The lectin type of Candida albicans--an epidemiological marker relevant to pathogenesis

Fifty Candida albicans strains isolated from the oral cavities of HIV-infected patients were typed with 14 different lectins by means of agglutination reactions. Sixteen different lectin types could be distinguished, the most frequent type representing 22% of strains. A change in the lectin type was found in about half of the Candida albicans strains representing control cultures from identical individuals. A simplified typing scheme based on three lectins seems to be almost as efficacious for epidemiological application.

[Isolated pemphigus vulgaris of the mouth mucosa--pemphigus test: diagnostic confirmation using direct immunofluorescence study of normal skin]

The diagnosis of oral pemphigus vulgaris (PV) without concomitant cutaneous manifestations is often complicated by difficulties in obtaining a biopsy specimen allowing histological examination and direct immunofluorescence (IF) microscopy. In this clinical study five of our patients with oral PV were investigated: biopsies were taken both from lesional oral mucous membranes and from unaffected gluteal skin for IF analysis. Identical IF results, with intercellular epidermal deposition of IgG in all and of C3 in two of the five cases, were obtained in lesional and nonlesional biopsies. Therefore, it is concluded that with current IF techniques examination of the normal skin is sufficient for the diagnosis of oral PV; thus, the often painful and difficult removal of biopsy specimens from within the affected oral cavity can be avoided. Further studies are needed to confirm the sensitivity of this method.

Absence of extracellular enzyme activity and cytotoxicity in cell-free culture filtrates of Haemophilus ducreyi

Ten isolates of Haemophilus ducreyi, including seven clinical isolates and three laboratory reference strains, were assessed for their ability to produce extracellular enzymes which might contribute to their pathogenicity. Protease, elastase, lecithinase, lipase or collagenase enzyme activity were not detected in culture filtrates from any of the isolates tested using either plate or spectrophotometrical assays. Furthermore, cell-free culture filtrates did not exhibit cytotoxic activity in vitro when tested using either an established tissue culture cell line (Vero) or a primary cell culture of human keratinocytes. These results suggest that extracellular products do not play a role in host invasion or production of tissue damage by H. ducreyi.

Soluble interleukin-2 receptors in serum and urine of patients with chancroid and their response to therapy

To investigate cell-mediated immune response in chancroid, soluble interleukin-2 receptor levels in serum and urine samples of healthy individuals and patients were measured by an enzyme-linked immunosorbent assay. Increased levels both in serum and in urine were observed in cases of Haemophilus ducreyi infection. In patients showing a prolonged incubation period, urine levels exceeded serum values. Therapy led to a reduction of elevated interleukin-2 receptor levels in serum and in urine.

Effect of iron limitation on protein composition and ultrastructure of Haemophilus ducreyi

Protein profiles of whole cells of Haemophilus ducreyi grown in the presence or absence of the iron chelator desferal, were compared by polyacrylamide gel electrophoresis. Each of four strains produced novel proteins in the range 43-160 kDa when cultured under conditions of reduced iron availability. At some sub-inhibitory concentrations, desferal produced enhanced growth, possibly due to it functioning as an exogenous siderophore. Organisms grown under conditions of reduced iron availability ultrastructurally showed also large periplasmic spaces between cytoplasm and outer membrane.

Detection of a novel "cryptic" plasmid of about 7.8 MDal in a non-penicillinase-producing Neisseria gonorrhoeae isolate from Munich

A novel plasmid of about 7.8 megadaltons (MDal) could be detected in a non-penicillinase-producing Neisseria gonorrhoeae strain isolated in Munich in 1987. As the strain showed no resistance against commonly used chemotherapeutic agents, at present the plasmid must be described as phenotypically "cryptic".

Increase of the relative frequency of penicillinase-producing Neisseria gonorrhoeae strains to more than five per cent in Munich

The relative frequency of penicillinase-producing Neisseria gonorrhoeae strains isolated from Munich STD patients nowadays clearly exceeds five percent. Penicillin resistance is either due to the 3.2 or 4.4 Megadalton plasmid. Similar trends are reported from other European countries. Therefore, treatment with third generation cephalosporins such as ceftriaxone, cefotaxime or others is now generally advisable not only in the Far East and Central Africa but also in Central Europe.

[Diagnosis and therapy of ulcus molle today. Case report and review of the literature]

Chancroid, an ulcerous disease of the genitalia caused by Haemophilus ducreyi, occurs rarely but regularly in Germany. Exact diagnosis is based on the clinical features and a direct smear, and in particular on cultivation of the organism, showing its unique macromorphological characteristics. The sensitivity of cultivation has increased due to the development of selective media for primary isolation. Resistance problems during the last decade meant that a change to new therapeutic strategies was unavoidable. The work presented here includes a case report and a review of the recent literature, it illustrates modern methods of diagnosis and treatment of Haemophilus ducreyi infections 100 years after the first description of the organism.

[The etiopathogenesis of ulcus molle: current status of knowledge--approaches to future research]

Chancroid is a sexually transmitted disease characterized by genital ulceration. Although the pathology of chancroid lesions has been well described, we still know relatively little about the mechanism by which the causative agent, the bacterium Haemophilus ducreyi, produces disease. It is hoped that a better understanding of both the pathogenicity of H. ducreyi and the pathogenesis of chancroid will provide a rational basis for the development of improved strategies for the control of this disease.

[Morphologic variants of genital ulcer caused by Haemophilus ducreyi]

The typical clinical picture, common variants and frequent complications of chancroid are presented in cases proven by culture. In general, the conventional view of the clinical spectrum of chancroid is substantiated. Certain types such as "chancre mou volant," however, could not be found in the present material. Their existence or association with Haemophilus ducreyi remains speculative.

Plasmid content, serotypes, and antimicrobial susceptibility of Neisseria gonorrhoeae strains isolated in Munich in 1987-88

Eighty-four strains of Neisseria gonorrhoeae isolated in Munich between January 1987 and June 1988 were characterized in terms of their plasmid content, protein I serovar and susceptibility or resistance to four antimicrobial agents. Eighty two percent of the strains belonged to serogroup 1B, the three most prevalent serovars being 1B-1, 1B-2 and 1B-6. Among the serogroup 1A strains, 1A-2 was the commonest serovar. Fourteen strains (16.7%) lacked the 2.6 Md cryptic plasmid, although two of these strains contained the conjugative gonococcal plasmid. Although some degree of resistance to penicillin and tetracycline was noted, all the strains were sensitive to spectinomycin and cefotiam.

[Lichen aureus zosteriformis]

A case of lichen aureus is presented, which is atypical in that a very large area was involved and there was a good response to topical fluorinated steroid therapy. Similarities to other cases reported in the literature are demonstrated.

One-shot treatment of uncomplicated gonorrhoea with third-generation cephalosporins with differing serum half-life. Results of a controlled trial with ceftriaxone and cefotaxime

The highest minimum inhibitory concentrations of ceftriaxone and cefotaxime in 89 analysed Neisseria gonorrhoeae isolates amounted to 0.008 and 0.031 micrograms/ml, respectively. In a randomized controlled trial the single intramuscular injection of ceftriaxone 250 mg and cefotaxime 500 mg cured bacteriologically 35 out of 35, and 29 out of 30 patients, respectively, with uncomplicated gonorrhoea. Facing the different phenotypes of the isolates grown before and after therapy in the case of the non-cured patient within the cefotaxime treatment group, reinfection rather than failure has to be presumed. Postgonococcal urethritis occurred about as often in both groups, the percentage amounting to 24.2 and 28.6%, respectively. If side effects were noted at all, they were considered minor: 4 patients belonging to the first and 3 belonging to the second treatment group complained temporarily about pain at the injection site. Due to the data presented here, ceftriaxone and cefotaxime appear equally effective and safe when used in the dose generally preferred, irrespective of differences in in vitro activity and pharmacokinetic behaviour.

[Lectin typing as an efficient epidemiological marker system for Neisseria gonorrhoeae infections]

A total of 102 Neisseria gonorrhoeae isolates from Munich with known nutritional requirements were examined for lectin agglutination patterns using Taxonolectin panels containing 14 different plant originated lectins with known specificity. 29 different lectin agglutination patterns were found (in comparison auxotyping showed 17 different groups). All strains reacted with Concanavalin A and Trichosanthes kinlowii and did not show positive reactions with Limax flavus and Ulex europaeus I. 49 Isolates (48%) had lectin agglutination patterns associated with only four lectin groups (in comparison the four major auxotyping groups comprised 58 (57%) of the tested isolates). A correlation between auxotype and lectin agglutination pattern could not be demonstrated. Reproducibility of lectin agglutination patterns was excellent.

Antibiotic susceptibilities and plasmid profiles of Haemophilus ducreyi isolates from southern Africa

Thirty-eight strains of Haemophilus ducreyi isolated in southern Africa were tested in vitro against 15 antimicrobial agents including those frequently used for the treatment of chancroid. In addition, newer compounds which possess characteristics consistent with their possible use as single-dose therapy for the disease were tested. All isolates were found to be resistant to penicillin as a result of beta-lactamase production. The majority of strains were also resistant to tetracycline, sulphamethoxazole and trimethoprim, but susceptible to co-trimoxazole, erythromycin, spectinomycin, ceftriaxone, ceftizoxime, cefodizime, ciprofloxacin, fleroxacin, rifampicin, rifabutin and FCE 22250. beta-Lactamase production appeared to be associated with the presence of low molecular weight plasmids (5.7 or 7 Md). Sulphonamide resistance appeared to be either chromosomally-mediated or due to the presence of a 4.9 Md plasmid. No evidence of plasmid-mediated tetracycline resistance was observed.

Lectin typing of Haemophilus ducreyi

The cell wall carbohydrates of 43 strains of Haemophilus ducreyi isolated in different parts of the world were subjected to lectin analysis using commercial panels containing 14 different plant lectins of known specificity. Preliminary evidence indicated both intrastrain and inter-strain variation in cell wall carbohydrate composition. In addition, it was possible to group strains from different geographical areas by lectin agglutination patterns. Lectin typing might thus become a useful marker system for epidemiological investigation of Haemophilus ducreyi infections.

Antigenic analysis of Haemophilus ducreyi by Western blotting

Twenty-one strains of Haemophilus ducreyi were analysed by Western blotting using two antisera produced in mice. Common antigens of molecular weights 58, 46, 41, 28, 22 and 16 kDa were detected in all the strains. The antigens were protein in nature, since they could not be detected in whole-cell lysates which had been treated with proteinase K. The H. ducreyi strains showed antigenic cross-reactivity with strains of H. influenzae and H. parainfluenzae, but showed minimal or no cross-reactivity with seven other species of bacteria.

In vitro activity of eight antimicrobial agents against non-penicillinase-producing gonococci isolated in Munich

The susceptibility of 119 strains of Neisseria gonorrhoeae isolated in Munich in 1986 to eight antibiotics was assessed. Although some degree of resistance to penicillin and tetracycline, as well as high minimum inhibitory concentrations (MIC) of spectinomycin, were observed, all the strains were sensitive to ciprofloxacin, enoxacin, fleroxacin, cefotaxime, and FCE 22250.

Plasmid content and protein I serovar of non-penicillinase-producing gonococci isolated in Munich

One hundred and twenty-four strains of non-penicillinase-producing gonococci isolated in Munich in 1986 were characterized in terms of their plasmid content and protein I serovar. Eighty-two per cent of the strains belonged to serogroup 1-B with over half belonging to either serovar 1B-2 or 1B-3. Half of the 22 serogroup 1A strains belonged to serovar 1A-2. Nineteen strains (15.3%) were found to lack the 2.6 Md cryptic plasmid although seven of these strains contained the 24.4 Md conjugative plasmid. Nine of the 105 strains which harboured the cryptic plasmid also contained the conjugative plasmid. The 19 strains which lacked the cryptic plasmid comprised 10 different serovars, indicating the heterogeneous nature of this group of organisms.

Characterisation of penicillinase producing gonococci isolated in Munich, 1981-6

Twenty three penicillinase producing strains of Neisseria gonorrhoeae (PPNG) isolated in Munich from 1981 to 1986 were characterised in terms of their plasmid content, auxotypes, protein I serovars, and sensitivity to antibiotics. Sixteen strains (70%) harboured a 4.4 megadalton plasmid, with 13 of these strains also containing a 24.4 megadalton plasmid. Seven strains (30%) contained a 3.2 megadalton plasmid, with only one of them containing a 24.4 megadalton plasmid. Thirteen strains (57%) were prototrophic, eight (35%) required proline, one required arginine, and one required proline and arginine for growth. Serovar analysis showed that 16 strains (70%) belonged to the protein IB serogroup and comprised four serovars (IB-1, IB-5, IB-7, and IB-8). The seven strains belonging to the IA serogroup also comprised four serovars (IA-2, IA-4, IA-6, and IA-10). Although 18 different categories of plasmid, auxotype, and serovar were found in the 23 PPNG strains, there was a similarity between the auxotypes in terms of the range of serovars they comprised. Measurement of minimum inhibitory concentrations (MICs) of antibiotics for the strains showed that they were all susceptible in vitro to spectinomycin (MIC less than or equal to 32 mg/l), enoxacin (MIC less than or equal to 0.25 mg/l), cefotaxime, ciprofloxacin, and ceftriaxone (MICs less than or equal to 0.064 mg/l), whereas about half showed some resistance to tetracycline or cefotiam, or both.