The brown colour effect (BCE) of Cryptococcus neoformans in the diagnosis, control and epidemiology of C. neoformans infections in AIDS patients.

Cryptococcus neoformans was found as the causative agent of cryptococcosis in 7 (3.6%) out of 195 HIV-positive persons, most of them being hospitalized. These 7 persons included 6 homosexuals and 1 heroin addict. The examinations were performed at the Mycology Unit of the Robert Koch Institute in Berlin (West) between 1984 and 1986. The brown colour effect (BCE) of the C. neoformans colonies on Guizotia abyssinica creatinine agar (with 0.1% glucose) within 2-5 days at 26 degrees C facilitated the diagnosis of disseminated cryptococcosis. In all 7 cryptococcosis cases, the antigen of C. neoformans was detected in serum and CSF by the latex agglutination test. The initial titres ranged from 1:100,000 to 1:160 in the serum and from 1:1280 to 1:10 in the CSF. In comparison to the progressive stage of the infection with the involvement of the various organs and high antigen titres, the fungus may be detected at an early stage in the respiratory tract only where low antigen titres are observed. All the C. neoformans isolates were found to belong to the variety neoformans. Proposals for an effective control of cryptococcosis are made.

[Amphotericin B and flucytosine therapy of Aspergillus pneumonia and acute renal failure]. / Amphotericin B und Flucytosin-Therapie bei Aspergillus-Pneumonie und akutem Nierenversagen. Doppelinfektion mit A. flavus und A. fumigatus.

Kidney failure and pneumonia by Aspergillus flavus and A. fumigatus were found in a 56-year-old woman who had received antibiotic and corticoid treatment to control high fever. Her bloody tracheal secretion was a suspension of granule-like spore-free colonies of both Aspergillus species. Hemorrhages in mucous membranes and skin suggested a hematogenous dissemination of the fungi. Aspergillus spores in the soil of ornamental plants were assumed to be responsible for the inhalatory infection. The kidney function normalized rapidly under treatment by amphotericin B plus flucytosine and hemodialysis performed eight times. After 29 days of antimycotic treatment (amphotericin B 463 mg, flucytosine 150 g), besides normalization of the kidney function, healing of the pneumonia and bleeding from skin and mucal membranes took place. One and a half years later kidney function and blood parameters were found to be normal. In cases of Aspergillus pneumonia and kidney failure, a combined treatment by hemodialysis and amphotericin B plus flucytosine is recommended. In addition, there is discussion of the general importance of uremia and its influence on the mycotic infection.

A new polyene with antimycotic activity produced by a streptomycete from the rhizosphere of an indoor plant.

From the rhizosphere of a potted Sanseviera trifasciata, a Streptomyces griseus strain with a broad antifungal activity was isolated; in the soil of this plant, a sole hyphomycete, Aspergillus niger, was found in pure culture at 37 degrees C. This streptomycete produced a polyene, belonging to the pentaene group. It was found to inhibit, in vitro, the growth of all the 123 strains tested; the strains belonging to the genera Aspergillus, Cryptococcus, Candida, Trichophyton, Epidermophyton, Microsporum, Penicillium and Mucor. An antimycotic activity of this substance was also found to be present after i.v. administration to white mice infected with Cr. neoformans. Toxicological tests will have to show if this polyene could be considered as a candidate antimycotic drug. The soil of potted indoor plants is discussed as a possible habitat for streptomycetes with defined antifungal activities.

Bird manure filtrate agar for the formation of the perfect state of Cryptococcus neoformans, Filobasidiella neoformans. A comparative study of the agars prepared from pigeon and canary manure.

An account is given to two pairs of C. neoformans strains on two different bird manure filtrate agars, i.e. pigeon manure filtrate and canary manure filtrate agar. Basidiospore formation was observed in both pairs after 3 d incubation at 26 degrees C on both media. 0.1% biphenyl in pigeon manure filtrate agar showed an inhibitory activity on the formation of the perfect state of the C. neoformans pairs tested. Concentrated pigeon manure filtrate allowed growth of the imperfect, however not of the perfect state of C. neoformans. On canary manure filtrate agar, a brown color effect (BCE) of the colonies of the C. neoformans strains was observed in addition to their formation of the perfect state. Except for a known self-fertile strain no self-fertility could be seen in 40 C. neoformans strains on pigeon manure filtrate agar. Attention is drawn to the risk of laboratory infection when handling the perfect state of C. neoformans.

Interaction between aspergilli and streptomycetes in the soil of potted indoor plants: a preliminary report (contribution to the epidemiology of human aspergillosis).

The soil of potted ornamental plants as a reservoir for Aspergillus species pathogenic for man is of epidemiological and ecological interest. Isolation of A. niger as the sole hyphomycete from the soil of potted African violets (Saintpaulia ionantha, Gesneriaceae), prompted us to look for A. inger on the surface of the roots of this plant. Small pieces of the roots were inoculated in the nutrient-free agar-gel with and without antibiotics. On the antibiotic-free gel, a dense growth of Streptomyces griseus was consistently observed around the root pieces. But the gel fortified with antibiotics showed pure growth of only A. niger. One of the two strains of S. ariseus isolated from the African violet, showed inhibitory effect against a number of fungi including A. niger but the other strain had no effect on this fungus. The possible influence of streptomycetes on the occurrence of aspergilli in the soil of potted ornamental plants is discussed.

Pathogenic yeast-like fungi in meat products.

100 samples of sausage and ham (cut in fine slices) were examined to find out whether meat products can harbour yeast-like fungi pathogenic for man. Pieces of the test material were placed in a sterile Petri dish containing 1 ml distilled water and incubated at 26 degrees C for 2 days. The colonies grown on the material were identified by international standard methods, tested for extracellular proteolytic activity and serotypes. Experimentally infected meat products were studied culturally and histologically (PAS stain). 14 out of the 100 samples examined were found to contain Candida parapsilosis and 1 C. tropicalis. In vitro, extracellular proteolytic activity was found in 54.5% of the C. parapsilosis isolates. By serotyping, 2 of the isolates wree found to be related with serotype A and 8 with serotype B of C. albicans. The strains isolated from the blood of 27 patients, in part of them, identity of serotype and proteolysing activity was established. In the experimentally infected meat products, C. albicans showed a scarce growth preferably in the pseudomycelium form. C. tropicalis grew very well on the boiled sausage of salami type but mostly in the pseudomycelium form. C. parapsilosis on the other hand, showed a strong growth preferably as round blastospores on all 3 meat products and Cryptococcus neoformans a moderate growth as round blastospores in all the 3 meat products (Bologna type sausage, boiled sausage of salami type and smoke ham). The findings are discussed with a view of their implications for Medical Mycology, epidemiology and the practice of food control.

Aspergillus fumigatus and Aspergillus niger in two potted ornamental plants, cactus (Epiphyllum truncatum) and clivia (Clivia miniata). Biological and epidemiological aspects.

The presence and growth of Aspergillus fumigatus and Aspergillus niger in the soil of ornamental plants have been demonstrated. The ecological conditions in the soil of such plants as influenced by temperature, humidity, desiccation, fertilization and ventilation obviously influence such fungal growth. The epidemiological significance of these findings is of interest with a view to the present efforts to control aspergillosis in the environment of susceptible persons. Observations of a preferential growth of certain Aspergillus species in the soil of defined plants under defined conditions raise problems of soil microbiology.

Epidemiology of Cryptococcus neoformans.

The concept of the epidemiology of Cryptococcus neoformans as the causative agent of cryptococcosis and as a basidiomycetous yeast is based on the fact that bird manure has been until now its only known habitat but not plant material which likewise harbours various nonpathogenic Cryptococcus species. It could be shown that the possible influence of nutritional factors on the morphology and morphogenesis earns attention not only in view of the epidemiology of C. neoformans but of its perfect states, too.

[Occurrence of Aspergillus fumigatus in West Berlin - contribution to the epidemiology of aspergillosis (author's transl)]. / Zum Vorkommen von Aspergillus fumigatus in Berlin (West) - Ein Beitrag zur Epidemiologie der Aspergillose des Menschen.

The increasing incidence of human A. fumigatus infections particularly such of the respiratory tract has led to this study of the epidemiological situation. During the period between October 1968 and December 1977, A. fumigatus was isolated from clinical material in 425 cases. These findings which were established at the Mycology Unit, Robert Koch Institute, Federal Health Office, exhibited the following distribution by regions of the body or type of specimen: respiratory tract 277 (65.1(); venous blood 58 (13.6%); urine 3 (0.7%); stools 9 (2.1%) and others 78 (18.3%). Approximately two thirds of these findings were made during the period from October to March and about one third between April and September. The presence of A. fumigatus in the air both indoors and outdoors and also in the environment of patients suffering from aspergillosis was studied with the aid of the sedimentation-method. This method was chosen because the occurrence of A. fumigatus conidia in the air is of epidemiological interest. The number of isolations of A. fumigatus from outdoors samples was low, so the search for inhalative conidia concentrated upon sites near A. fumigatus habitats. These studies revealed that aspergillosis patients, clinical material sampled from them, decaying plant material (agriculture, horticulture), and used clothes and linen may form foci for the spread of A. fumigatus conidia. The control of aspergillosis in the hospital environment involves in particular a control of aspergillosis patients by means of culture and serology (preferably by ghe immunodiffusion test). Numerous recommendations are made on how to prevent A. fumigatus infections in hospitals, at the working site, and in the laboratory.

Growth of Cryptococcus neoformans on uric acid agar.

Effect of certain low molecular nitrogen substances, namely uric acid, eura and creatinine as sole source of nitrogen was studied on 31 strains of Cryptococcus neoformans as well as on a rough looking isolate recovered from the brain of a mouse inoculated with a mucoid strain of C. neoformans. Uric acid as a nitrogen source caused striking alterations in the morphology of C. neoformans. In view of the facts that uric acid is a common end-product of human and animal metabolism, it is abundantly present in the avian faecal matter and is capable of inducing mucoid growth and capsule formation in dry growing non-encapsulated strains or in an otherwise rough looking hypha forming isolate, its role in studying the phylogenesis of C. neoformans and its pathogenicity seems to be an important proposition.