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EN
The aim of this study was to compare the efficiency of DNA extraction from water as well as from blood samples spiked with A. fumigatus spores, using selected commercial kits. Extraction of DNA according to manufacturer's protocols was preceded by blood cells lysis and disruption of fungal cells by enzymatic digestion or bead beating. The efficiency of DNA extraction was measured by PCR using Aspergillus-specific primers and SYBR Green I dye or TaqMan probes targeting 28S rRNA gene. All methods allowed the detection of Aspergillus at the lowest tested density of water suspensions of spores (101 cells/ml). The highest DNA yield was obtained using the ZR Fungal/Bacterial DNA kit, YeastStar Genomic DNA kit, and QIAamp DNA Mini kit with mechanical cell disruption. The ZR Fungal/Bacterial DNA and YeastStar kits showed the highest sensitivity in examination of blood samples spiked with Aspergillus (100 % for the detection of 102 spores and 75 % for 101 spores). Recently, the enzymatic method ceased to be recommended for examination of blood samples for Aspergillus, thus ZR Fungal/Bacterial DNA kit and QIAamp DNA Mini kit with mechanical cell disruption could be used for extraction of Aspergillus DNA from clinical samples.
EN
The frequency of severe systemic fungal diseases has increased in the last few decades. The clinical use of antibacterial drugs, immunosuppressive agents after organ transplantation, cancer chemotherapy, and advances in surgery are associated with increasing risk of fungal infections. Opportunistic pathogens from the genera Candida and Aspergillus as well as pathogenic fungi from the genus Cryptococcus can invade human organism and may lead to mucosal and skin infections or to deep-seated mycoses of almost all inner organs, especially in immunocompromised patients. Nowadays, there are some effective antifungal agents, but, unfortunately, some of the pathogenic species show increasing resistance. The identification of fungal virulence factors and recognition of mechanisms of pathogenesis may lead to development of new efficient antifungal therapies. This review is focused on major virulence factors of the most common fungal pathogens of humans: Candida albicans, Aspergillus fumigatus and Cryptococcus neoformans. The adherence to host cells and tissues, secretion of hydrolytic enzymes, phenotypic switching and morphological dimorphism contribute to C. albicans virulence. The ability to grow at 37°C, capsule synthesis and melanin formation are important virulence factors of C. neoformans. The putative virulence factors of A. fumigatus include production of pigments, adhesion molecules present on the cell surface and secretion of hydrolytic enzymes and toxins.
EN
Bezoars are foreign bodies in the form of round balls typically found in the alimentary tract, in the area of the stomach. They are created from residual material, e.g. from accidentally swallowed objects (buttons, coins) or some medicines as well as hair and vegetable fibres. Bezoars increase in size as the result of accumulation of undigested food wastes and are unable to pass through the subsequent alimentary tack sections. Bezoars mostly cause nonspecific abdominal pain. In rarer cases, they can be found in the urinary tract. In this case, they develop in the course of a fungal infection within the urinary tract or generalised infection. Their mass is usually made of Candida albicans hyphae. The major factor strongly predisposing to severe fungal infections is host immunosuppression caused by iatrogenic action of medicines that block the immune system as well as different diseases that weaken immunity. In this review, the authors present selected clinical cases of urinary tract bezoars along with the diagnostic and therapeutic management.
PL
Bezoary to ciała obce, kuliste twory występujące zazwyczaj w przewodzie pokarmowym, w obrębie żołądka. Powstają najczęściej z zalegającego w nim materiału, tj. połkniętych przypadkowo przedmiotów (guziki, monety) lub niektórych leków, a oprócz tego włosów i włókien roślinnych. Na skutek odkładania się na ich powierzchni niestrawionych resztek pokarmowych bezoary powiększają swoje rozmiary i nie przedostają się do kolejnego odcinka przewodu pokarmowego. Pod względem klinicznym jednym z symptomów tej patologii są niespecyficzne dolegliwości bólowe brzucha. W znacznie rzadszych przypadkach bezoary mogą występować w obrębie układu moczowego. Jednak wówczas powstają one wskutek trwającej infekcji grzybiczej dróg moczowych lub uogólnionego procesu, a masa bezoaru składa się najczęściej ze strzępek grzybni, głównie Candida albicans. Do czynników wysoce predysponujących do poważnych infekcji grzybiczych należy przede wszystkim stan immunosupresji organizmu, wywołany jatrogennym działaniem leków hamujących aktywność układu immunologicznego lub różnych stanów chorobowych, w których dochodzi do obniżenia odporności. W niniejszej pracy przedstawione zostały wybrane przypadki kliniczne występowania bezoarów w obrębie dróg moczowych wraz z zastosowanym postępowaniem diagnostycznym i terapeutycznym.
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