European Journal of Clinical Microbiology最新文献

A new cell culture method was developed for the diagnostic isolation of Chlamydia trachomatis using McCoy cells pretreated with mitomycin-C. This drug acts on the cell by producing cross links between strands of DNA and results in the production of large, flat cells, which are similar to irradiated cells, and large chlamydial inclusions. In tests using a laboratory isolate of Chlamydia trachomatis, there were significantly more inclusions produced in mitomycin-treated monolayers than in cycloheximide-treated monolayers. Using clinical specimens, significantly more isolates were obtained in mitomycin-treated cells than in cycloheximide-treated cells. The new cell culture technique therefore offers a cell culture method which has the advantages of producing large inclusions similar to irradiated cells but with the convenience of drug treatment.

A 37 year old man developed transient fungemia caused by Candida zeylanoides following a kidney and pancreas transplant. For the next seven months the patient had signs and symptoms of right knee arthritis. Candida zeylanoides was finally identified as the aetiological agent. Treatment with intravenous amphotericin B was successful. To our knowledge this is the first report of Candida zeylanoides arthritis.

Weekly fungal surveillance cultures (1,542 cultures) of urine (475), stool (520) and oropharyngeal (547) specimens from 111 patients on the bone marrow transplant and hematologic malignancy services were analyzed. Forty-three percent of the patients were colonized by Candida albicans and 10.8% by Candida tropicalis. There were 22 proven systemic fungal infections, ten due to Candida albicans, eight to Candida tropicalis, one each to Candida pseudotropicalis and Torulopsis glabrata, and two to Aspergillus species. Positive surveillance cultures for Candida tropicalis were highly predictive of systemic infection. The finding of two or more positive cultures yielded high positive predictive values (100%) as a function of body site. Positive surveillance cultures for Candida albicans were not predictive of disease but negative cultures for Candida albicans and Candida tropicalis had a high negative predictive value (95-99%). Surveillance culture data for specific Candida species may aid in diagnostic and therapeutic decision making.

To determine the value of gas chromatographically measured lactate in distinguishing between empyema and other causes of pleural effusion, consecutively collected samples of pleural fluid were studied. In 15 cases of empyema the mean lactate concentration was 11.60 mM and higher than in 41 patients with other diagnoses (mean 3.98 mM). The concentration of lactate remained unchanged during storage at 4 degrees C for two years. Gas chromatographic quantitation of lactate is useful in the presumptive diagnosis of empyema, and stability of the lactate concentration allows retrospective analyses.

The clinical efficacy of the conventional aminoglycoside plus beta-lactam treatment was compared to that of monotherapy with oral quinolones in 26 adult cystic fibrosis patients in an open prospective clinical trial in which six two-week courses of antipseudomonas treatment were administered with an interval of approximately three months between treatments. In each patient two courses of conventional treatment were followed by two courses of quinolone treatment and then by another two courses of conventional treatment. The observed improvements in pulmonary function were somewhat higher when the patients received conventional treatments, and in the most seriously affected patients conventional treatment was significantly better than quinolone treatment. On the basis of these findings it is suggested that quinolone monotherapy cannot replace conventional antipseudomonal chemotherapy in patients with severe pulmonary involvement.

Three methods of typing herpes simplex virus were compared. A total of 111 clinical isolates obtained from patients not treated with antivirals and seven resistant mutants selected in vitro were tested by immunofluorescence assay using antibodies against herpes simplex virus types 1 and 2. Twenty-nine isolates were also studied by restriction endonuclease analysis. The sensitivity of isolates and resistant mutants to (E)-5-(2-bromovinyl)-2'-deoxyuridine was determined. Although a clear difference between the 50% inhibitory dose for type 1 and type 2 isolates was observed, some drug-resistant mutants might be misidentified by this method.