Increased incidence of allergic sensitisation and respiratory diseases due to mould exposure: results of the Leipzig Allergy Risk children Study (LARS)

To investigate mould effects on health, the concentration of mould spores in air and dust was determined during a prospective cohort study. Clinical outcome was estimated by questionnaires and determination of specific IgE antibodies and intracellular cytokine production of T cells. A significant association was observed between the incidence of respiratory tract infections and exposure to Penicillium spores. Moreover, Aspergillus exposure was found to be associated with allergic rhinitis or related symptoms. In addition, T cells of children exposed to Aspergillus showed a significantly lower content of TH1 cytokines (IFN-gamma, TNF-alpha, IL-2) producing cells. Our data suggest that mould exposure is associated with several effects on health, depending on the species involved.

Fungal meningitis

Fungi provide many benefits to humans. However, some of these fungi have the ability to become human pathogens. All the major fungal pathogens can produce meningitis. From the common cryptococcal meningitis to the rare fungal meningitis caused by a dimorphic or filamentous fungus, medical issues are discussed in this review on a fungus-specific basis. Both primary (Cryptococcus, Blastomyces, Histoplasma, Coccidioides, and other dimorphic fungi) and secondary (Aspergillus, Candida, and a series of molds) fungal pathogens can produce life-threatening central nervous system infections. These infections require immediate and precise diagnosis and carefully selected management strategies to optimize outcomes. In this review, we examine the epidemiology, pathogenesis, clinical manifestations, and treatment for fungal meningitis in all the major fungal groups.

Effects of substrate, water activity, and temperature on growth and verrucosidin production by Penicillium polonicum isolated from dry-cured ham

Penicillium polonicum, a common mold on dry-cured meat products, is able to produce verrucosidin, a potent neurotoxin. The ability of P. polonicum isolated from dry-cured ham to grow and produce verrucosidin from 4 to 40 degrees C at water activities (a(w)) of 0.99, 0.97, and 0.95 on malt extract agar (MEA) and a medium made up with meat extract, peptone, and agar (MPA) was evaluated. Verrucosidin was quantified by high-pressure liquid chromatography and mass spectrometry. P. polonicum was able to grow on MEA and MPA at all the a(w) values tested from 4 to 37 degrees C but not at 40 degrees C. The optimal environmental conditions for growth were 20 degrees C, 0.99 a(w) on MEA and 20 to 25 degrees C, 0.97 a(w) on MPA, but the highest amount of verrucosidin was obtained at 25 degrees C, 0.99 a(w) in both media. No direct correlation between extension of mold growth and verrucosidin production was found. Temperature appears to be the most important factor ruling mycelial growth, whereas verrucosidin accumulation is mostly influenced by a(w). However, analysis of variance of the data showed that there was a complex interaction among all the environmental factors (medium, temperature, and a(w)) that significantly (P < 0.0001) affected growth and verrucosidin production. The reduction of a(w) to intermediates values of 0.95 has a stronger effect on growth on MEA than on MPA. Given that the meat-based medium proved to be an appropriate substrate for the biosynthesis of verrucosidin by P. polonicum, the ability of this mold to produce the toxin on meat products should be established.

Penicillium marneffei: an insurgent species among the penicillia

Most species of Penicillium are considered relatively benign with respect to causing human disease. However, one species, P. marneffei, has emerged as a significant pathogen particularly among individuals who live in Southeast Asia and are concurrently infected with the human immunodeficiency virus. While environmental and epidemiological studies have yet to resolve the reason for the heightened virulence of P. marneffi, one characteristic does distinguish this fungus from other Penicillium species. Whereas the latter grow as monomorphic moulds bearing typical asexual propagules (conidia), P. marneffei is thermally dimorphic. At room temperature, P. marneffei exhibits the morphology characteristic of the genus. In contrast to other Penicillia, though, P. marneffei grows as a yeast-like entity (arthroconidium) when found in diseased tissue or cultivated at 37 degrees C. Studies in our laboratory have focused on the differential gene expression between the mould and arthroconidial phases. Many of the genes whose expression differs during mould-to-arthrocondium transition are related to energy metabolism. A better understanding of gene expression during morphogenesis in P. marneffei may help detect unique target sites or cellular processes that can be exploited in the development of antifungal agents or immunomodulation therapies.

Penicilliosis marneffei: another AIDS defining illness in Southeast Asia

Penicilliosis marneffei, a common mycosis among AIDS patients living in Southeast Asia, has been recently suggested for inclusion in the AIDS surveillance case definition. Infections with Penicillium marneffei were rare in the past, but infections with this dimorphic fungus have increased with the endemic of AIDS in the region. The reservoir of P. marneffei in nature is still unknown, although it seems likely that inhalation may be the route of entry of the organism leading to infection in humans. P. marneffei can cause two clinical types of the disease; focal and fatal progressive, disseminated infections, characterized by a variety of symptoms which can mimic those of other diseases. Oral P. marneffei lesions usually occur in patients with disseminated infections, presenting as shiny papules, as erosions or as shallow ulcers covered with whitish yellow, necrotic slough which may be found on the palate, gingiva, labial mucosa, tongue and oropharynx. Biopsy and culture provide definitive diagnoses, while serologic tests for both antibody and antigen are useful in rapid presumptive diagnoses as well as in surveillance studies of the prevalence and latency of the infection. Penicilliosis marneffei is a treatable disease, but late diagnosis and treatment may be fatal. Itraconazole and ketoconazole are the drugs of first choice for mild to moderately severe forms of the disease, whereas parenteral therapy with amphotericin B may be required for seriously ill patients. Recurrence of the disease is common, therefore maintenance is recommended. As reported, prophylaxis generating resistant strains are likely to develop.

Sialic acid-dependent recognition of laminin by Penicillium marneffei conidia

Immunofluorescence microscopy demonstrated that laminin bound to the surface of Penicillium marneffei conidia. Attachment of P. marneffei conidia in an adherence assay was inhibited by soluble laminin and anti-laminin antibody. N-Acetylneuraminic acid abolished adherence, indicating an interaction mediated by a sialic acid-specific lectin.

Fatal Penicillium citrinum pneumonia with pericarditis in a patient with acute leukemia

We report here a case of fatal Penicillium citrinum infection. The patient, who suffered from acute myeloid leukemia, developed signs and symptoms typical of fungal pneumonia and pericardial tamponade after undergoing standard induction chemotherapy. Despite attaining complete remission of her leukemia, the patient succumbed 8 weeks after presentation. At autopsy, multiple nodular cavitary pulmonary lesions with invasion by fungal hyphae were found. Pericardial and lung tissue obtained at autopsy grew P. citrinum, a fungus ubiquitous in the environment but seldom reported as a pathogen. The microbiological findings were consistent with the histopathological features and confirmed this as a case of true P. citrinum infection causing fatal pulmonary and pericardial complications in an immunocompromised host.

Pathology of Penicillium marneffei. An emerging acquired immunodeficiency syndrome-related pathogen

OBJECTIVE

To summarize current knowledge regarding the opportunistic dimorphic fungal pathogen Penicillium marneffei. Clinical presentation, differential diagnosis, mycology, histopathology, diagnostic serology, in vitro antifungal agent susceptibility testing, and therapy are discussed for human immunodeficiency virus-infected individuals primarily living in Southeast Asia.

DATA SOURCES

Critical evaluation of peer-reviewed publications located through an electronic literature database search, supplemented by unpublished observations, were used to prepare this report.

STUDY SELECTION

Studies were selected based on either the fungal name Penicillium marneffei, penicilliosis, penicilliosis marneffei, or a combination of these.

DATA EXTRACTION

Articles were reviewed with appropriate data being abstracted and then synthesized into the review.

DATA SYNTHESIS

Differential diagnostic criteria for tissue diagnosis and laboratory identification of the fungus are detailed. The usefulness of mycoserology and antifungal therapy are evaluated.

CONCLUSIONS

Penicillium marneffei is an emerging pathogen, primarily among patients with acquired immunodeficiency syndrome residing in Southeast Asia. Although infection caused by P marneffei is endemic to this portion of the world, cases are being diagnosed and treated involving individuals who have traveled to this region. Penicilliosis marneffei can clinically resemble tuberculosis, molluscum contagiosum, cryptococcosis, and histoplasmosis. The successful treatment of P marneffei infection is dependent on its rapid and accurate diagnosis.

Penicillium brevicompactum as the cause of a necrotic lung ball in an allogeneic bone marrow transplant recipient

The non-Candida, non-Aspergillus fungal infections are being reported with increasing frequency in BMT patients. One of these agents is Penicillium which has rarely been implicated as a pathogen in these patients. Only a few cases of isolated fungemias have been reported to date. We present the first documented case of invasive lung infection due to Penicillium brevicompactum in an allogeneic BMT recipient. As this case shows, the diagnosis of non-Candida, non-Aspergillus fungal infections may be incorrect if only histologic findings are available, mainly because misdiagnosis with other more common fungus can occur. A positive culture is required in order to make an accurate diagnosis.

Infection due to Penicillium marneffei, an emerging pathogen: review of 155 reported cases

A disseminated and progressive infection, penicilliosis marneffei is the third most common opportunistic infection in human immunodeficiency virus (HIV)-infected patients in certain parts of Southeast Asia. Penicillium marneffei is endemic in Southeast Asia and the southern part of China. Cases have been reported from both Eastern and Western countries. This review discusses the history, epidemiology, mycology, clinical manifestations, diagnosis, and treatment of penicilliosis marneffei, on the basis of 155 cases of the infection. About 80% of the patients are immunocompromised. P. marneffei can infect various organs, particularly the lung, liver, and skin. The most common clinical features include fever, weight loss, and anemia. The organism has been isolated most commonly from skin, blood, and bone marrow. Immunologic identification of fungal isolates can be done with exoantigen tests and immunohistochemical methods. Treatment of disseminated penicilliosis marneffei in HIV-infected patients with parenteral amphotericin B and itraconazole is relatively effective and safe.

A novel secondary metabolite relative to the degradation of PR toxin by Penicillium roqueforti

A secondary metabolite different from PR-imine and PR-amide was produced in the liquid (YESC) and solid (buckwheat) culture medium of Penicillium roqueforti. We isolated and purified the compound in pure and colorless crystalline form. On the basis of elemental analysis, mass, 1H and 13C nuclear magnetic resonance, infrared, and UV spectroscopy, the compound was identified as PR-acid (C17H20O7). The structures of PR-acid and PR toxin (C17H20O6) are closely related. Moreover, we discovered that PR-acid disappeared concurrently with the PR toxin in the culture medium. Thus, we postulate that PR toxin is degraded to PR-acid in the culture of P. roqueforti.

Development of a microbial community of bacterial and yeast antagonists to control wound-invading postharvest pathogens of fruits

Two antagonists, the bacterium Pseudomonas syringae and the pink yeast Sporobolomyces roseus, against blue mold (caused by Penicillium expansum) on apple controlled this disease more effectively when combined at approximately equal biomass (50:50 of the same turbidity) than in individual applications. Addition of L-asparagine enhanced the biocontrol effectiveness of P. syringae but decreased that of S. roseus and had no significant effect when the antagonists were combined. Populations of both antagonists increased in apple wounds and were further stimulated by the addition of L-asparagine. The carrying capacity of wounds for P. syringae was not affected by S. roseus. Populations of P. syringae in wounds inoculated individually or in a 50:50 mixture with S. roseus reached the same level after 3 days at 22 degrees C. However, populations of S. roseus recovered after applications of the mixture were consistently lower than those recovered after individual applications. Similar effects were observed in in vitro tests in which populations of S. roseus grown in mixtures with P. syringae were consistently lower than those grown alone, while the populations of P. syringae were not affected by the presence of S. roseus. A total of 36 carbon and 35 nitrogen compounds were tested for utilization by both antagonists. Fourteen nitrogenous compounds were utilized by both P. syringae and S. roseus, and an additional nine compounds were utilized by P. syringae. S. roseus and P. syringae utilized 17 and 13 carbon sources, respectively; 9 sources were common to both antagonists. Populations of these antagonists in apple wounds appear to form a relatively stable community dominated by P. syringae.(ABSTRACT TRUNCATED AT 250 WORDS)

Disseminated Penicillium marneffei: presenting illness of advanced HIV infection; a clinicopathological review, illustrated by a case report

BACKGROUND

Until recently Penicillium marneffei rarely caused human disease. It is now a frequently encountered opportunistic mycosis in HIV positive residents of, and travellers to, south-east Asia.

AIMS

To review aspects of clinical presentation, pathology, treatment, epidemiology and ecology of P. marneffei. To report a case of disseminated P. marneffei occurring in the Northern Territory which illustrates many typical clinical and pathological features of this infection.

CASE PRESENTATION

A Burmese immigrant presented to Royal Darwin Hospital, Australia with a non-specific, subacute, febrile illness and a diffuse papular rash. The etiological agent was Penicillium marneffei, disseminated in association with advanced HIV infection. The typical travel history and umbilicated papular rash were recognized on admission. Fungal stains of skin biopsies and touch smears facilitated rapid diagnosis, and early antifungal therapy resulted in clinical cure.

CONCLUSIONS

Early distinction of penicilliosis from other opportunistic mycoses, tuberculosis, Leishmaniasis, and molluscum contagiosum is critical for effective management. The characteristic histological and mycological properties of P. marneffei are easily recognizable if the diagnosis is considered. In view of geographic proximity, travel and immigration from endemic areas, Australia should expect further imported penicilliosis as illustrated by this case report.

Phylogeny and PCR identification of the human pathogenic fungus Penicillium marneffei

The phylogenetic position of the human pathogenic fungus Penicillium marneffei was assessed from the nucleotide sequences of the nuclear and mitochondrial ribosomal DNA regions. Phylogenetic analysis determined that P. marneffei is closely related to species of Penicillium subgenus Biverticillium and sexual Talaromyces species with asexual biverticillate Penicillium states. Knowledge of the phylogenetic position of P. marneffei facilitated the design of unique oligonucleotide primers, from the nuclear ribosomal DNA internal transcribed spacer region, for the specific amplification of P. marneffei DNA. These primers were successful at selectively amplifying DNA from six isolates of P. marneffei and excluding the other species tested, which included Penicillium subgenus Biverticillium and Talaromyces species and several well-known fungal pathogens, namely, Aspergillus fumigatus, Coccidioides immitis, Histoplasma capsulatum, and Pneumocystis carinii. The primers that we have developed for the specific amplification of P. marneffei have the potential to be incorporated in a PCR identification system which could be used for the identification of this pathogenic agent from clinical material.

Pulmonary penicillosis marneffei: report of the first imported case in Canada

A 57-year-old female, born in Laos and who had lived in Thailand prior to immigrating to Canada in 1989, was seen by her physician with a chief complaint of cough and dyspnea. Her chest X-ray showed bilateral pulmonary air fluid levels. A fungus, with a diffusible red pigment, tentatively identified as Penicillium marneffei, was isolated from the patient's bronchial washings and sputum specimens. At 37 degrees C, the fungus converted to a yeast form when cultured on brain heart infusion agar. Microscopic examination of this culture revealed yeast cells that reproduced by fission. The identity of the patient's isolate was confirmed as P. marneffei with an exoantigen test. The patient's serum demonstrated specific antibodies to P. marneffei antigen. Treatment with amphotericin B and ketoconazole resulted in clinical improvement, clearing of chest X-rays and conversion to sero-negativity. Our case is the first recorded diagnosis of imported penicillosis marneffei in Canada. The minimal inhibitory concentrations recorded for the patient's isolate to fluconazole, 5-fluorocytosine, itraconazole and miconazole were 12.5, 0.39, < 0.195 and < 0.195 micrograms/ml, respectively.

Disseminated Penicillium marneffei infection diagnosed on examination of a peripheral blood smear of a patient with human immunodeficiency virus infection

We describe a case of disseminated Penicillium marneffei infection in a patient infected with human immunodeficiency virus. The diagnosis was made by examination of a peripheral blood smear. The patient presented with fever, jaundice, generalized lymphadenopathy, hepatosplenomegaly, and an erythematous, papular rash. Microscopic examination of a Wright's-stained peripheral blood smear revealed many yeast cells in neutrophils. Some yeast cells had clear central septation. Presumptive diagnosis of disseminated P. marneffei infection was made, and treatment was started several days before the culture results were available.

Emerging fungal pathogens in immunocompromised patients: classification, diagnosis, and management

Fungi such as Fusarium species, Trichosporon species, Curvularia species, and Alternaria species previously were thought to represent contamination or harmless colonization when isolated from immunocompromised patients. More recently, the pathogenic role of these and other fungi has been clearly established. Three diverse groups of fungi are responsible for these emerging infections: the agents of phaeohyphomycosis and hyalohyphomycosis and certain yeasts. Reports of the emergence of these organisms as significant pathogens may be ascribed to increasing awareness by physicians and microbiologists, aggressive culture of patient specimens, increasingly cytotoxic chemotherapy, and selection of resistant organisms by the widespread empirical use of amphotericin B. Infections with these fungi tend to be disseminated and are frequently fatal in immunocompromised hosts. Treatment of these infections is not standardized. Experimental therapy in murine models of fungal infections suggests a role for newer agents, combination antifungal chemotherapy, and immunotherapy.

Disseminated Penicillium marneffei infection associated with human immunodeficiency virus: a report of two cases and a review of 35 published cases

Penicillium marneffei, a dimorphic fungus that is endemic in southeast Asia, causes deep-seated infection in humans and rodents. About 20 cases have been reported among the local populations of China, Thailand, and Hong Kong, and 35 cases have now been described in patients infected with the human immunodeficiency virus (HIV). We present a review of the literature and report two additional cases. Both immunocompromised and apparently immunocompetent hosts tend to develop disseminated, symptomatic infection. HIV-infected patients having travelled to southeast Asia and presenting with fever, skin lesions, hepatomegaly, adenopathies, or lung disease should be investigated for Penicillium marneffei infection. The diagnosis is based on the demonstration of the organism in clinical specimens. Treatment with amphotericin B or itraconazole is generally successful, but maintenance therapy is warranted for patients with an underlying immunodeficiency.

[Identification of toxigenic mould in soft drink causing food poisoning]

In a soft drink caused food poisoning, white floccus was found and mould count was 6.0 x 10(2) CFU/ml. The Mycoflora was made of only one kind of mould which was identified as Penicillium janthinellum Biourge. This isolate can grow under anaerobic condition. The culture liquid of the isolate was fed to mice orally for toxicity test, which made the mice lose weight. An extract of the culture liquid was tested in weaned mice inaberitoneally for toxicity and all mice died in 24h. The toxic symptoms were tic, sway and paralysis of right rear-leg. Gross anatomy changes were gastrectosis, flatulence and intestinal edema. The conclusion is: the P. janthinellum isolate from the soft drink was the toxigenic mould.

Morphological variation in pathogenic strains of Penicillium marneffei

Penicillium marneffei is a dimorphic fungus known to be pathogenic to animals and man. The natural reservoir of this organism was known to be bamboo rats found in South Vietnam, Thailand and China. The first two human infections were reported in 1959 and 1973 from the United States. Up to 1984, five new cases of human penicillosis were reported from Thailand. Since then several more cases have been reported from different parts of the world mainly from the southern part of China. However, there are very limited mycological descriptions of this fungi. In this report, five Thai strains were studied for colonial morphology in comparison with Reference strain PLM 689. Variation in mycelial pigment was observed ranging from yellowish-green to orange with water soluble red pigment produced in every strain which can be seen early from the reverse side. Ultrastructural study by both scanning electron microscopy (SEM) and transmission electron microscopy (TEM) was compared with that of the reference strain PLM 689. PLM 689 strain had only biverticillate penicilli, but all five strains from Thailand had both monoverticillate and biverticillate penicilli which occasionally appeared on the same branch. The conidia of the Thai isolates were oval in shape and 1.3-2 x 0.7-1.6 microns in size smaller than those of PLM 689 which were 2.5-4 x 2-3 microns. Phialides were also smaller and a little shorter but the number of phialides was similar to those of PLM 689 ranging 4-10 except for one strain which had 3-16 phialides. All Thai strains have stipes smaller and somewhat longer than those of PLM 689.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute histopathological changes produced by Penicillium aurantiogriseum nephrotoxin in the rat

Shredded wheat moulded by an isolate of Penicillium aurantiogriseum elicited progressive histopathological changes at the rat renal cortico-medullary junction during 5 days of dosing, when incorporated into diet as a 20% component. The changes of acute tubular necrosis and regeneration were seen in the P3 segment of the nephron. In rats exposed to contaminated diet for 5 days the histopathological changes regressed in severity by about one-half within a further 4 days on normal diet and by 7 days the tubular epithelium was nearly normal. A partially purified fraction of an alcohol extract, selected by preparative high-voltage electrophoresis and anion exchange and notably rich in amino-compounds, was typically nephrotoxic when given in diet over 4 days. Acute marked tubular necrosis also occurred when the same fraction was given intraperitoneally over a similar period. The acute histological changes provide a rapid bioassay for this Penicillium nephrotoxicity and facilitate the search for the toxic metabolite(s). The cumulative expression of necrosis and repair over only a few days in tubular epithelium suggests that chronic exposure will elicit a more complex pathology which might serve as an experimental model for the idiopathic Balkan endemic nephropathy.

[A toxicological evaluation of micromycetes isolated from salmon roe]

Three species of micromycetes (Aspergillus clavatus Desm., Cladosporium herbarum (Pers) Lk., Penicillium canescens Sopp.) isolated from the cultivated salmon spawn have been studied for their toxigenic properties and pathogenicity for warm-blooded animals. LD50 are determined for mice perorally administered mycelium suspension of the first two species; the third of the studied species proved to be nontoxicogenic. The possible pathogenic action of mycotoxins on fish spawn in aquarium is discussed.

Nephrotoxicity of Penicillium aurantiogriseum, a possible factor in the aetiology of Balkan endemic nephropathy

Water-soluble components of a nephrotoxic isolate of Penicillium aurantiogriseum have been fractionated by sequential ion-exchange, size-exclusion gel filtration, reverse-phase silica chromatography and HPLC. Nephrotoxicity in the rat was confined to a size-exclusion fraction approximating to 1,500 daltons, which also inhibited DNA synthesis in cultured kidney cells. The more sensitive in vitro assay allowed toxicity to be followed to a sub-fraction from gradient-elution HPLC which in further HPLC resolved into a small group of glycopeptides. Recent Yugoslavian P. aurantiogriseum isolates, from a village in which the idiopathic human disease Balkan Nephropathy is hyperendemic, elicited a similar nephropathology and were acutely cytotoxic, reinforcing a need to regard this novel Penicillium nephrotoxin as a potential factor in human nephropathy.

Successful management of Penicillium endocarditis

Penicillium endocarditis involving an aortic valvular tissue prosthesis (Ionescu-Shiley) was successfully managed. This is the fourth reported case of Penicillium endocarditis, and the first survivor. A review of the literature shows that this fungus is ubiguitous though rarely pathogenic. The management of this rare type of infection is outlined.

The effect of feeding corn molded with Penicillium lanosum to broiler chicks

Penicillium lanosum was isolated from broiler feed obtained from troughs in a house in which the litter was wet and the chicks were substantially smaller than expected at the time of slaughter. Corn was inoculated with the fungus, incubated for 8 weeks, dried, and incorporated in a broiler ration. The ration was fed to broiler chicks for a period of 2 weeks in order to evaluate toxicity. Experimental chicks developed diarrhea and grew slower than the controls. Gross lesions consisted of swollen kidneys and erosions in the lining of the gizzard. Histologic examination revealed mild toxic nephritis and growth of fungus in and on the surface of the gizzard lining. Penicillium lanosum was isolated from the gizzards of affected birds. Diarrhea but no gizzard lesions occurred in birds feld molded corn which had been treated with ethylene oxide. This finding indicates that this isolate of P. lanosum is both toxigenic and capable of producing gizzard erosion.

The mycotoxins and human health hazards

The general background of the role of mycotoxins in human disease is briefly reviewed. The acute effects of the ingestion of the aflatoxins and the role that long term exposure may play in human disease are examined in detail. The necessity for co-operation between chemists, veterinarians, physicians and mycologists in the elucidation of the role of the mycotoxins in human disease is stressed.

[PBV5 virus induction in Penicillium chrysogenum mycelium]

The effect of some physical (increased temperature, UV light) and chemical (N-nitrosomethylbiuret, proflavin, acridine orange) factors on the virus titer in 2 strains of Penicillium chrysogenum was studied. Thermoinactivation of the virus and its induction under the effect of UV light and proflavin were shown. Slight induction was observed with N-nitrosomethylbiuret and acridin orange. It was supposed that induction of the virus in the mycelium of Penicillium chrysogenum was spontaneous.

Production of patulin by Penicillium expansum

Twenty-seven isolates of Penicillium expansum Lk. ex Thom obtained from Europe, Australia, and North America from seven different fruit hosts all produced patulin in culture. Six isolates were essentially nonpathogenic in apple fruits. In culture, patulin generally accumulated to much higher levels than in apple fruits. At all temperatures permitting fungus growth, patulin was produced. However, only small amounts were observed near the maximal temperature for growth (30 C). At 0 C, patulin accumulated but slowly in culture. Modified atmospheres suppressed both fungus growth and patulin accumulation in apples. After varying incubation periods to obtain similar total growth, the patulin concentration was low in modified atmospheres and high in air.

Thirthy years of penicillin therapy

Three decades have passed since the publication in the Lancet (Abraham et al . 1941) of the paper by our group at Oxford in which it was, for the first time, reported that the mould metabolite penicillin exhibited remarkable chemotherapeutic effects in clinical bacterial infections, including those caused by Staphylococcus aureus , against which no member of the only then known group of antibacterials possessing in vivo chemotherapeutic activity, the sulphonamides, was fully effective. A year earlier, in 1940, we had published, also in the Lancet (Chain et al . 1940), our first paper on the chemotherapeutic power of penicillin in experimental bacterial infections in mice which was dramatic and of unprecedented magnitude. The introduction into clinical medicine of penicillin therapy and of the antibiotics therapy stemming from it has, by general consensus of opinion, completely revolutionized the treatment of bacterial infections in both man and animals, and rendered the large majority of them, including the most severe ones, amenable to successful therapeutic control.