Potential role for a carbohydrate moiety in anti-Candida activity of human oral epithelial cells.

Candida albicans is both a commensal and a pathogen at the oral mucosa. Although an intricate network of host defense mechanisms are expected for protection against oropharyngeal candidiasis, anti-Candida host defense mechanisms at the oral mucosa are poorly understood. Our laboratory recently showed that primary epithelial cells from human oral mucosa, as well as an oral epithelial cell line, inhibit the growth of blastoconidia and/or hyphal phases of several Candida species in vitro with a requirement for cell contact and with no demonstrable role for soluble factors. In the present study, we show that oral epithelial cell-mediated anti-Candida activity is resistant to gamma-irradiation and is not mediated by phagocytosis, nitric oxide, hydrogen peroxide, and superoxide oxidative inhibitory pathways or by nonoxidative components such as soluble defensin and calprotectin peptides. In contrast, epithelial cell-mediated anti-Candida activity was sensitive to heat, paraformaldehyde fixation, and detergents, but these treatments were accompanied by a significant loss in epithelial cell viability. Treatments that removed existing membrane protein or lipid moieties in the presence or absence of protein synthesis inhibitors had no effect on epithelial cell inhibitory activity. In contrast, the epithelial cell-mediated anti-Candida activity was abrogated after treatment of the epithelial cells with periodic acid, suggesting a role for carbohydrates. Adherence of C. albicans to oral epithelial cells was unaffected, indicating that the carbohydrate moiety is exclusively associated with the growth inhibition activity. Subsequent studies that evaluated specific membrane carbohydrate moieties, however, showed no role for sulfated polysaccharides, sialic acid residues, or glucose- and mannose-containing carbohydrates. These results suggest that oral epithelial cell-mediated anti-Candida activity occurs exclusively with viable epithelial cells through contact with C. albicans by an as-yet-undefined carbohydrate moiety.

Aerobic bacterial and fungal infections in peripheral blood stem cell transplants.

Allogeneic and autologous peripheral blood stem cell transplants are frequently complicated by infections. This study was performed to evaluate early and late infections in 74 patients who underwent peripheral blood stem cell transplantation (PBSCT). Fifty-eight patients received allogeneic and 16 autologous PBSCT. All patients received fluconazole, ciprofloxacin and acyclovir prophylaxis. 93.1% of alloPBSCT patients and 87.5% of autoPBSCT patients developed fever. Febrile episodes were commonly seen in the week of transplantation (66%). There was a median of 3 days with fever in alloPBSCT, and 2 days in autoPBSCT. Period of neutropenia was 15 days for AlloPBSCT and 12 days for AutoPBSCT. The microbiological identification rate was 47% (32/68). Gram-positive infections dominated the early period (50%) and Gram-negative bacterial infections dominated the late period (50%). All our patients had Hickman-type catheters and 26 infections involving catheters were seen. Sixteen occurred in the early, and 10 in the late period. Ten of 14 (71.4%) late bacterial infections were catheter-related. The dominance of Gram-positive infections and high rates of methicillin resistance warranted the use of vancomycin extensively. Surveillance cultures were found to be useful in selected patients. Although slime factor is an important virulence factor, there was no difference between slime factor positive and negative coagulase-negative staphylococci isolated during infections. In conclusion, febrile episodes are the most frequent complication of PBSCT and Gram-positive microorganisms remain the main pathogen in these patients because of catheter use, mucositis and ciprofloxacin prophylaxis. Methicillin resistance is increasing and glycopeptides remain the only choice for treating such infections. Although the infection rate is high, measures taken to prevent and treat infections result in very low rates of mortality from infection in PBSCT patients.

Growth inhibition of Candida albicans by vaginal cells from naïve mice.

Recurrent vulvovaginal candidiasis (RVVC) is a common idiopathic mucosal infection caused by Candida albicans. Current data suggests that local immunity is more important than that in the peripheral circulation for protection against infection. In the present study, anti-Candida innate resistance at the vaginal mucosa was investigated using a murine model. For this, splenic and vaginal cells were assessed for in vitro growth inhibition (GI) of C. albicans and cytotoxicity of natural killer (NK) cell-sensitive tumour targets (YAC-1). As expected, significant GI of C. albicans by splenic cells was mediated predominantly by polymorphonuclear leucocytes (PMNL) at effector to target (E:T) ratios of 100 and 50:1. From the vaginal mucosa, naïve unfractionated, but not nylon wool non-adherent (NWN), cells extracted from whole vaginal tissue showed significant GI of C. albicans at E:T ratios as low as 1:1, but only modest killing of YAC-1 targets at all E:T ratios. Subsequent experiments showed significant GI of C. albicans by vaginal epithelioid-enriched cells and with several epithelial cell lines, but not in supernatants collected from the co-cultures. In contrast, lymphoid cell lines had no anti-Candida activity. These results suggest that anti-Candida activity is present at the vaginal mucosa, but unlike that from the spleen, the vaginal activity appears to be predominantly mediated by epithelial cells.

Fungal colonization and infection in children with acute leukemia and lymphoma during induction therapy.

BACKGROUND: Fungal infection represents a growing problem in children with hematologic malignancies. During chemotherapy induced neutropenia, colonization with fungi is considered a major risk factor for subsequent fungal infection. The rates and risk factors for mycotic infections in pediatric oncology patients is undetermined, particularly for centers in developing countries. The aim of this study was to evaluate the rates and risk factors of fungal colonization in children with acute leukemia and lymphoma at one of the major pediatric hematology/oncology centers in Turkey. PROCEDURE: Fifty-two consecutive children newly diagnosed with acute leukemia and lymphoma during intensive remission induction therapy were evaluated for the occurrence of fungal colonization (defined as at least one positive surveillance culture) and infection. RESULTS: Thirty-six of the 52 patients (69.2%) were colonized by Candida albicans which was the only fungus isolated from surveillance cultures. There were three (5.8%) proven systemic fungal infections: two cases of candidemia and one case of brain abscess with Aspergillus spp. isolated from tissue. All patients with fungal colonization were receiving prophylactic or curative antibiotics. No significant association was found between type of disease and fungal colonization, but there was a significant association with neutropenia. CONCLUSIONS: Our findings suggest that there is a high rate of fungal colonization in children receiving remission induction therapy for acute leukemia and lymphoma. Limiting the use of antibiotics and instituting antifungal chemoprophylaxis may decrease the rate, while the early initiation of empiric antifungal therapy in patients with fever and suspected mycotic colonization may increase survival in these patients.

Incidence of urinary tract infection in patients without bacteriuria undergoing SWL: comparison of stone types.

Extracorporeal shockwave lithotripsy (SWL) currently is accepted as the preferred treatment for most renal and upper ureteral calculi. However, little is known about the infection risks of SWL. In this study, the incidence and severity of urinary tract infection in 117 patients with renal calculi undergoing SWL were evaluated and the stone characteristics of those with and without infection were compared. The patients were followed clinically and bacteriologically 1 and 14 days after the procedure. Bacteriuria was noted in six patients within 24 hours after SWL. No bacteriuria was noted 2 weeks later. Of these patients, three were symptomatic (including dysuria, burning, and fever >38 degrees C). No patient was hospitalized. We found no significant correlation between the occurrence of bacteriuria and the number or size of the stones (P > 0.05), nor was there any correlation between bacteriuria and the stone-free rate or the location of the calculi (P > 0.05). However, there was a significantly higher risk of urinary tract infection in patients with struvite stones than in those with other types of stones (17.3% v 2.1%). In patients with infection stones, prophylactic antimicrobial chemotherapy is necessary even if bacteriuria is not present before SWL.

Ig A antibodies to klebsiella in ankylosing spondylitis.

In this study anti-klebsiella Ig A values were compared in 40 patients with definite diagnosis of ankylosing spondylitis and a control group of 40 healthy subjects. Anti-Klebsiella Ig A antibody values were significantly higher in patients with ankylosing spondylitis as compared to the control group (p < 0.001). Correlation between these antibodies and erythrocyte sedimentation rate, CRP, serum Ig A, HLA B 27, age, sex and disease duration was searched, but no correlation was found. In our opinion, these results support the suggestion that inflammatory response in ankylosing spondylitis is triggered by Klebsiella but is insufficient to prove the causal relationship between ankylosing spondylitis and Klebsiella.

[Analysis of early, late-phase and delayed skin reactions against 10 groups of antigens in 420 patients with allergic asthma]. / Allerjik astmali 420 hastanin 10 adet antijen grubuna karsi erken-geç faz ve geç deri reaksiyonlarinin analizi.

Immediate, late phase and delayed skin reactions against ten group of allergens were investigated in 420 patients with allergic asthma. The wheal and flare reaction were characteristic for type I IgE-mediated hypersensitivity reaction in human skin. This reaction develops rapidly after injection of antigen, peaks in 10-30 minutes, and then subsides within a few hours. However, careful observation for longer periods has shown that in many instances a late inflammatory response also appears at the same site and is quite different in appearance from the initial reaction. This late phase reaction sometimes lasts for 24 hours and it is characterized by a dense cellular infiltrate and is more oedematous than the early reaction. These late phase reactions can also be seen following challenge of the nasal mucosa and bronchi of allergic subjects and may be of major importance in the development of chronic asthma. In this study, we have investigated immediate, late phase also delayed phase skin reactivity incidence of the allergic asthma patients.

[Prevalence of G. vaginalis, Mycoplasma, Ureaplasma, T. vaginalis, yeast, N. gonorrhoeae and other bacteria in women with vaginal discharge]. / Vajinal akintisi olan kadinlarda G. vaginalis mikoplazma, üreaplazma, T vaginalis, maya ve N. gonorrhoeae ve diger bakterilerin sikligi.

Vaginal discharge of 118 women attended to outdoor clinics of obstetrics and gynaecology at Medical Faculty of Ankara University (A.U.T.F.), have been examined. Direct microscopy has been made by means of wet mount, Gram and Giemsa staining. Vaginal pH has been measured, by 10% KOH the presence of "fishy odor" has been investigated. For culturing vaginal secretions in Amies transport medium have been brought to Microbiology Department of Ankara University, Faculty of Medicine Inoculations have been made on to Blood agar, MacConkey agar, Sabouraud Dextrose agar, New York City. Medium, % 5 Human blood bilayer Tween 80 Medium (HBT), Vivey Trichomonas Agar Medium and into M-broth and U9 broth. In this study, we have isolated 9 (7.62%) Gardnerella vaginalis, 41 (33.89%) Ureaplasma, 13 (11.01%) Mycoplasma, 25 (21.18%) yeasts, 4 (3.38%) Trichomonas vaginalis and 43 (36.46%) various bacteria, 26 cases were found to have polymicrobial etiology.

[Klebsiella pneumoniae capsular type 48 isolated for the first time in Turkey]. / Türkiye'de ilk defa izole edilen Klebsiella pneumoniae kapsül tip 48 susu.

Capsule type 48 Klebsiella pneumoniae strains were isolated from cerebrospinal fluid and blood specimens of 4 days old baby. This type of Klebsiella were the first observation in Turkey.

[Klebsiella pneumoniae capsular type 25 and type 16 isolated for the first time in Turkey]. / Türkiye'de ilk defa izole edilen Klebsiella pneumoniae kapsül tip 25 tip 16 suslari.

Klebsiella pneumoniae capsule type 25 and 16 strains were isolated from the urines of two cases having urinary tract infection. These capsule types of Klebsiella were the first observation in Turkey.

[Isolation of beta-hemolytic streptococci from throat and nasal swabs and their antibiotic susceptibility]. / Bogaz-burun kültürlerinden izole edilen beta hemolitik streptokoklarve antibiyotiklere duyarliliklari.

1218 throat and 888 nasal swabs were collected from non hospitalized patients were examined for beta haemolytic streptococci. The samples were cultured on blood agar. To facilitate the isolation of beta haemolytic streptococci the samples were also cultured on biologically anaerobic sheep blood agar. From throat swabs and nasal swabs 174 and 13 beta haemolytic streptococci were isolated respectively. 113 beta haemolytic streptococci were identified as a group A (60%). In this study we evaluated the antibiotic susceptibility of streptococci. As a result the most effective antibiotics are in order Cefuroxime, Cefotaxime, Cephalothin, Thiamphenicol, Erythromycin.

[Antibacterial sensitivity of Staphylococcus aureus isolated from clinical specimens]. / Cesitli klinik örneklerden izole edilen Staphylococcus aureus suslarinin antibakteriyellere duyarliliklari.

In this study we evaluated the susceptibility of Staph. aureus to antibacterials in vitro by disk diffusion technique. 393 staph. aureus strains isolated from various clinical samples at the Bacteriology laboratory of Ankara University Medical Faculty Microbiology Department. As a result, the most effectual antibacterials are in order: Cefotaxime, Cefuroxime, Cephalothin, Ceftazidime, Sulbactam, Erythromycin, Kanamycin, Tetracycline, Clindamycin, Vancomycin, Thiamphenicol, Methicillin, Penicillin G.

[The effect of netilmicin on gram negative rods isolated in the Konya region]. / Netilmicin'in Konya bölgesinde kullanilmaya baslamadan once soyutulan gram negatif basillere etkisinin saptanmasi.

Netilmicin, was tested for the effect against 276 isolates of gram negative bacteria, before had used in Konya region. 15.9% of the isolates were resistant and 84.1% were sensitive to netilmicin. The effects of Netilmicin and gentamicin for 50 Pseudomonas isolates were compared. The other aminoglycosides also were tested against isolates of the bacterium, amikacin was the most active one.

[A case of subacute endocarditis caused by C. endocarditis (author's transl)]. / Corynebacterium endocarditis'e bagli bir subakut endokarditis olgusu.

Corynebacterium endocarditis isolated from the blood culture obtained in fever period of a patient who had endocarditis and hospitalized in cardiology department of Ankara University Medical School. Good result is obtained by penicillin therapy. Other cases in literature are discussed.

[Isolation of Salmonellae from streams in and about Ankara (author's transl)]. / Ankara içi ve çevresindeki dere sularinda Salmonella arastirmasi.

S.typhimurium, S.paratyphi B, S.typhi were isolated from 132 samples, collected from sewage of eight different regions, by using selenit F, Wilson Blair and Mac Conkey media. Isolations were done in September, October, November and December. The isolations were 53% positive in these months. It was seen that S.typhimurium was dominant in Ankara and Widal reaction has to be concidered.