Diagnostic value of serum galactomannan, (1,3)‐β‐d‐glucan,and Aspergillus fumigatus‐specific IgA and IgG assays for invasive pulmonary aspergillosis in non‐neutropenic patients

Detection of serum galactomannan (GM) and (1,3)‐β‐d ‐glucan (BG) is considered useful for non‐culture diagnosis of invasive pulmonary aspergillosis (IPA) in neutropenic patients. Only few studies evaluated these seromarkers in non‐neutropenic patients suspected of having IPA. The aim of this study was to evaluate both tests together with the Aspergillus fumigatus‐specific serum IgG and IgA (IgAG) test for serological IPA diagnosis in non‐neutropenic patients. Sera from 87 patients suspected of having IPA were retrospectively analysed. Patients were categorised into groups of proven IPA (n = 10), putative IPA (n = 31) and non‐IPA colonisation (n = 46). When the GM, BG and IgAG assays were used for patients included in the study, the sensitivity/specificity/positive predictive value (PPV)/negative predictive value (NPV) were 48.8%/91.3%/83.3%/66.7%, 82.9%/73.9%/73.9%/82.9% and 75.6%/95.7%/93.9%/81.5%, respectively. Thus, the highest specificity and PPV were confirmed for the IgAG assay. Improvements in the sensitivity and NPV were achieved by “at least one positive” analysis with the GM and BG assays, with the sensitivity/specificity/PPV/NPV values being 85.0%/69.6%/71.4%/84.2%. Nevertheless, the highest sensitivity and NPV were achieved by the “at least one positive” analysis combining the GM, BG and IgAG tests (97.6% and 96.8%, respectively). The involvement of the IgAG assay could improve IPA diagnosis in non‐neutropenic patients by increasing the sensitivity and NPV when combined with the GM or BG assays. Furthermore, improvement was achieved by combining the GM, BG and IgAG assays using the “at least one positive test” strategy, especially if doubt exists.     

烟曲霉pbs2基因功能初步探讨

目的 克隆烟曲霉pbs2基因,并构建烟曲霉pbs2基因突变株,了解该基因对烟曲霉形态学影响以及对渗透压、氧化压力物质敏感性的变化.方法 通过基因同源性比对,在烟曲霉基因组找出与酿酒酵母pbs2基因同源的序列,分析其结构并通过PCR扩增烟曲霉pbs2基因连同其上下游各约1.0 kb的DNA片段,将该片段重组到质粒pDHt/SK中形成PA,再通过PCR扩增pyrG作为筛选标记插入到PA的pbs2基因开放阅读框架(ORF)中,构建好pbs2基因敲除载体PB.将敲除载体转化到根瘤农杆菌,再利用ATMT法转化嘧啶营养缺陷株烟曲霉AF293.1,筛选出烟曲霉pbs2基因缺陷株△Pbs2.观察突变株和野生株AF293在基础培养基上的生长速度并测定二者对渗透压、氧化压力物质敏感性的变化.结果 经过SMART软件分析发现烟曲霉pbs2基因编码一种磷酸转移酶.在基础培养基上△pbs2生长速度同野生株间差异无统计学意义(P＞0.05),但在氧化压力和渗透压的信号传导中,△pbs2对氧化压力和渗透压的敏感性较野生株AF293敏感.结论 烟曲霉中pbs2基因不仅参与渗透压的传导,还参与氧化压力的传导,但只参与传导特定的氧化压力.     

Relationships between Indoor Environments and Nasal Inflammation in Nursing Personnel

In this study, the authors sought to address the relationships between measured indoor environmental factors and nasal patency (i.e., minimum cross-sectional area) and volume and markers of nasal inflammation in nasal lavage fluid. Clinical data were obtained for 115 females who worked at 36 geriatric nursing departments. The indoor climates in the nursing departments were characterized by high room temperatures (median = 23 °C), low relative air humidities (median = 24%), and high air exchange rates indicated by low carbon dioxide levels (median = 570 ppm). Evidence of microbial amplification was observed in the ventilation unit in 3 of the departments. Decreased nasal patency was observed relative to microbial amplification in the ventilation units (minimum cross-sectional area 1 = 0.80 cm² vs. 0.64 cm², p = .003, minimum cross-sectional area 2 = 0.80 cm² vs. 0.67 cm², p = .02) and in relation to elevated indoor temperature (volume 1 = 3.46 cm³ vs. 3.22 cm³, p = .03). The authors concluded that the indoor environment may have affected the nasal mucosa of nursing personnel, thus causing nasal mucosal swelling. The results support the view that fungal contamination of air-supply ducts may be a source of microbial pollution, which can affect the nasal mucosa.     

Effect of sequential combination of amphotericin B and azole antifungal agents against Aspergillus fumigatus

Patients with aspergillosis have a poor prognosis because there are no effective antifungal agents except for amphotericin B. However, administration of amphotericin B is limited in immunocompromised patients due to its toxicity, which includes impairment of renal function. We attempted to evaluate the efficacy of a sequential combination of antifungal agents against Aspergillus fumigatus strain. The in vitro effects of sequential combinations of antifungal agents against five strains of Aspergillus fumigatus were determined by assessing changes in the wet weight of mycelial cells. The effect of a sequential combination was examined by pretreating mycelial cells with an antifungal agent, followed by the addition of a second antifungal agent. Pretreatment with amphotericin B (AMPH) followed by miconazole (MCZ) or fluconazole (FLCZ) resulted in better in vitro effects compared with the effect of simultaneous use of the agents. In contrast, pretreatment of mycelial cells with azole antifungal agents, other than MCZ, followed by AMPH, resulted in an increase in the wet weight compared with that recorded after simultaneous incubation with AMPH and azole antifungal agents. Our results showed that combined treatment, of AMPH followed by MCZ or FLCZ, inhibited the growth of A. fumigatus, suggesting that such a regimen may be effective against aspergillosis. Received: December 4, 1998 / Accepted: March 31, 1999     

两性霉素B缓释系统治疗兔烟曲霉菌眼内炎的药效学实验研究

目的探讨两性霉素B缓释系统（AmB—DDS）玻璃体腔植入对烟曲霉菌性眼内炎的疗效、AmB-DDS的药物释放规律及最佳释药量。方法选取40只新西兰白兔作为实验动物。（1）Amb-DDS治疗烟曲霉菌性眼内炎疗效学观察：动物玻璃体腔内注入烟曲霉菌悬液,48h后随机分为5组,A组为空白对照组（6只眼）,B组为空白DDS组（6只眼）,C组为两性霉素B玻璃体腔内注射组（6只眼）,D组为AmB—DDS250μg植入联合玻璃体切除术组（8只眼）,E组为AmB—DDS500μg植入联合玻璃体切除术组（8只眼）。术后不同时间点检测前房闪辉、细胞及玻璃体混浊程度,取玻璃体腔内容物行涂片检查和真菌培养,2个月时取眼球标本行病理学检查;（2）AmB—DDS玻璃体腔内药物浓度检测：H组玻璃体切除术后植入500μg AmB—DDS1个（6只眼）,术后第1、3、7天及2、4、6、8周取玻璃体液,高效液相色谱分析法检测药物浓度。结果A、B组全部发生严重眼内炎,伴眶内感染,组间比较差异无统计学意义（P〉0．05）;C、D、E组炎性反应较A、B组轻,差异有统计学意义（P≤0．005）;E组玻璃体混浊程度较C组轻,7～14d前房反应较C组轻,差异均有统计学意义（P≤0．005）;D组5只眼、E组8只眼治愈,差异有统计学意义（x^2=10．494,P=0．003）。不同时间点取玻璃体腔内容物涂片,所有标本6周内均见菌丝,真菌培养仅A、B组为阳性。病理学检查示治愈眼结构正常,感染未控制眼均萎缩,球壁结构被破坏。H组术后第1天即有释药,药物浓度迅速升高超出有效抑菌浓度,观察期内释药较平稳。结论AmB—DDS玻璃体腔内植入治疗烟曲霉菌性眼内炎安全有效,释药恒定,速率得当;以含药量为500μg的AmB—DDS治疗效果最佳。（中华腰科杂志,2007,43：546-553）     

两株非典型烟曲霉临床株抗真菌药物敏感性和形态异常相关分子机制研究

目的:比较两株白色不产孢烟曲霉临床株(A1j和A2j)的抗真菌药物敏感性及形态异常产孢基因与Af293的差异性.方法:采用改良的琼脂稀释药敏实验方法检测A1j和A2j与模式对照菌Af293对伏立康唑(VRC)、伊曲康唑(ITC)和两性霉素B(AMB)的敏感性.采用PCR和RT-PCR的方法对A1j和A2j产孢相关基因b...     

Aspergillus fumigatus as a cause of mycotic tracheitis in a chicken

An unusual case of mycotic tracheitis in a young chick caused by Aspergillus fumigatus was recorded from Anand, India, during 1987. The pathogen was demonstrated in the tracheal exudate by potassium hydroxide technique and also recovered from the trachea on Sabouraud dextrose agar at 37 degrees C. The characteristic hyphae of Aspergillus spp. were demonstrated in tracheal mucosa in histopathological sections stained by periodic acid Schiff method. Interestingly, the lesions were confined only to the trachea. Environmental investigations established the source of infection in the farm where the litter was highly contaminated with A. fumigatus.