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The aim of this study was to test the air in a single hospital department for fungal contamination. The department included three fully protected rooms with laminar air flow, comprising a bone marrow transplant unit (BMTU) and eleven naturally ventilated patient rooms of a haematology unit (HAEMU). Air samples were taken with an IDEAL air sampler (bioMerieux) on Sabouraud dextrose agar plates. The concentration of fungi in the air of the HEPA-filtered rooms of the BMTU ranged from 0-75 CFU/m3. Penicillium and Cladosporium were dominant among the fungal biota in the whole department. Of aspergilli, A. fumigatus was prevalent and seasonal increases in the frequencies of A. clavatus and A. niger isolation were observed. The detection of potentially pathogenic species of Aspergillus and Mucor in the BMTU and an increased concentration of Aspergillus in the HAEMU (up to 200 CFU/m3) instigated the introduction of additional preventive measure besides routine disinfection, namely an exchange of the HEPA filters in the BMTU and the installation of equipment based on multifunctional ion technology in the HAEMU. In a subsequent examination, a diminished number of fungi in the air was observed. During the study, 2 cases of proven and 3 of probable aspergillosis (according to EORT criteria) were noted. There was no link observed between the higher concentration of Aspergillus detected in the hospital air and the development of the infection. The authors conclude that hospital air examination can be helpful in indicating problems with hospital air facilities, enabling the introduction of procedures improving air quality and subsequently diminishing the risk of nosocomial mycoses.
The frequency of severe systemic fungal diseases has increased in the last few decades. The clinical use of antibacterial drugs, immunosuppressive agents after organ transplantation, cancer chemotherapy, and advances in surgery are associated with increasing risk of fungal infections. Opportunistic pathogens from the genera Candida and Aspergillus as well as pathogenic fungi from the genus Cryptococcus can invade human organism and may lead to mucosal and skin infections or to deep-seated mycoses of almost all inner organs, especially in immunocompromised patients. Nowadays, there are some effective antifungal agents, but, unfortunately, some of the pathogenic species show increasing resistance. The identification of fungal virulence factors and recognition of mechanisms of pathogenesis may lead to development of new efficient antifungal therapies. This review is focused on major virulence factors of the most common fungal pathogens of humans: Candida albicans, Aspergillus fumigatus and Cryptococcus neoformans. The adherence to host cells and tissues, secretion of hydrolytic enzymes, phenotypic switching and morphological dimorphism contribute to C. albicans virulence. The ability to grow at 37°C, capsule synthesis and melanin formation are important virulence factors of C. neoformans. The putative virulence factors of A. fumigatus include production of pigments, adhesion molecules present on the cell surface and secretion of hydrolytic enzymes and toxins.
Fungi are organisms which occur in the human environment. One of the potential pathogenic fungi is Aspergillus which belongs to mould, and is an etiological factor of non-invasive fungal paranasal sinusitis. Objective. Epidemiological analysis of aspergillosis of the maxillary sinuses. Material and methods. Retrospective analysis of the medical histories of 41 patients treated in the Maxillofacial Surgery Department of Medical University in Lublin, Poland between 2005–2014 due to non-invasive aspergillus maxillary sinusitis. The patients’ gender, age, and etiopathogenesis of the condition with signs and symptoms, and methods of treatment were analysed. Histological examination was crucial in the final diagnosis. Results. The majority of the patients constituted women aged 29–72. The most common complaints were suborbital pain, rhinorrhoea and impaired nasal ventilation. All the patients were treated surgically, and pharmacologically with Fluconazole. Conclusion. Fungal maxillary sinusitis should be taken into account in every case of chronic maxillary sinusitis resistant to standard treatment. Women are more susceptible to Aspergillosis, and the risk factors for the disease are endodontic treatment of the maxillary teeth and fistula antro-oralis post extractionem. Surgical treatment sometimes should be complemented by pharmacological antimycotic treatment.
The aim of this study was to determine the sensitivity of Aspergillus niger strains isolated from birds to available antifungal drugs using different in vitro assays - classical disk diffusion, Etest® and broth microdilution NCCLS/CLSI M 38-A. The study material consisted of about 2.000 swabs and samples from different species of birds. A. niger (n=10) was accounted for 6.81% of the total pool of strains isolated. Determinations were made for 13 antifungal drugs using the disk diffusion method. The A. niger exhibited high susceptibility to enilconazole, terbinafine, voriconazole, tioconazole and ketoconazole, low susceptibility to clotrimazole, miconazole and nystatin, and resistance to amphotericin B, itraconazole, pimaricin, fluconazole and 5-fluorocytosine. Minimum inhibitory concentration (MIC) was determined for 9 antifungal drugs using the micromethod of duplicate serial dilutions in a liquid medium. A. niger strains were most susceptible to enilconazole and voriconazole. MIC ranged from 0.0625 to 0.5 μg/ml for enilconazole, with MIC90-0.5 μg/ml and MIC50-0.125 μg/ml. The corresponding values for voriconazole were 0.25-1 μg/ml, 1 μg/ml and 0.5 μg/ml. MIC for amphotericin B and terbinafine ranged from 0.5 to 4 μg/ml, while the values for the remaining drugs were highly varied. MIC was measured by the gradient diffusion method using Etest® for 5 antifungal drugs: amphotericin B, fluconazole, itraconazole, ketoconazole and voriconazole. By far the highest susceptibility was obtained in the case of voriconazole, with MIC ranging from 0.0625 to 1 μg/ml. MIC for amphotericin B ranged from 0.25 to 4 μg/ml, for itraconazole and ketoconazole ranging from 0.5 to 16 μg/ml. Methods available for this purpose are not always applicable in field conditions. The present results indicate that the Etest® technique, due to its high percentage of agreement with the M 38-A microdilution method, should find application in medical and veterinary practice.
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