Syntheses of Novel 4-Substituted N-(5-amino-1H-1,2,4-triazol-3-yl)pyridine-3-sulfonamide Derivatives with Potential Antifungal Activity.

Candidiasis represent a serious threat for patients with altered immune responses. Therefore, we have undertaken the synthesis of compounds comprising a pyridine-3-sulfonamide scaffold and known antifungally active 1,2,4-triazole substituents. Thus a series of novel 4-substituted N-(5-amino-1H-1,2,4-triazol-3-yl)pyridine-3-sulfonamides have been synthesized by multistep reactions starting from 4-chloropyridine-3-sulfonamide via N'-cyano-N-[(4-substitutedpyridin-3-yl)sulfonyl]carbamimidothioates which were further converted with hydrazine hydrate to the corresponding 1,2,4-triazole derivatives 26-36. The final compounds were evaluated for antifungal activity against strains of the genera Candida, Geotrichum, Rhodotorula, and Saccharomycess isolated from patients with mycosis. Many of them show greater efficacy than fluconazole, mostly towards Candida albicans and Rhodotorula mucilaginosa species, with MIC values ≤ 25 µg/mL. A docking study of the most active compounds 26, 34 and 35 was performed showing the potential mode of binding to Candida albicans lanosterol 14α-demethylase. Also in vitro cytotoxicity of selected compounds have been evaluated on the NCI-60 cell line panel.

Capping Agent-Dependent Toxicity and Antimicrobial Activity of Silver Nanoparticles: An In Vitro Study. Concerns about Potential Application in Dental Practice.

Objectives: In dentistry, silver nanoparticles (AgNPs) have drawn particular attention because of their wide antimicrobial activity spectrum. However, controversial information on AgNPs toxicity limited their use in oral infections. Therefore, the aim of the present study was to evaluate the antibacterial activities against a panel of oral pathogenic bacteria and bacterial biofilms together with potential cytotoxic effects on human gingival fibroblasts of 10 nm AgNPs: non-functionalized - uncapped (AgNPs-UC) as well as surface-functionalized with capping agent: lipoic acid (AgNPs-LA), polyethylene glycol (AgNPs-PEG) or tannic acid (AgNPs-TA) using silver nitrate (AgNO3) as control. Methods: The interaction of AgNPs with human gingival fibroblast cells (HGF-1) was evaluated using the mitochondrial metabolic potential assay (MTT). Antimicrobial activity of AgNPs was tested against anaerobic Gram-positive and Gram-negative bacteria isolated from patients with oral cavity and respiratory tract infections, and selected aerobic Staphylococci strains. Minimal inhibitory concentration (MIC) values were determined by the agar dilution method for anaerobic bacteria or broth microdilution method for reference Staphylococci strains and Streptococcus mutans. These strains were also used for antibiofilm activity of AgNPs. Results: The highest antimicrobial activities at nontoxic concentrations were observed for the uncapped AgNPs and the AgNPs capped with LA. It was found that AgNPs-LA and AgNPs-PEG demonstrated lower cytotoxicity as compared with the AgNPs-TA or AgNPs-UC in the gingival fibroblast model. All of the tested nanoparticles proved less toxic and demonstrated wider spectrum of antimicrobial activities than AgNO3 solution. Additionally, AgNPs-LA eradicated Staphylococcus epidermidis and Streptococcus mutans 1-day biofilm at concentration nontoxic to oral cells. Conclusions: Our results proved that a capping agent had significant influence on the antibacterial, antibiofilm activity and cytotoxicity of AgNPs. Clinical significance: This study highlighted potential usefulness of AgNPs against oral anaerobic Gram-positive and Gram-negative bacterial infections and aerobic Staphylococci strains provided that pharmacological activity and risk assessment are carefully performed.

EVALUATION OF THE TEA TREE OIL ACTIVITY TO ANAEROBIC BACTERIA--IN VITRO STUDY.

The study of the sensitivity to tea tree oil (Australian Company TTD International Pty. Ltd. Sydney) was carried out on 193 strains of anaerobic bacteria isolated from patients with various infections within the oral cavity and respiratory tracts. The susceptibility (MIC) of anaerobes was determined by means of plate dilution technique in Brucella agar supplemented with 5% defibrinated sheep blood, menadione and hemin. Inoculum contained 10(5) CFU per spot was cultured with Steers replicator upon the surface of agar with various tea tree oil concentrations or without oil (anaerobes growth control). Incubation the plates was performed in anaerobic jars under anaerobic conditions at 37 degrees C for 48 h. MIC was defined as the lowest concentrations of the essential oil completely inhibiting growth of anaerobic bacteria. Test results indicate, that among Gram-negative bacteria the most sensitive to essential oil were strains of Veillonella and Porphyromonas species. Essential oil in low concentrations (MIC in the range of = 0.12 - 0.5 mg/mL) inhibited growth of accordingly 80% and 68% strains. The least sensitive were strains of the genus Tannerella, Parabacteroides and Dialister (MIC 1.0 - 2.0 mg/mL). In the case of Gram-positive anaerobic bacteria the tea tree oil was the most active to strains of cocci of the genus Anaerococcus and Ruminococcus (MIC in range = 0.12 - 0.5 mg/mL) or strains of rods of the genus Eubacterium and Eggerthella (MIC = 0.25 mg/mL). Among Gram-positive rods the least sensitive were the strains of the genus Bifidobacterium ( MIC = 2.0 mg/mL). The tea tree oil was more active to Gram-positive than to Gram-negative anaerobic bacteria.

N-Substituted N'-(2-alkylthio-4-chloro-5-methylbenzenesulfonyl)guanidines--Antibacterial, Cytotoxic Activities and Some Structure-Activity Relationships.

A series of N-substituted N'-(2-alkylthio-4-chloro-5-methylbenzenesulfonyl)guanidine derivatives bearing sulfonamide moiety have been screened in vitro for antibacterial activity against isolates from patients with infections of oral cavity, respiratory tract and intestinal tract. The majority of compounds exhibited good antibacterial potency. 1-[4-Chloro-5-methyl-2-(4-trifluoromethylbenzylthio)benzenesulfonyl]-3-(3-sulfamoylphenyl)guanidine (13) showed very strong activity, with MIC ≤ 6.2 µg/ml against eleven bacteria strains belonged to Gram-positive anaerobes and aerobes. Furthermore, compound 13 exhibited promising activity toward highly resistant microorganisms such as methicillin-resistant Staphylococcus aureus and Enterococcusfaecalis. It was found that Parvimonas micra, Finegoldia magna, Peptostreptococcus anaerobius, Propionibacterium acnes showed the highest susceptibility toward the investigated guanidines.

IN-VITRO ANTIMICROBIAL ACTIVITY OF BRONCHOSOL.

Bronchosol is a traditional medicinal product in the form of syrup used in cough and impeded expectoration. The active ingredients that it contains include extracts from the herb of thyme, the root of primrose and thymol. It is recommended in disorders of the respiratory tract when expectoration is impeded and secretion of liquid mucus in bronchi is insufficient. Antimicrobial activity of the components of Bronchosol, especially thyme and thymol, has frequently been reported in the literature. To date, there have not been any studies to confirm such activity of Bronchosol, though. The results of our research are the first one to point to the great activity of Bronchosol against microorganisms causing infections of the respiratory tract. It has been demonstrated that this product displayed antimicrobial activity against reference strains as well as strains of anaerobic and aerobic bacteria and fungi isolated from patients. The confirmation of the antimicrobial activity of Bronchosol provides an explanation of its effectiveness in the therapy of the respiratory tract infections.

Synthesis and anti-yeast evaluation of novel 2-alkylthio-4-chloro-5-methyl-N-[imino-(1-oxo-(1H)-phthalazin-2-yl)methyl]benzenesulfonamide derivatives.

Pathogenic fungi are one of the main causes of hospital-related infections. Since conventional antifungals have become less effective because of the increasing fungal resistance to the standard drugs, the need for new agents is becoming urgent. Herein we report a synthesis of a series of novel N-[imino-(1-oxo-(1H)-phthalazin-2-yl)methyl]-benzenesulfonamide derivatives with in vitro activity against yeast-like fungi isolated from the oral cavity and respiratory tract of patients with candidiasis. These compounds were synthesized by the one-step or two-step reactions of 1-(2-alkylthiobenzensulfonyl)-2-aminoguanidines with the appropriate ortho-carbonyl benzoic acids. The biological study revealed that new derivatives have shown significant growth-inhibitory activity, superior or comparable, than those of the reference drug fluconazole. The most promising activities were observed against Candida albicans, with inhibition at least 1-3 (12.5%-37.5%) of the eight tested strains at the low MIC level of ≤6.2-25 µg/mL.

Antimicrobial activity of preparation Bioaron C.

The antimicrobial activity of sirupus Bioaron C, a preparation, whose main ingredient is an extract from the leaves of Aloe arborescens, was tested against different microorganisms isolated from patients with upper respiratory tract infections. The experiments were performed on 40 strains: 20 strains of anaerobic bacteria, 13 strains of aerobic bacteria and 7 strains of yeast-like fungi from the genus Candida and on 18 reference strains (ATCC). The antimicrobial activity of Bioaron C (MBC and MFC) was determined at undiluted concentration. Bioaron C proved to be very effective against the microorganisms causing infections. At the concentration recommended by the producer, the preparation showed biocidal activity (MBC, MFC) against the strains of the pathogenic microorganisms, which cause respiratory infections most frequently, including, among others, Peptostreptococcus anaerobius, Parvimonas micra, Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae, Streptococcus anginosus, Haemophilus influenzae, Moraxella catarrhalis, Pseudomonas aeruginosa and Candida albicans, already after 15 min. The MIC of Bioaron C against most of the tested microorganisms was 5 to 100 times lower than the usually applied concentration. The great antimicrobial activity means that the preparation may be used in the prevention and treatment of infections of the upper respiratory tract. Bioaron C may be an alternative or complement to classical therapy, especially in children.

Synthesis and antibacterial activity of novel 4-chloro-2-mercaptobenzenesulfonamide derivatives.

Few series of novel 4-chloro-2-mercaptobenzenesulfonamides have been synthesized by the reactions of N-(benzenesulfonyl)cyanamide potassium salts 7-15 with corresponding hydrazinecarbodithioic acid esters, 1-substituted carbothioic acid hydrazides, methyl 3-aminothiophene-2-carboxylate, methyl 2-aminobenzoate, 2-aminophenol or 2-aminothiophenol. The synthesized compounds (16-49) were screened in vitro for their antibacterial activity. Some of the tested compounds 16, 17, 23, 24, 31, 32 and 48 showed the promising activity against many of anaerobic Gram-positive bacteria strains.

[Bacteriological spectrum of periodontal pocket in patients with coronary heart disease and myocardial infarction]. / Spektrum bakteriologiczne kieszonki przyzebnej u osób z choroba wiencowa i po zawale serca.

INTRODUCTION: In the last years literature has paid attention to positive correlation between periodontitis and coronary heart disease, acute coronary events, including myocardial infarction. Mechanisms of this relationship are not completely known. One of the research trends for elucidation of these problems are bacteriological studies. The aim of this study was qualitative and quantitative evaluation of bacterial flora of the periodontal pocket in patients with coronary heart disease and myocardial infarction, with co-existing periodontitis. MATERIAL AND METHODS: The research included 40 patients, hospitalised in 1st Clinic of Cardiology, Medical University in Gdansk. Group 1 included 20 patients after myocardial infarction, group 2 of 20 patients with diagnosed coronary heart disease, with many years duration without acute events. Control group encompassed 20 patients of Chair and Department of Periodontology and Oral Mucosa Diseases, Medical University in Gdansk, without cardiovascular diseases. Inclusion criterion for the study was diagnosed chronic periodontitis in all patients. In clinical evaluation indices: API, SBI, PD and CAL were used. The material for bacteriological research was taken in each patient from 4 periodontal pockets, minimum 5 mm depth. The culture and identification were performed with present principles. Based on the litearture data about potential pathogenicity for periodontium and cardiovascular system, species for analyse were chosen. RESULTS: Statistical analyse proved equality of evaluated groups and control group in gender, age and estimated clinical indices. In periodontal pockets all patients anaerobic flora dominated, however without significiant differences in species range. Among microaerophilia and streptococci statistical analyse showed significiant differences in frequency of isolation of Actinobacillus actinomycetescomitans and Streptococcus sanguis in group 1 in comparision to group 2 and control group. Quantitative analyse showed no significiant differences between groups for all bacteria species. CONCLUSIONS: Clinical evaluation showed comparable values of periodontal parameters. The bacteria species Porphyromonas gingivalis, Actinobacillus actinomycetescomitans and Streptococcus sanguis were more often isolated from periodontal pockets in persons after myocardial infarction, statistically significant for A.a. and S.s.

In vitro activity of synthetic antimicrobial peptides against Candida.

Yeast-like fungi are the most common cause of fungal infections in humans. Actually, in the age of opportunistic infections and increasing resistance, development of modern antifungal agents becomes a very important challenge. This paper describes synthesis and antimicrobial assay of four naturally occurring peptide antibiotics (aurein 1.2, citropin 1.1, temporin A, uperin 3.6) and three chemically engineered analogues actually passing clinical trials (iseganan, pexiganan, omiganan) against Candida strains isolated from patients with infections of the oral cavity or respiratory tract. The peptides were synthesized using solid-phase method and purified by high-performance liquid chromatography. Biological tests were performed using the broth microdilution method. The antifungal activity of the peptide antibiotics was compared to that of nystatin and amphotericin B. We found synthetic peptides to be generally less potent than amphotericin B or nystatin. However, some of the naturally occurring peptides still retained reasonable antifungal activities which were higher than these of iseganan, pexiganan or omiganan. We think that the naturally occurring peptide antibiotics included in our study can be a good matrix for development of novel antifungal compounds.

Studies on pyrazine derivatives. XLVII. Synthesis and antibacterial activity of novel pyrazine derivatives with amidoxime moiety.

The new pyrazine derivatives exhibiting an antibacterial activity have been synthesized. Initial amidoxime 1 was obtained in the reaction of pyrazinecarbonitrile with hydroxylamine. Upon treatment of amidoxime with methyl iodide O-methyl derivative 2 was formed. Both amidoximes were transformed into imidoyl chlorides 3, 4. Then the chloride atom in those derivatives was substituted with various secondary amines giving appropriate oximes 5-18 and O-methyl-oximes 19 and 20. The obtained compounds were tested in vitro for their tuberculostatic activity. The inhibiting concentration (MIC) values were within 25-100 microg/mL. Their activity towards 25 strains of anaerobic and 25 strains of aerobic bacteria was also studied. Three compounds exhibited activity against both types of bacteria.

[Candida infections of the oral mucosa--not only a dental problem]. / Kandydoza blony sluzowej jamy ustnej problem nie tylko stomatologiczny.

UNLABELLED: Frequency of occurrence of mycotic infections of the oral mucosa is higher in later years. It is connected with common use of antibiotics, intensive cancer treatment (cytostatics, radiation therapy) as well as immunosuppressant drugs and antibiotics, which have an influence on mikroflora disorders of the oral cavity. Candidiasis of oral mucosa occurs in old patients, in people suffering from diabetes mellitus, hypothyreosis, sideropenia, hypovitaminosis and xerostomia, which is often caused by hypofunction of salivary glands during autoimmune diseases and/or drug and systemic treatment. The aim of the study was to make a retrospective evaluation of frequency of occurring mycotic infections in patients treated in the Department of Periodontology and Oral Mucosa Diseases, Medical University of Gdansk in the 2003, as well as recognition of systemic conditioning of these disorders. The Study material was clinical documentation of 4172 patients, treated because of different oral mucose and periodontium disorders. From these patients, selected was a group of 105 (83 women and 22 men) with diagnosis--Candidosis mucosae oris. Clinical and mycotic examination was performed. RESULTS: Mycotic infections were found in 105 patients (2.5%). Systemic diseases (74.3%) were found in a maturity of the patients, which indicated systemic predispositions to candida infections. CONCLUSION: A wide cooperation between general practitioners and dentists, especially perio-dontologists, is necessary to give full care to patients. Early diagnosis of disorders of the oral cavity of patients with systemic diseases and dentistry treatment or taking preventive measures seems to be necessary.

Association between Bacterial Infection and Peripheral Vascular Disease: A Review.

There are an increasing number of data showing a clinically important association between bacterial infection and peripheral artery disease (PAD). Bacteria suspected of being involved in PAD pathogenesis are: periodontal bacteria, gut microbiota, Helicobacter pylori, and Chlamydia pneumoniae. Infectious agents may be involved in the pathogenesis of atherosclerosis via activation of a systemic or local host immunological response to contamination of extravascular tissues or the vascular wall, respectively. A systemic immunological reaction may damage vascular walls in the course of autoimmunological cross-reactions between anti-pathogen antibodies and host vascular antigens (immunological mimicry), pathogen burden mechanisms (nonspecific activation of inflammatory processes in the vascular wall), and neuroendocrine-immune cross-talk. Besides activating the inflammatory pathway, bacterial infection may trigger PAD progression or exacerbation by enhancement of platelet reactivity, by a stimulatory effect on von Willebrand factor binding, factor VIII, fibrinogen, P-selectin activation, disturbances in plasma lipids, increase in oxidative stress, and resistance to insulin. Local inflammatory host reaction and induction of atherosclerotic plaque progression and/or instability result mainly from atherosclerotic plaque colonization by microorganisms. Despite these premises, the role of bacterial infection in PAD pathogenesis should still be recognized as controversial, and randomized, controlled trials are required to evaluate the outcome of periodontal or gut bacteria modification (through diet, prebiotics, and probiotics) or eradication (using antibiotics) in hard and surrogate cardiovascular endpoints.

Synthesis and Antifungal Activity of Some 4,6-Dimethylisoxazolo[3,4- b]pyridin-3(1H)-one Derivatives.

BACKGROUND: Cutaneous and invasive fungal infections are constant threats to human health that substantiate the need for the development of new efficacious and safe antimycotics. METHODS: A series of N1-alkyl, N1-acyl and N1-sulfonyl derivatives of 4,6- dimethylisoxazolo[3,4-b]pyridin-3(1H)-one (1) were synthesized. The antimicrobial activities of title compounds against 21 pathogenic yeast-like fungal clinical isolates and 5 reference strains were evaluated by means of a broth microdilution method. RESULTS: Among the compounds tested, the newly prepared N1-benzoyl (2m) and N1-(4-fluorobenzoyl) (2n) derivatives of 1 showed 81% and 95% inhibitory efficacy, respectively, against the clinical isolates, which were comparable to that of the reference drug fluconazole. The strains that exhibited the highest susceptibility to the compound 2n included Candida utilis (MIC < 6.2 µg/mL), C. parapsilosis (MIC in the range <6.2 - 12.5 µg/mL), Geotrichum candidum (MIC = 12.5 µg/mL) as well as C. lusitaniae and Rhodotorula mucilaginosa (MIC = 25 µg/mL). CONCLUSION: In terms of MIC, compound 2n proved to be four times more active against the clinical isolates of Candida albicans and C. albicans ATCC 10231 standard strain than fluconazole, the widely prescribed antifungal agent for mucosal and systemic yeast infections (MIC = 50 vs 200 µg/mL).

Synthesis and antibacterial activity of 1H-pyrazolo[3,4-b]pyrazine and -pyridine derivatives.

The investigations of new pyrazine and pyridine derivatives showing an antibacterial activity have been made. Upon treatment of 3-chloro-2-cyanopyrazine [1] and 2-chloro-3-cyanopyridine with 1,1-dimethyl-hydrazine, 1-aminopiperidine and 1-amino-4-methylpiperazine, either the pyrazolo-pyrazine (1), and -pyridine (2) derivatives, or ammonium salts (3-8) were obtained, according to the reaction conditions. Compound 1 was obtained in the reaction of the initial nitrile with methylhydrazine as well. The reactions of 1 gave the following derivatives: acylation-(9), that with p-chlorobenzoic aldehyde-(10), and with phenyl-isothiocyanate-(11). 3-Chloro-2-cyanopyrazine treated with hydrazine hydrate gave amidrazone (12), which upon condensation with p-chlorobenzoic aldehyde produced (13). The compounds obtained were tested in vitro for their tuberculostatic activity. The minimal inhibitory concentration (MIC) values were within 22-100 microg/cm3. Compounds 1, 5 and 6 were also tested in vitro for their activity towards 25 strains of anaerobic, and 25 strains of aerobic bacteria. They appeared to be of elevated activity towards the anaerobes and of low one towards the aerobes (Table 2).

[The occurrence of microorganisms in intraoral abscesses]. / Wystepowanie drobnoustrojów w ropniach wewnatrzustnych.

The aim of this study was to assess the occurrence of microorganisms in 39 intraoral abscesses. The samples were place in transport medium. The materials were inoculated on adequate enrichment and selective media and cultivated under anaerobic and aerobic conditions. The microorganisms were found in all samples (100%), Anaerobic bacteria most frequently were recovered. The predominant anaerobes were from genus Prevotella, Bacteroides, Fusobacterium and Peptostreptococcus. Among aerobic bacteria, the most frequent were gram-positive cocci. The microaerophilic bacteria and fungi most rarely were isolated from pus samples.

[Anaerobic bacteria in bronchoalveolar lavage fluid (BAL) after thoracic surgery]. / Wystepowanie bakterii beztlenowych w popluczynach pecherzykowo-oskrzelikowych u chorych po operacjach torakochirurgicznych.

Purpose of this study was to find out what kind of anaerobic bacteria were in lower respiratory tract and how often they were present there considering patients after thoracic surgery. Also, what is susceptibility of bacteria to antibiotics. Research covered 30 patients after operation. Material for research was bronchoalveolar lavage (BAL) taken during bronchoscopy. Collected sample was cultivated in anaerobic and aerobic conditions. Anaerobic bacteria were found in 28 samples (93%). Totally there were 100 anaerobic bacteria strains. The most common Gram-negative rods were from genus Prevotella (24 strains, 24%) and Bacteroides (15 strains, 15%). Gram-negative bacteria except Bacteroides characterised biggest susceptibility to imipenem, piperacillin/tazobactam, amoxicillin/clavulanate, ampicillin/sulbactam, piperacillin, clindamycin and metronidazol. Bacteroides were susceptible to imipenem, piperacillin/tazobactam and metronidazol. Among Gram-positive anaerobic bacteria mostly were isolated from cocci Peptostreptococcus (18 strains, 18%) and were susceptible to all antibiotics. Gram-positive rods were in most cases represented by Actinomyces (12 strains 12%) and were highly susceptible to all antibacterial means except metronidazol (100% is resistant).

[Incidence of anaerobic bacteria in respiratory tract infections]. / Wystepowanie bakterii beztlenowych w zakazeniach ukladu oddechowego.

Anaerobic bacteria are predominant components of normal oral cavity, upper respiratory tract, gastrointestinal, genital and skin flora. They are involved in infections such as pneumonia, aspiration pneumonia, lung abscess and empyema. Laboratory diagnosis of anaerobic infections is based on recovering the etiological agents from clinical materials. Appropriatte specimens include: pus, purulent fluid, biopsy specimen of lung, transtracheal aspirates and bronchoalveolar lavage (BAL). Lower respiratory infections are usually either polymicrobial or mixed anaerobic-aerobic infections. Peptostreptococcus, Fusobacterium, Prevotella and Bacteroides are the most common anaerobes. Anaerobic bacteria are susceptible to metronidazole, tinidazole (exception of Gram-positive rods), amoxicillin/clavulanate, ampicillin/sulbactam, piperacillin/tazobactam, imipenem and clindamycin. Treatment includes an antibiotics regimen with an agent active against anaerobic and aerobic bacteria (therapy with 2 or 3 antimicrobial drugs).

[Evaluation of anaerobic flora in lung neoplasms]. / Ocena flory beztlenowej guzów nowotworowych pluca.

Purpose of this study was to analyse the kind and frequency of anaerobic bacteria in the lower respiratory tract as well as susceptibility of the bacteria to antibiotics. Material from 35 patients with lung tumour derived from tumour and post-tumoural area sample. Collected sample was cultivated in anaerobic and aerobic conditions. Anaerobic bacteria were found in 23 (66%) samples. Totally there were 44 isolated of anaerobic bacteria strains. The most common G-negative strains belonged to genus of Bacteroides (11 strains); two types dominated: Bacteroides gracilis (4 strains) Bacteroides fragilis (4 strains). Among G-positive anaerobic bacteria most common were Peptostreptococcus (9 strains). G-positive rods were represented by Propionibacterium genus (8 strains). The susceptibility of anaerobic bacteria was estimated towards mostly used antibacterial drugs. Results suggest that most of bacteria were susceptible for imipenem, piperacillin/tazobactam, amoxicillin/clavulanate, ampicillin/sulbactam, metronidazole, piperacillin and clindamycin. Bacteria were less susceptible to roxitromycin and examined cephalosporins. Most of the strains were resistant for cefuroxime.

[Clinical and mycological examinations of oral mucosa in cyclosporine A treated patients after renal transplantation]. / Badania kliniczne i mikologiczne blony sluzowej jamy ustnej u pacjentów po przeszczepieniu nerki leczonych cyklosporyna A.

Cyclosporine A (CsA) is one of the basic and often used immunosuppressive agents. It is used to prevent rejection of allogenic transplants and to cure many diseases with autoimmunological components. The development of transplantology and frequent presence of autoaggressive disorders causes increased use of CsA, which intensifies problem of side-effects. Gingival overgrowth, oral mucosa pathologies related with bacterial, viral and fungal infections and neoplasma are described as most frequent side-effects of cyclosporine A in the oral cavity. The aim of this study was to assess the frequency of presence of different types of oral mucosa lesions in cyclosporine A-treated patients after renal transplantation. Thirty renal transplant recipients aged 11-64 years (including 13 females and 17 males) with cyclosporine treatment period from 6 months to 10 years were examined. Pathological changes on the oral mucosa were noted in 18 patients (60%). The fungal infections were the most often observed pathology (46.7% of examined persons). In mycological tests Candida albicans was most often isolated. Other species: C. kefyr, C. parapsilosis and C. tropicalis were also found. In 4 cases cheilitis angularis was additionally diagnosed. In 16.7% of CsA-treated patients, pathological changes of epithelium with homogenic leucoplakia features were observed. Hypertrophic lesions of oral mucosa in 10% of cases and many small erosions of inflamed mucosa of hard palate in 1 case were also noted. Our observations show connection between incidence of oral mucosa pathologies and immunosuppressive treatment. This suggests that interdisciplinary cooperation is necessary for early start of prevention and treatment program.