新生隐球菌L型致病性的实验研究

以稳定新生隐球菌Ｌ型感染小鼠后，部分脑组织中出现长丝体和巨形体。病原分离，新生隐球菌大小不一、形态不规则。病理学检查，各脏器主要表现为间质性炎症。我们认为：①新生隐球菌Ｌ型致病的特征性表现为间质性炎症；②隐球菌性肉芽肿的形成可能与病灶处新生隐球菌变异成Ｌ型有关。     

Infection due to Cryptococcus neoformans of unusual morphology in a patient with AIDS

Cryptococcus neoformans with a rare morphology of hand-mirror appearance was demonstrated by direct microscopic preparation of both cerebrospinal fluid (CSF) and sputum of a patient with AIDS. In addition, one to six blastoconidia were seen at the tip of a germ-tube like structure. Cr. neoformans was isolated in pure culture and the identification was confirmed by biochemical and serological tests as well as by animal pathogenicity.     

Microcomputer system for automatic identification of theCryptococcus neoformans and its clinical application

Summary In this study, microcomputer image processing and pattern recognitiontechnology, and the knowledge of morphology and optical characteristics ofCryptococcus neoformans were used for identification ofCryptococcus neoformans. Four groups of mice were lethally infected with standard strain, Wuhan strain, American B-2643 strain and Var. Shanghainesis of theCryptococcus neoformans. The samples collected included mice brain, lung, kidney, liver, small intestine tissue and were observed under a light microscope. More than 600 images of the fungus were input into a microcomputer. A system of computer for automatic identification of theCryptococcus neoformans was developed. The technique involved image preprocessing, image segmenting, coding of line-length on the edge, curve fitting, extracting of image feature, building of image library and feature data bank etc. And then, 768 images of the clinical samples and other fungus samples whose morphological features tend to be confused withCryptococcus neoformans were input into microcomputer and subjected to automatic identification. TheCryptococcus neoformans was accurately identified within 15 min, and the consistence rate with results of routine culture was 98 %.     

Growth inhibition of pathogenic yeasts by Pseudomonas aeruginosa in vitro: clinical implications in blood cultures

The interaction between yeasts and bacteria may have clinical implications in polymicrobial septicaemia. The in vitro effect of Pseudomonas aeruginosa on five pathogenic yeast species, Candida albicans, Candida tropicalis, Candida parapsilosis, Candida glabrata and Cyptococcus neoformans, was investigated. Yeast inhibition assays were performed in an aerobic blood culture medium, inoculated with yeast cells (inoculum 1–10 CFU ml ^?1) and bacterial cells (inoculum 10?10⁷ CFU m1^?1). Interactions between P. aeruginosa and yeasts were determined after incubation by enumeration of pure and mixed cultures. Growth of all isolates tested was completely or partially inhibited by P. aeruginosa in blood culture medium, the phenomenon depending on the yeast genus and bacterial inoculum. Suppression of fungal growth was also observed in bacterial culture filtrate. This in vitro antifungal activity may preclude yeast recovery from blood cultures in mixed infections.     

Schleimkapselbildung in vitro von Cryptococcus neoformans: Mucoid Encapsulation in vitro of Cryptococcus neoformans

Zusammenfassung:  Die Schleimkapselbildung in vivo von Cryptococcus neoformans ermöglicht häufig das Erkennen einer Cryptococcosis bereits bei der Direktuntersuchung (Liquor cerebrospinalis, histologische Präparate). Auf herkömmlichen festen oder flüssigen Medien bleibt die Kapselbildung zumeist aus. Deshalb wurde ein neues Medium formuliert, das die Kapselbildung besonders begünstigt. Hierdurch wird die Bestimmung von Cryptococcus neoformans erleichtert.
Summary:  The formation of a mucoid capsule of Cryptococcus neoformans cells in vivo often is helpful in the histological diagnosis of a cryptococcosis or when samples of cerebrospinal fluid are studied by direct microscopy. In cultures on conventional solid or liquid media encapsulation frequently does not occur. For this reason, a new medium has been developed which stimulates capsule formation and thus facilitates the identification of Cryptococcus neoformans.     

慢性活动型肝炎肝硬化医院内感染隐球菌脑膜炎三例报告

本文报道我院收治的慢性活动型肝炎肝硬化医院内感染隐球菌脑膜炎三例,其中男性1例,女性2例,年龄分别为44、42、35岁。均有慢性活动型肝炎的临床表现及肝脾肿大、蜘蛛痣、肝掌和腹水等肝硬化体征。分别于住院12月、5月、2月后出现发热和头痛等症状。经腰穿脑脊液隐球菌涂片和培养阳性,确诊为医院内感染隐球菌脑膜炎。本文重点对医院内真菌感染的易感因素、发病机理,临床特征,早期诊断和预防措施作了讨论。     

Cryptococcus neoformans var. neoformans resistant to fluconazole in an HIV-negative patient with chronic lymphocytic leukemia

Cases of fluconazole-resistant Cryptococcus neoformans have been reported in AIDS patients previously treated with fluconazole. We report a case of fluconazole-resistant cryptococcal meningitis in an HIV-negative patient not previously exposed to fluconazole. The patient experienced a clinical relapse after discontinuation of therapy with amphotericin B and subsequent initiation of fluconazole therapy. In vitro resistance was initially verified by Etest and tablet diffusion and later confirmed by NCCLS broth microdilution.     

Cryptococcosis--a review of 13 autopsy cases from a 54-year period in a large hospital

From 1952 to 2005, 13 cases of cryptococcosis confirmed by postmortem examination were diagnosed in autopsy material from the University Hospital in Hradec Králové, the Czech Republic. Histologically, Cryptococcus was found in multiple organs (brain and spinal cord, lungs, lymph nodes, spleen, bone marrow, liver, kidneys and adrenal glands). The lungs and CNS were the organs most often involved. Only in two cases was the diagnosis of cryptococcal infection established during the patient's lifetime, in both presenting clinically as meningitis, with positive result of CSF cultivation. Data and issues of diagnostics and treatment of cryptococcosis are discussed.