The study of cell-mediated immune response in recurrent vulvovaginal candidiasis.

The aim of this work was to examine in vitro the ability of cells from patients with recurrent vulvovaginal candidiasis (RVVC) to cell-mediated immune response. Peripheral blood mononuclear cells (PBMC) and whole blood cells (WBC) of 37 RVVC patients in acute infection and 14 in remission were examined for the ability to proliferation and cytokines production (IFN, TNF, IL-6). As a control, a group of 25 healthy women were examined. The cells were stimulated with Candida antigen (HKCA), LPS and PHA. To indicate the level of cytokines, the following cell-lines were used: A549 for IFN, WEHI 164 for TNF and 7TD1 for IL-6. The proliferation/death of cells was determined by colorimetric test using MTT. Distinct suppression of cell-mediated immune response (CMI) was shown in all patients comparing to the control. Greatest suppression was found in the acute phase of the disease. The ability of cells to proliferate and produce IFN increases only in remission. The data seem to suggest that in this phase of disease, the ability of cell-mediated immune response is restored. It was also indicated that IFN may take part in protection against Candida infection.

[Detection of IgA antibodies as important markers of acute primary infection with Toxoplasma gondii]. / Wykrycie przeciwcial klasy IgA waznym markerem ostrego zakazenia pierwotniakiem Toxoplasma gondii.

The diagnosis of Toxoplasma gondii infection is currently based on immunological tests, but tests for IgM and IgG antibodies alone are often insufficient to estimate the risk of active disease, especially during pregnancy and in immunodeficient patients. Classically the study of anti-toxoplasma immunity involves titration of IgG antibodies, which reflect immunity to the parasite, and IgM antibodies which of present, reveal acute infection. However, technical advances have shown the limitations of these tests as tests for IgM can be positive because of residual specific IgM or even in subjects free of acute infection due to the existence of natural interfering IgM. In addition, IgM can be absent in children with congenital toxoplasmosis or subjects with secondary reactivation. The purpose of our study was to evaluated of IgA antibodies to T. gondii in serum samples which were positive in screening test. Our results confirm the diagnostic value of testing for anti-toxoplasma IgA antibodies. These antibodies are absent in uninfected subjects and are detected rapidly after primary infection. The determination of IgA complements IgM determination for the diagnosis of toxoplasmosis.

[The dependence of serum opsonic activity on fibronectin and alpha- 1 acid glycoprotein levels in children with burns]. / Zaleznosc aktywnosci opsonizacyjnej surowicy od stezenia fibronektyny i alpha-1 kwasnej glikoproteiny u dzieci z choroba oparzeniowa.

The concentration of acute phase proteins following burn is known to increase in serum rapidly, while that of fibronectin often decreases. Fibronectin (Fn) has been demonstrated to serve as an opsonin involved in the ingestion phase in phagocytic process. On the other hand, some acute phase proteins such as alpha-1 acid glycoprotein (AG) may inhibit phagocytic activity. In our study, the phagocytic activity of normal granulocytes was decreased by those sera in which a high level of AG was accompanied by a fall in the Fn Level. Attempts to detect a possible link between the acute phase response and fibronectin led as to study whether fibronectin and AG may interact antagonistically on the phagocytic activity of neutrophils. For this reason we calculated the Fn/Ag coefficient. We showed that an Fn/Ag coefficient in normal sera equals more than 0.20. The higher the coefficient, the better the opsonic activity of sera. We propose here that an Fn/AG coefficient may be a useful risk factor for infections in burned patients.

The mechanism of bactericidal action of normal human serum against Salmonella rods.

Forty Salmonella strains sensitive to the bactericidal action of serum were investigated. All these strains were susceptible to complement activated by the classical pathway though in part (60%) of these strains the presence of lysozyme was necessary for killing. S. typhimurium rods were susceptible to only one mechanism of the action of bactericidal factors. On the contrary, S. enteritidis strains were sensitive to three various mechanisms of bactericidal action of serum. Next eight forms of Salmonella typhimurium LT2 differing with respect to the structure of LPS were studied. Original strain was a smooth, form S, and remaining strains were various rough (R) forms such as Ra, Rb1, Rb2, Rc, Rd1, Rd2, Re. The S form was susceptible only to the complete human serum what means that all bactericidal factors of serum were needed for killing. Ra form was susceptible to two independent bactericidal mechanisms: complement (C) activated by the alternative pathway in the presence of lysozyme and C activated simultaneously by both bactericidal C pathways without the participation of lysozyme (al, ac). The next form, Rb1, besides the mechanism mentioned above was also susceptible to C activated by the classical pathway in the presence of lysozyme (al, ac, cl). Other forms (Rb2, Rc, Rd1, Rd2, Re) were susceptible to three mechanisms (al, ac, cl) as well as to C activated by the classical pathway without lysozyme (c). The mechanism (c) was weakly efficient against forms Rb2 and Rc and somewhat more efficient against Rd1 and Rd2 and the most efficient against Re.

[Extraintestinal salmonellosis in patients with blood diseases caused by Salmonella enteritidis]. / Pozajelitowa salmoneloza u osób z chorobami krwi, wywolana przez Salmonella enteritidis.

Four cases of extraintestinal salmonellosis caused by Salmonella enteritidis were described. Underlying diseases in the three patients were haematological neoplasms (2 splenectomized and 1 with massive leukemic infiltrations of the spleen) and in the fourth haemophilia B: only that patient had a prior symptomatic intestinal infection. Blood cultures for S.ent. were positive in all patients and additionally in that suffering from Hodgkin's disease urine, lymph node and stool cultures also showed S.ent. In the haemophiliac patient culture of suppurated hematoma was positive. All patients recovered from S. sepsis but three then died of their neoplastic diseases. The haemophiliac patient is in a good condition. Various disturbances in the immunological tests were observed.

[Serologic diagnosis of infections caused by Borrelia burgdorferi]. / Serologiczna diagnostyka zakazen wywolanych przez Borrelia burgdorferi.

This investigation was aimed at selection of optimal serological test for diagnosis of borreliosis occurring at our territory. In our investigations, and indirect immunofluorescence test (IF) was used in which antigen consisted of an American strain of Borrelia burgdorferi B31 and immunoenzymatic test (IE) with an antigen prepared from an European strain. Hundred sixty eight sera were tested, including 138 sera received from patients with suspection of borreliosis or directed for testing because of suspected tick bite. Thirty sera from healthy blood donors served as a control. In 30 out of 138 patients with suspected borreliosis presence of specific antibodies in IF or IE test was detected. In control group positive results were obtained in 4 persons. From our study comparing two tests occurs that more suitable for serodiagnosis of borreliosis on our territory is determination employing as an antigen the European strain of Borrelia burgdorferi.

Opsonic activity of sera in children with hematological malignancies treated with Sandoglobulin.

Twenty seven children with hematological malignancies were treated with Sandoglobulin for life threatening infections due to severe granulocytopenia. We have studied the opsonic activity of sera in patients before and 7,14 and 21 days after the infusion of Sandoglobulin. Before the therapy a decrease of serum opsonic activity at the stage of ingestion and intracellular killing of bacteria has been shown. It was due to a deficiency of opsonizing factors. After treatment with Sandoglobulin the significant improvement of the opsonic activity of tested sera was found, but only at the stage of the ingestion of bacteria. The optimal interrelationship between opsonizing capacity of sera at the ingestion and intracellular killing phase was observed in the group of children treated with the relatively low Sandoglobulin dose (0.3-0.6 g/kg). In patients with the longest infection duration, who received the high Sandoglobulin doses (> 0.6 g/kg), the largest percentage of sera containing immune complexes was detected. These data demonstrate that high doses of globulins should be administered with certain care.

[Susceptibility to roxithromycin of gram-positive cocci isolated from patients with lowered immunity]. / Wrazliwosc na roksytromcyne gram-dodatnich ziarenkowców izolowanych od chorych z obnizona odpornoscia.

The study involved 412 strains of Gram-positive cocci isolated from throat, sputum, urine and stool of patients prepared for bone marrow transplantation at Department of Hematology. Determination of drug susceptibility was performed by disc diffusion method applying discs with roxithromycin, erythromycin, lincomycin, clindamycin and augmentin. Among strains of S. aureus, S. epidermidis and Micrococcus susceptible strains comprised respectively 48, 48 and 45%; among group A, B, C and G streptococci respectively 92 and 52%. Among 108 strains of group D Streptococci only 24% were susceptible to roxithromycin. Comparison of susceptibility of tested strains to roxithromycin and other antibiotics revealed similar susceptibility of staphylococci and streptococci to roxithromycin and erythromycin, while among staphylococci higher percentage of strains and among streptococci lower percentage was susceptible to lincomycin than to roxithromycin.

[Susceptibility in vitro to certain quinolines of gram-negative bacteria and gram-positive cocci causing urinary tract infections]. / Wrazliwosc in vitro na niektóre chinolony Gram-ujemnych paleczek i Gram-dodatnich ziarenkowców powodujacych zakazenia ukladu moczowego.

Susceptibility to norfloxacin, ofloxacin, pipemidic acid and nalidixic acid of 848 bacterial strains isolated from urine of patients treated in 1989-1992 in Wroclaw hospitals was investigated. The study, performed by the disc diffusion methods, concerned 568 Enterobacteriaceae strains, 147 Gram-negative non-fermenting bacteria and 133 strains of staphylococci. Highest percentage (90-100%) of susceptibility to all used antimicrobial agents was detected among Escherichia, Proteus, Morganella and Citrobacter. Less frequent susceptibility (30-70%) was observed among Klebsiella, Enterobacter and Serratia. Among strains of P. aeruginosa susceptible to norfloxacin and ofloxacin were, respectively, 61.4 and 22.2% isolates. Over 95% of strains of P. aeruginosa were resistant to nalidixic acid. Among other non-fermenting Gram-negative bacteria, over 50% were resistant to norfloxacin and ofloxacin. Both S. aureus and S. epidermidis were susceptible to ofloxacin and norfloxacin in 81-93% of tested strains. They were 2-3 times less frequently susceptible to pipemidic and nalidixic acid.

Susceptibility of isolates of Acinetobacter anitratus and Acinetobacter lwoffii to the bactericidal activity of normal human serum.

The bactericidal activity of normal human serum against the Gram-negative coccobacilli Acinetobacter anitratus and Acinetobacter lwoffii was studied; 12% and 84%, respectively, of the tested strains appeared to be sensitive. Thus, serum resistance may be an important factor contributing to the pathogenic potential of A. anitratus strains. Three types of bactericidal action were shown. In the first, the strains were killed when the alternative complement pathway was activated. In the second, some strains required both the classical and alternative pathways. In the third variant, the strains needed either the alternative or classical activation pathway.

Impaired bactericidal activity of serum of a child suffering from focal proliferative glomerulonephritis.

The serum of a child with focal proliferative glomerulonephritis was found to exhibit a weaker bactericidal activity against Pseudomonas aeruginosa, Salmonella typhimurium, Salmonella enteritidis and Escherichia coli strains as compared with sera of the child's parents. The child's serum showed a low haemolytical activity of complement as well as a low C3 concentration. The authors believe that the abnormal complement concentration could cause the impaired bactericidal activity of the patient serum.

Evaluation of polyvalent anti-Pseudomonas aeruginosa vaccine in phagocytic reaction.

In order to obtain immune reaction for all known Pseudomonas aeruginosa immunotypes (7 according to Fisher), mucoid and nonmucoid variants, rabbits were immunized with polyvalent vaccine consisting of 3 mucoid (1, 3, 5) and 4 nonmucoid (2, 4, 6, 7) immunotypes. The serum of immunized animals induced an increase in normal rabbit granulocyte phagocytosis level as well as intracellular killing of all Pseudomonas aeruginosa immunotypes, both mucoid and nonmucoid variants. The serum was also observed to have high agglutinin titer (1:1024-1:8192) for all the bacteria. While the cross affinity of the mucoid antigens in polyvalent vaccine it was possible to reduce by 4 the number of the mucoid antigens used for immunization.

Sensitivity of Shigella strains to bactericidal activity of human serum. I. Participation of two independently active mechanisms in bactericidal action against Shigella sonnei phase II.

Normal human serum is strongly bactericidal for all studied Shigella sonnei phase II (10 strains). The studied bacteria were sensitive to two alternative mechanisms of the bactericidal activity of serum factors. The first mechanism involves the action of serum in which complement (C) is activated by the studied bacteria via the classical pathway. Lysozyme did not participate in this reaction. The second mechanism involves the combined action of two factors: C activated via the alternative pathway and lysozyme.

Sensitivity of Shigella strains to the bactericidal activity of human serum. II. Shigella flexneri 3 a is killed by complement activated via the classical pathway, with participation of lysozyme.

Normal human serum is bactericidal for all studied strains (15) of Shigella flexneri serotype 3a. The activity of the serum was similar irrespective of the invasiveness of the bacteria or its lack. The studied bacteria were susceptible to a single mechanism of bactericidal activity involving complement activated via the classical pathway, accompanied by the action of lysozyme.

Sensitivity of Shigella strains to the bactericidal activity of human serum. III. The diversity of activity variants of bactericidal serum factors against Shigella flexneri serotypes.

Normal human serum is bactericidal for all studied Shigella flexneri strains (38) belonging to nine serotypes. Six variants of bactericidal activity of serum factors for these bacteria were determined.

[Rotavirus diarrhea in children hospitalized in Wroclaw clinics]. / Rotawirusy w biegunkach u dzieci hospitalizowanych w Klinikach Wroclawia.

Studies have been performed in 250 children aged 0 to 3 years suffering from diarrhoea. Rotaviruses have been founded in 25% of cases, most frequently in children aged 0 to 3 months (29.6%), and 6 to 12 months (21.8%). Frequency of rotavirus infections was highest during February. In 26% of subjects studied the coexisting infection with enteropathogenic Escherichia coli strains or Salmonella and Campylobacter jejuni has been observed. The Rotazyme II test is more sensitive than the Rotalex and Rota-kit tests.

Studies on phagocytosis of mucoid and nonmucoid variants of Pseudomonas aeruginosa. I. Induction of homologous immunity by nonmucoid strains of P. aeruginosa.

Monovalent immune sera against somatic antigens (anti-O) have been shown to potentiate phagocytosis exclusively of nonmucoid homologous immunotypes. To obtain polyvalent immunity for all nonmucoid immunotypes of P. aeruginosa, all immunotypes of these bacteria have to be used for immunization.

Bactericidal activity of human sera with a physiologic or genetic defect of the complement system.

The serum of patient suffering genetically conditioned C2 defect showed a weak bactericidal activity against Pseudomonas aeruginosa strains. Out of 23 tested strains one was susceptible comparing with 16 ones sensitive to normal human serum. The normal cord serum exerted a bactericidal effect on 8 strains. All sera were found to be active against Salmonella strains tested.