Filamentous Fungal Keratitis in Greece: A 16-Year Nationwide Multicenter Survey.

In a multicenter, prospective study of filamentous fungal keratitis in Greece, predisposing factors, etiology, treatment practices, and outcome, were determined. Corneal scrapings were collected from patients with clinical suspicion of fungal keratitis, and demographic and clinical data were recorded. Fungal identification was based on morphology, molecular methods, and matrix assisted laser desorption ionization time-of-flight mass-spectrometry. A total of 35 cases were identified in a 16-year study period. Female to male ratio was 1:1.7 and median age 48 years. Corneal injury by plant material, and soft contact lens use were the main risk factors (42.8% and 31.4%, respectively). Trauma was the leading risk factor for men (68.1%), contact lens use (61.5%) for women. Fusarium species were isolated more frequently (n = 21, 61.8%). F. solani was mostly associated with trauma, F. verticillioides and F. proliferatum with soft contact lens use. Other fungi were: Purpureocillium lilacinum (14.7%), Alternaria (11.8%), Aspergillus (8.8%), and Phoma foliaceiphila, Beauveria bassiana and Curvularia spicifera, one case each. Amphotericin B and voriconazole MIC50s against Fusarium were 2 mg/L and 4 mg/L respectively. Antifungal therapy consisted mainly of voriconazole locally or both locally and systemically, alone or in combination with liposomal AmB. Cure/improvement rate with antifungal therapy alone was 52%, keratoplasty was required in 40% of cases, and enucleation in 8%. In conclusion, filamentous fungal keratitis in Greece is rare, but with considerable morbidity. A large proportion of cases resulted in keratoplasty despite appropriate antifungal treatment.

In vitro anti-Helicobacter pylori activity of Greek herbal medicines.

In this paper, we have studied the anti-Helicobacter pylori effect of 70 Greek plant extracts and a number of commercially available herbs used traditionally in folk medicine against gastric ailments, peptic ulcer included. The extracts of Anthemis melanolepis, Cerastium candidissimum, Chamomilla recutita, Conyza albida, Dittrichia viscosa, Origanum vulgare and Stachys alopecuros have been proved active against one standard strain and 15 clinical isolates of H. pylori.

Depsides and other polar constituents from Origanum dictamnus L. and their in vitro antimicrobial activity in clinical strains.

Phytochemical investigation of the polar extracts of the aerial parts of Origanum dictamnus afforded 15 secondary metabolites. One new depside was isolated, to which the trivial name salvianolic acid P (1) was given, in addition to the known depsides rosmarinic acid (2) and rosmarinic acid methyl ester (3), as well as two monoterpenes, thymoquinone (4) and thymoquinol 2-O-beta-glucopyranoside (5); two simple phenolic acids, oresbiusin A (6) and E-caffeic acid (7); six flavonoids, namely, apigenin (8), kaempferol (9), quercetin (10), eriodictyol (11), taxifolin (12), naringenin (13); and two alicyclic derivatives, that is, 12-hydroxyjasmonic acid (14) and its 12-O-beta-d-glucoside (15). The structures of all isolated compounds were established by spectroscopic methods, mainly 1D and 2D NMR, as well as HPLC-DAD-MS and HR-MS spectrometric analyses. The absolute configuration of compound 1 was determined by CD measurements as 7'R, 7''S, 8''S. Compound 1 is interesting as it contains a benzodioxane ring, which is unusual in natural products. Moreover, it has been proved to be active against the Gram-negative clinical strains Acinetobacter hemolyticus , Empedobacter brevis , Pseudomonas aeruginosa , and Klebsiella pneumoniae .