition. Among 78 isolates obtained from 55 solid organ transplant recipients and 2 organ donors, 44 different C. glabrata PCR MP fingerprints were observed. Forty-seven organ recipients and one organ donor carried unique C. glabrata strains. Among 37 isolates obtained from 31 patients receiving long-term TPN, 8 different PCR MP profiles of C. glabrata strains were observed. Two patients carried unique C. glabrata strains. Most of the C. glabrata colonization and infections in solid-organ transplant recipients were caused by endogenic strains. Most of the C. glabrata colonization and infections in hospitalized patients receiving long-term total parenteral nutrition could result by patient-to-patient transmission. The results showed that the PCR MP technique is a good discriminatory method for genotyping for C. glabrata strains.