Table of Content

28 June 2011, Volume 6 Issue 3

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Clinical value of(1,3)-β-D-glucan in plasma on the diagnosis of deep fungal infection

YANG Hui-qing, MEI Ya-ning

2011, 6(3):  136-140. 

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Objective To study the value of plasma(1,3)-β-D-glucan and fungal culture on the diagnosis of deep fungal infection.Methods Retrospective investigation were performed on 1 868 patients with fever and treatment of immunosuppressant,corticosteroid or wide-spectrum antibiotics for a long time from August 2009 to July 2010.(1,3)-β-D-glucan concentration in plasm and culture results of peripheral blood,respiratory tract,urinary tract and intestinal canal were analysed.Results Symptoms of 757 cases in 1 868 patients were relieved after antifungal treatment.Other 1 082 cases,showed no improvement or received no antifungal drugs.Another 29 cases(eliminate) had no clinical data.In the 1 839 valuble cases,the detection ratio of(1,3)-β-D-glucan was 778/1 061 with 20 pg/mL as critical value,and 623/1 216 with 50 pg/mL as critical value respectively.Positive to negative rate in fungal culture was 457/1 382.Sensitivity(89.3%,74.9%), specificity(90.6%,94.8%),positive predictive value(PPV,86.9%,91.0%) and negative predictive value(NPV,92.4%,84.4%) obtained by different critical value showed no significal differences(P>0.05).The sensitivity,specificity,PPV and NPV of fungal culture were 49.0%,,92.1%,81.2% and 72.1% respectively.The sensitivity and specificity raised to 93.0% and 88.9% after combination of the two methods.Conclusions G-test for(1,3)-β-D-glucan detection is simple,rapid with high positive rate of fungi detection.It is suggested that G-test,fungal dtermination should be combine in the diagnosis of deep fungal infection for satisfied sensitivity and specificity.

Experimental study on corneal aspergillosis

WU Ran, CHENG Bo, JIA Min

2011, 6(3):  141-144. 

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Objective To establish a murine model of corneal aspergillosis and investigate the formation condition and pathogenic mechanism of corneal aspergillosis.Methods Murine model of corneal aspergillosis was set up by corneal scarification and intrastromal injection.Morphological observation,histopathological study and fungal examinations(light microscope and culture) were performed afterwards.Results The infection rate was 100% in immunocompetent mice by introstromal injection method.Mild changes which could be self-recovered were observed on the infected corneas,whereas moderate to severe keratomycosis developed in cyclophosphamide-treated mice with the same inoculation.Conclusions The infection rate of Aspergillus fumigatus to murine corneal is related to the damage level of corneal and the amount of spores adhered.Immudeficiency may cause corneal aspergillosis and make the lesion more serious.

Four methods of DNA extraction for Aspergillus niger

ZHANG Xiao-li, LV Xue-lian, SHEN Yong-nian, LV Gui-xia, WANG Miao-miao, GE Yi-ping, LIU Wei-da

2011, 6(3):  145-148. 

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Objective To find the best DNA extraction method for Aspergillus niger.Methods The purity and output of Aspergillus.niger DNA extracted by benzyl chloride method,CTAB method,Biospin kit and microwave method were compared via agarose gel electrophoresis and PCR.Results The extracted DNA cultured for 3 ds was purer than that for 7-14 ds.All the DNA products were amplifiable for PCR,but the purity and output via CTAB method showed the best results.Conclusions CTAB is suitable for Aspergillus niger DNA extraction.

Antifungal susceptibilities of 44 isolates of Trichophyton mentagrophytes isolates evaluated with CLSI M38-A2 scheme

HU Xiao-ping, WAN Zhe, LI Ruo-yu

2011, 6(3):  149-153. 

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Objective To determine the susceptibilities of Trichophyton mentagrophytes strains and to evaluate the M38-A2 scheme of CLSI.Methods Thirty-eight isolates of Trichophyton interdigitale(T.interdigitale) and 6 isolates of Trichophyton anamorph of A.benhamiae strains from 8 different regions of China were included and the MICs to fluconazol(FLU),itraconazole(ITR), voriconazole(VIR), terbinafine(TER),griseofulvin(GRI),ciclopiroxolamine(CIC),bifonazole(BIF),and amorofine(AMO) were determined by M38-A2 scheme.Results MICs(μg/mL) of T.interdigitale and A.benhamiae to FLU,ITR,VIR,TER,GRI,CIC,BIF,AMO were 0.25～32,0.031 2～1,0.015 6～0.062 5,0.000 937～0.007 81,0.062 5～1,0.031 2～2,1～2,0.007 81～0.062 5(T.interdigitale) and ≥64,2,0.25～0.5,0.000 937～0.003 81,1,2～4,1～2,0.031 2～0.062 5(A.benhamiae) respectively.There were significant differences in the sensitivities to FLU,ITR,VIR,GRI and CIC,but no significants were found in the sensitivities to TER,AMO and BIF.Conclusions M38-A2 scheme could be applied to determine the susceptibility of T.mentagrophytes to antifungal drugs with good reproducibility and feasibility.

A retrospective analysis on clinical characteristics and laboratory detection of Cryptococcus neoformans infections

SUN Ji-mei, WANG Yan-ling, ZHOU Xiu-zhen, ZHENG Wei, ZHANG Zhi-jie, LIU Yong

2011, 6(3):  154-157. 

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Objective To explore the clinical characteristics and laboratory detection of Cryptococcus neoformans infections and to analyse its drug resistance.Methods Retrospective analysis was made on the clinical data of 12 patients infected by Cryptococcus neoformans.Germiculture and fungi culture were performed and the yeast was identified by API20C.Susceptibility test was made on FUNGUS3 micro dilution plate.Results Of all the 12 patients diagnosed by etiology,there were 6 cases of CNS infection,5 cases in blood system,1 case in abdominalcavity.Cryptococcus neoformans was sensitive to 5 kinds of antifungal drugs,but intermediate to fluconazole in 2 cases.Conclusions Early etiological examinations are essential to the diagnosis of Cryptococcus neoformans infection and combinated antifungal therapy has good therapeutic effects.

Death risk factors in AIDS patients complicated with Penicilliosis marneffei

OU Ru-zhi, LU Xiang-chan, LI Wei-xin

2011, 6(3):  158-161. 

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Objective To explore the death risk factors of Penicillium marneffei(PM) infection in AIDS patients for death risks reducing and prognosis improvement.Methods A total of 101 AIDS cases complicated with Penicilliosis marneffei(PSM) who had been hospitalized in our hospital between 2007 and 2010 were involved and divided into death group and survival group,according to prognosis.Indexes including age,sex,fever,periumbilical concave rash,bellyache,dyspnea,gastrointestinal hemorrhage,bacterial septicemia,the counts of WBC,HGB,PLT,CR,ALT,AST,T.BIL,absolute counting of CD4+ T lymphocytes,triglycerides,the time of positive fungus cultivation,beginning time of effctive antifungal therapy,regimen of antimycotic therapy,HAART(High active anti-retroviral therapy)accepted or not were compared and statistical analysis was carried out.Results Abdominal pain,dyspnea,gastrointestinal hemorrhage,peritoneal irritation sign,the counts of WBC,Cr,T.BIL,AST,CD4+ acounts,triglycerides,positive fungal culture time between two groups showed statistical significance(P< 0.05).The ORs of peritoneal irritation sign,dyspnea and WBC counting increasing in multivariate logistic regression were 226.733,90.213 and 2.216 respectively.The OR of elevated Cr was 1.014.Conclusions The peritoneal irritation sign,dyspnea,hoist of WBC counting,elevated Cr were the main death risk factors in AIDS patients complicated with PSM.Treatment of the complication may be helpful for mortality decreasing.

A case of endocarditis caused by Microascus trigonosporus

WANG Peng, WANG He, ZHAO Ying, ZHANG Xiao-jiang, XU Ying-chun

2011, 6(3):  162-165. 

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A case of endocarditis caused by Microascus trigonosporus related was reported.The strain was isolated from the pacemaker surface and identified as Microascus trigonosporus by ITS analysis.Histopathology showed abundant septate hyphae and intercalary swollen chlamydospores in the vegetaion.Microascus trigonosporus widely spread in the natural world was anamorphs(asexual forms) of Scopulariopsis.Endocarditis caused by Microascus was rarely reported.Etest showed the MICs of itraconazole and amphotericin B were ≥32 μg/mL,while the MIC of voriconazole was 4 μg/mL.The patient improved by vegetation removal and itroconazole treatment.

Remote consultation in dermatomycosis

KUAI Hao, XU Hong

2011, 6(3):  176-179. 

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Remote consultation as a new kind of medical service mode,comparing with the methods of traditional medical treatment,develops fastly and has fully showed its superiority,for vast territory in China,uneven distribution of medical resources and lack of advanced medical talents and equipments in remote regions.Skin diseases with characteristics of high incidence and strong intuition is suitable for remote consultation.