常见病原念珠菌鉴定的数码分类方法

建立了一种用于常见病原性念珠菌菌种鉴定的多种碳源同化试验及结果分析的数码分类方法。结果，对１４种碳源固相同化试验结果的编码分析可形成５位数码，进而形成１８种数码可明确区分８种受试的病原念珠菌。结果表明，多种碳源同化试验及编码分析方法可以快速、明确地鉴定８种临床最常见的念珠菌，也为今后建立临床酵母菌快速鉴定系统打下了基础。     

“酵母鉴定系统”对鉴定医学上重要酵母的评价

作者利用新近市售的“酵母鉴定”(Yeast-IDENT,Y-I)系统对9属医学重要酵母91株进行了评价。该鉴定系统中含有酵母尿素、磷酸对硝基酚等,另以一般鉴定法包括光镜形态学、碳原同化、发酵试验、其他营养试验及(或)API20C 试验等进行对照。结果显示:Y-I 鉴定系统对白念珠菌、伪热带念珠菌,白色隐球菌、新生隐球菌、红色隐球酵母,绿色掷孢酵母、念珠隐球菌菌光滑球拟酵母、二组符合率为100%。对其他菌如克柔念     

阴道定植因肯毛孢子菌的分离鉴定

目的 报道1例因肯毛孢子菌(Trichospomn inkin)的阴道定植病例并对该菌进行临床实验研究.方法 患者女,34岁,阴道分泌物增多伴异味2个月就诊.对其进行临床实验室检查,并对分离菌株进行纯化、玻片小培养鉴定、温度试验、脲酶试验、生化鉴定、体外药敏试验和分子测序基因鉴定等实验研究.结果 患者妇科体检阴道内可见乳白色均质化分泌物附着于阴道壁黏膜,阴道分泌物Nugent评分5～6分.两次阴道分泌物培养均分离出淡黄色有皱褶酵母样菌落.该菌在42℃可生长,玻片玉米琼脂小培养见菌丝顶端附着胞形成及典型八叠球菌样结构,最佳生长培养基为酵母菌形态琼脂培养基,脲酶试验阳性,API 20C AUX和分子测序鉴定为因肯毛孢子菌;该菌对两性霉素B和克霉唑、氟康唑等唑类药物敏感,对氟胞嘧啶和卡泊芬净耐药.结论 国内首次发现毛孢子菌在阴道内定植,其准确鉴定有赖于表型特征、生化反应及分子测序的综合分析.     

利用RapID检测系统在5小时内鉴定出304株临床酵母菌

酵母菌和酵母样真菌所引起的系统性真菌感染日益增多,但由于不同真菌对于抗真菌药物的敏感性不同,所以对其作出快速、准确地鉴定是至关重要的。RapID酵母菌检测系统使用常规显色基质对医学重要酵母菌和酵母样真菌进行鉴定,此系统在5小时内可较准确地鉴定出包括念珠菌属的真菌、新生隐球菌、酿酒酵母、白吉利丝孢酵母等304株酵母菌或酵母样真菌,其中有286株(94.1％)可准确地鉴定到     

住院病人酵母样菌的迁生(Colonization)

鉴于近10年来酵母样菌感染的发病率有所增加,而且,某些罕见菌如拟球酵母菌、红色隐球菌、地丝菌、毛孢子菌等也可使人类致病。作者对126例住院患者进行调查研究,其方法和结果如下:     

综合医院院内检出酵母样菌3年结果分析

目的了解3年来我院检出酵母样菌的分布特点及耐药情况。方法用沙氏培养基分离菌株，API生化鉴定菌种；微量液基稀释法测定药敏。结果338份标本分离培养出238株酵母样菌，阳性率71．41％，其中白念珠菌占68．69％；其次热带念珠菌、光滑念珠菌和近平滑念珠菌分别占9．66％、8．82％和5．04％。70株酵母样菌对7种抗真菌药物的耐药率均在10％以上，两性霉素B和制霉菌素耐药率相对较低，分别为11．43％和10％；白念珠菌对氟康唑和伊曲康唑的耐药率高达18．25％和25．92％。结论白念珠菌仍然是我院第一位的机会性致病真菌，且对氟康唑和伊曲康唑有较高的耐药率。     

Biolog微生物自动分析系统建立六种皮肤癣菌的鉴定数据库

目的 探讨Biolog微生物自动分析系统鉴定皮肤癣菌的应用前景。 方法 采用表型及DNA测序的方法,将临床收集的菌株鉴定至种;选取红色毛癣菌、须癣毛癣菌、断发毛癣菌、犬小孢子菌、石膏样小孢子菌和絮状表皮癣菌6种常见皮肤癣菌接种于FF微量板,记录皮肤癣菌对95种不同碳源的利用情况,描述其各自的生长反应谱,建立鉴定数据库。结果 6种皮肤癣菌对一些碳源的利用具有明显的差别,通过是否利用棉子糖可以将须癣毛癣菌、断发毛癣菌同其他4种毛癣菌进行区分;而葵二酸可以区分须癣毛癣菌、断发毛癣菌;通过延胡索酸和琥珀酸可以将红色毛癣菌同石膏样小孢子菌、絮状表皮癣菌和犬小孢子菌进行区分;通过是否利用丙氨酸和苯丙氨酸可以对石膏样小孢子菌进行鉴定。而糊精的利用可以区分絮状表皮癣菌和犬小孢子菌。结论 Biolog微生物鉴定系统采用一种特殊的表型鉴定方法,可以对常见皮肤癣菌进行鉴定。     

A型新生隐球菌质粒克隆库的构建及其特征分析

新生隐球菌是一种条件致病菌，当机体免疫力减低时就可能侵犯人体，引起严重的隐球菌病，特别是隐球菌性脑膜炎的死亡率极高。隐球菌属包括１７个种７个变种，然而能够致病的只有新生隐球菌及其变种，且以血清型Ａ型最常见。我们以Ａ型新生隐球菌标准菌为实验菌株，构建了质粒克隆库，这是进一步进行分子生物学研究的基础，如在核酸水平探索致病机理，建立快速诊断方法等。一、材料和方法（一）菌株和质粒：①Ａ型新生隐球菌标准株Ｄ４８由世界卫生组织（ＷＨＯ）提供，本研究室保藏；②质粒ＰＵＣ１８及宿主菌ＪＭ１０３由复旦大学遗传学研…     

粤东地区皮肤深部真菌病临床及致病菌种分析

目的 探讨粤东地区皮肤深部真菌病的发病特点及致病菌种分布情况.方法 分析我院确诊的39例皮肤深部真菌病临床特点及皮损组织真菌培养结果.结果 中老年男性农民是好发人群,79.5％患者发病前存在伤口感染史.真菌培养检出申克氏孢子菌(41％)是主要致病菌种;其次为酵母样菌(15.4％).结论 本地区皮肤深部真菌病以申克氏孢子菌感染引起的孢子丝菌病为主,酵母样菌等机会致病性真菌活跃增殖成为致病菌的病例应引起关注和警惕.     

艾滋病患者中偶见的真菌病

在人类免疫缺陷病毒感染者中真菌是常见条件致病菌,其中最常见的是念珠菌、新生隐球菌、粗球孢子菌及荚膜组织胞浆菌,近来还报告一些不常见的致病真菌,这里介绍其中几种。     

Value of patch tests in clindamycin-related drug eruptions

Background. Patch tests help to confirm the aetiology of the cutaneous adverse drug reactions involving delayed hypersensitivity mechanisms, but the results vary with the pattern of skin reaction and the culprit drug. Objectives. To analyse the results of patch tests in patients with cutaneous adverse drug reactions imputable to clindamycin and assess their contribution to the diagnosis. Patients and methods. Between 2005 and 2009, we studied patients with delayed cutaneous adverse drug reactions following administration of clindamycin, usually associated with other drugs. After resolution of the cutaneous adverse drug reaction, patch tests were performed with a series of antibiotics, including pure clindamycin 10% in petrolatum. Results. We studied 30 patients (23 females and 7 males) aged 33–86 years (mean 59.97 years) with generalized maculopapular exanthema where clindamycin was among the highly suspected drugs. Two patients had a previous positive involuntary rechallenge. Patch tests with clindamycin were positive in 9 of 30 patients (30%). More than 50 control patients patch tested with clindamycin were negative. Discussion. We considered the positive patch tests results with clindamycin, in the 9 patients with maculopapular exantema, to be specific, versus the negative results observed in the control group. Although the sensitivity is low (30%), they confirmed the responsibility of this antibiotic in cutaneous adverse drug reactions in which, with only chronological criteria, it was not possible to conclude on the culprit drug.     

Chromate-allergic patients challenged orally with potassium dichromate

30 patients who had positive patch tests to potassium dichromate participated in a placebo-controlled oral challenge with 2.5 mg chromium given as potassium dichromate. 17 reacted to chromate but not to the placebo, 2 reacted to both chromate and the placebo, and 4 reacted to the placebo but not chromate. 7 patients had no reaction. A specific reaction to chromate was most common among patients with dermatitis of the hands and/or feet.     

Severe contact urticaria to guar gum included as gelling agent in a local anaesthetic

We report the first case of a life-threatening immediate-type hypersensitivity caused by Dynexan, a local anaesthetic gel. After mucosal application by his dentist, a 63-year-old man rapidly developed urticaria, dyspnea and, at last, he collapsed and remained unconscious for 2 hr despite emergency care. While the standard prick tests were negative to all local anaesthetics tested including lidocaine, a 1-fold positive reaction was detected to Meyprogat 60, an ingredient of Dynexan. As the gelling agent Meyprogat represents a derivative of guar (synonymous guar gum, guaran, E-412), we subsequently tested different guar products derived from Cyamopsis tetragonoloba beans and, as control, the closely related locust bean gum E-410. In the prick-to-prick tests, the guar-derived food additive Provigel NAG 905 provoked a 1-fold positive reaction. Native guar beans pounded and resuspended in water showed a 2-fold positive reaction, whereas no reaction was found to derivatives of locust bean gum. Specific immunoglobulin E were negative in all cases. Despite the common use of guar as versatile food additive or gelling agent, this is the first case of a severe immediate-type hypersensitivity after mucosal contact.     

A Study about the Cause and Clinicopathologic Findings of Injection-Induced Dermatitis

BackgroundCases of dermatitis induced by the injection of certain drugs have been reported.ObjectiveThe aim of this study was to assess the cause and clinicopathologic findings of injection-induced dermatitis, and to reveal whether the reaction has any relation to the patient''s age, injection site, drug concentration, and time interval from the injection to the occurrence of the skin lesion.MethodsIn this study, we enrolled 10 patients who developed erythematous skin lesions after the injection of causative drugs. The lesions were compared to each other according to the injection site, time interval from the injection to the occurrence of the skin lesion, and clinical characteristics. We performed intradermal and patch tests in each patient with different concentrations of causative drugs.ResultsThe most common causative drugs were diclofenac and vitamin K1. The eczematous type was the most frequent clinical type. The intradermal test showed more positive results than the patch test. The patch tests with diclofenac (as is, 2.5%, 5%, and 10%) and vitamin K1 (10%) were all negative in 10 patients. Furthermore, intradermal tests with diclofenac (as is) and vitamin K1 (0.1%, 1%, and 10%) were performed in 8 patients. Six patients had a positive reaction, consisting of erythema, induration, and vesiculation, after 1 and 2 days.ConclusionOur results showed that the most common causative agents were diclofenac and vitamin K1. Moreover, it seems that that intradermal test is more useful than the patch test in the diagnosis of injection-induced dermatitis.     

Toxic epidermal necrolysis following allergic contact dermatitis caused by occupational exposure to ultraviolet-cured inks

Erythema multiforme is a relatively common skin disorder; the most common cause is herpes simplex infection, but topical sensitivities reportedly also provoke this reaction. We report here a case that progressed to toxic epidermal necrolysis due to contact with ultraviolet (UV)-cured inks. The diagnosis was confirmed by patch tests to acrylates in the UV-cured inks, histopathological studies of the lesions, and positive patch test to 1,6-hexanediol diacrylate.     

中国合肥与日本新两地白念珠菌分离株的生物学特性比较

目的由合肥、新两地 ,分别取白念珠菌分离株32株及36株 ,展开试验。旨在探索不同地区可能出现的差别。方法试验包括形态学(芽管、厚膜孢子)、生理学(碳源同化试验、蛋白酶、磷脂酶)及生物分型试验。结果形态学、生理学试验 ,两地的菌株均无显著性差异 ;但生物分型有区别———两地菌株除了唯一的型别(37734003)为共有外 ,其他8个型别均不相同。结论生物分型可作为流行病学调查工具     

Proximal nail plate destruction in subungual melanoma could be a possible predictor of invasiveness thicker than 1.25 mm

Various patterns of nail plate destruction are common features in subungual melanoma (SUM), but there has been no reports regarding their clinical significance according to the pattern of nail plate destruction in terms of tumor thickness. We tried to find a relationship between dermal invasion of SUM and proximal nail plate destruction (PNPD). Clinical information of patients with SUM was reviewed retrospectively from seven dermatology training hospitals in Korea. The PNPD was defined as a visible loss of full thickness of nail plate touching the eponychium at the most proximal part of it. We evaluated whether there are correlations between patients' age, sex, location of SUM, Breslow thickness (BT) and the presence of PNPD. Among 93 patients with SUM, 36 (38.7%) showed PNPD. Sex and BT showed significant correlations with the presence of PNPD in univariate analysis (P < 0.05). BT, age and sex showed significant correlations with the presence of PNPD in multivariate analysis (P < 0.05). Among them, BT showed the strongest correlation with the presence of PNPD (area under the curve, 0.722) and the cut‐off value was 1.25 mm. In conclusion, we suggest that PNPD in SUM could be a possible predictor of invasiveness of more than 1.25 mm BT.     

Glucose tolerance test in leprosy

Glucose tolerance test was carried out in 43 cases of leprosy. They included cases of tuberculoid, borderline, lepromatous leprosy and those with lepra reaction. It was observed that normal curve was common in tuberculoid leprosy. Flat glucose tolerance curve was observed in borderline and lepromatous leprosy. However, the diabetic curve was common in Lepra reaction. Fasting blood sugar was low in lepromatous leprosy and it tended to be marginally high in lepra reaction. Normal GTT response was observed in those with duration of disease between 0-6 months, flat curves in those with duration of disease between 7-12 months while diabetic curve was more common in those with disease duration of more than 2 years.     

Oral challenge in patients with suspected cutaneous adverse drug reactions: findings in 784 patients during a 25-year-period

The aim of this study was to analyse the usefulness of oral challenge test with different drugs in confirming cutaneous adverse drug reactions in routine clinical practice. During the years 1975-2000 a total of 1,001 challenges were carried out in 784 patients. Patients with serious drug reactions were excluded and those with positive skin test reactions were challenged only in dubious cases. Of 1,001 challenges, 136 (13%) patients developed a positive challenge reaction. Antimicrobial drugs were most commonly suspected, accounting for 67% of challenges and 66% of the positive reactions. Exanthema was the most common skin reaction (72%), followed by fixed drug eruption (16%) and urticaria (12%). One serious challenge reaction with salazosulfapyridine was seen. We conclude that the challenge test is most useful as a tolerance test or to exclude drug hypersensitivity. It may be useful to complete studies of adverse drug reactions in patients with a history of exanthema, if other diagnostic methods are not available or if other diagnostic tests yield negative results. Out-patient protocol can be used in most cases.     

PATHOGENESIS AND CAUSATIVE AGENT OF "TULIP FINGER"

SUMMARY.— An investigation into the pathogenesis of the occupational skin disorder known as "tulip finger" showed it to be determined by an allergic mechanism. This is in line with the findings of some other investigators.
Paper-chromatography of active extracts from tulip bulbs, and subsequent patch-tests with these paper-chromatograms in sensitized individuals, made it possible to localize the allergic principle in the paper-chromatograms and to find a reagent (Tollens) for chemical spot tests with the active agent. In later experiments we used the Tollens reaction to locate the active substance in paper-chromatograms, without doing patch tests.
A quantity of "crude allergen" was obtained by preparative paper-chromatography.
Qualitative analysis indicated a compound related to sugars, which is probably a glucoside. Hydrolysis of this compound yielded glucose, and a substance identified by chemical, spectroscopic and gas-chromatographic methods as: α-methylene-γ-butyrolactone.