Natural Solution for Candida Albicans

Yeast Infection No More

Linda Allen is a professional health expert who has worked as a health consultant and medical researcher for more than 17 years. Linda has worked with many experts to create the special online guide called Yeast Infection No More. The program had helped many yeast infection sufferers to cure their yeast infection permanently. Linda Allen explains the causes of yeast infection and the various forms it can take, describes all of the signs and symptoms that can develop in different parts of the body, and explains what the consequences of a severe infection can be. She then goes on to describe how conventional medical approaches to the treatment of yeast infection differ from complementary therapies. This treatment program is based on the principle that a single approach to yeast infection is not going to work. You need more. Treatment has to be a combination of different approaches which tackle every aspect of the problem. Taking such a holistic approach will permanently get rid of your yeast infection and all of its side effects. Read more...

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Candida vulvovaginitis

Candida vulvovaginitis accounts for one-third of vaginitis. Up to 75 of women report having had at least one episode of candidiasis. The condition is rare before menarche. It is less common in postmenopausal women, unless they are taking estrogen replacement therapy. B. Microbiology and risk factors. Candida albicans is responsible for 80-92 of vulvovaginal candidiasis. Sporadic attacks of vulvovaginal candidiasis usually occur without an identifiable precipitating factor. 1. Antibiotics. A minority of women are prone to vulvovaginal candidiasis while taking antibiotics. 2. Intrauterine devices have been associated with vulvovaginal candidiasis.

Candida Vaginitis

Vulvovaginal Candidiasis

Candida species are a common cause of vaginitis. While there are no reliable figures as to prevalence of vulvovaginal candidiasis (VVC) because the disease is not reportable, it is estimated that 75 percent of women will experience at least one infection during their childbearing years (with the highest attack rate during the third trimester of pregnancy), making it the second commonest vaginal infection.2 A small subpopulation of women, less than 5 percent, have repeated episodes of disease with no apparent factors being responsible for recurrent infection. The organism can be isolated from up to 20 percent of asymptomatic, healthy women of childbearing age, some of whom are celibate. Therefore, this infection is not considered a sexually transmitted disease (STD), although it can be transmitted that way. Factors that favor increased rates of asymptomatic vaginal colonization include pregnancy, oral contraceptives, uncontrolled diabetes mellitus, and frequent visits to STD clinics...

Oral Candidiasis

Candidiasis commonly affects the oral cavity. Nearly 60 percent of healthy adults harbor candidal microorganisms. Concurrent histologic evidence of tissue invasion and clinical manifestations of candidal infections are the primary means for diagnosing oral candidiasis. Many predisposing factors influence the development of oral candidiasis. These include the extremes of age, intraoral prosthetic devices such as dentures, malnourished states, associated mucosal disorders, concurrent infections, antibiotics, and immunocompromised conditions such as acquired immunodeficiency syndrome (AIDS), transplant recipients, radiation therapy, and chronic immunosuppressive therapy. Three oral clinical types have been described. The most common type is the psuedomembranous type with white, curdlike plaques. These plaques can be easily scraped off to reveal an underlying erythematous mucosal base. The second type is atrophic or erythematous and usually involves the dorsum of the tongue. Atrophy of...

Candida spp

Candida spp. is the most common cause of FE and is responsible for 33-44 of all cases 339 . Approximately 50 of FE cases are caused by C. albicans 339 . Candida endocarditis occurs in the setting of particular risk factors, including structural cardiac valvular abnormalities, use of broad-spectrum antibiotics, central lines, par-enteral nutrition, and surgery 339,406 . A previous review had reported intravenous drug abuse as a major risk factor for FE 407 . The epidemiology of risk factors, however, has since changed, and in a more recent review, only 4 of patients were reported as drug abusers 406 . With the increasing use of the above risk factors as a reflection of medical progress, it is probable that the incidence of candidal FE will increase. The management of candidal FE remains poorly defined. An inherent difficulty in establishing treatment guidelines is the low incidence of this disease, thus precluding any appropriately powered, randomized, controlled clinical trials. Prior...

. Bajpai B. Patil S. Tannin Acyl Hydrolase Ec Activity Of Aspergillus Penicilium Fusarium And Trichoderma.

Kumnuanta. Raw cassava starch-digestive glucoamylase of Aspergillus sp. N-2 isolated from cassava chips J. Ferment. Technol. 64 405-410, 1986. Pandey, A., S. Benjamin, C.R. Soccol, P. Nigam, N. Krieger, V.T. Soccol. The realm of microbial lipases in biotechnology. Biotechnol. Appl. Biochem. 29(2) 119-131, 1999. Benjamin, S., A. Pandey. Candida rugosa lipases molecular biology and its versatility in biotechnology. Yeast 14 1069-1087, 1998. Benjamin, S., A. Pandey. Coconut cake a potent substrate for production of lipase by Candida rugosa in solid-state fermentation. Acta Biotechnol. 17 241-251, 1997. Benjamin, S., A. Pandey. Mixed-solid substrate fermentation a novel process for enhanced lipase production by Candida rugosa. Acta Biotechnol. 18 315-324, 1998. Cordova, J., M. Nemmaoui, M. Isma'ili-Alaoui, A. Morin, S. Roussos, M. Raimbault, B. Benjilali. Lipase production by solid state fermentation of olive cake and sugar cane bagasse. J. Mol. Catal. B...

Disorders Involving the Foreskin

The microbiology of infectious balanoposthitis reveals an abundance of gram-positive and gram-negative organisms. Most infections of the foreskin and glans penis represent invasion by normal flora and are usually polymicrobial. Contributing factors to the development of these infections (e.g., poor hygiene) are unproved and controversial. Candida albicans may be the pathogen in prepubertal children, and recurrences of balanoposthitis due to this organism should alert the physician to the possibility of immunocompromise, such as occurs with diabetes mellitus. Group A b-hemolytic streptococcus has been reported as an infectious organism, and its identification (via rapid antigen detection of associated thin, purulent discharge) warrants aggressive and specific antistreptococcal therapy. Sexually transmitted organisms are responsible for many cases of balanoposthitis in older adolescents.

Legumebased Fermented Foods

Molds, covered with banana leaves, and fermented at room temperature for about 2 days to form oncom (Fardiaz 1987) (d) West African Dawadawa This is prepared by fermenting locust beans and consumed mainly in West Africa. Yeasts, spore forming bacilli and lactic acid bacteria are involved in the fermentation. The pulp is removed from the seeds before they are boiled and then dehulled. The dehulled seeds are soaked, washed, cooked, spread on a tray, and covered with leaves then fermented for 2-3 days (Padmaja and George 1999). (e) Chinese Chee-fan This is in solid form, prepared from soybean whey curd in China and eaten like cheese. Mucor spp. and A. glauca are involved in fermentation (Padmaja and George 1999) (f) Chinese Meitauza This is Chinese soybean cake. It can be fried in oil or cooked with vegetables. Actinomucor elegans is the microorganism involved in fermentation (Padmaja and George 1999) (g) Chinese Sufu (Tau-hu-yi) Soybean milk is made from ground soybeans strained through...

Production Of Pigments

Microbial production of pigments has usually been carried out in SmF, though SSF processes have also been applied. Candida flareri, C. guilliermundii, Debaromyces subglobosus, Hansenula polymorpha, Saccharomyces, Torulopsis xylinus, Ashbya gossypi and Eremothecium ashbyii have commonly been used for the production of riboflavin, a yellow pigmented B vitamin. Monascus pigments have good properties as food colorants possessing reasonable light and chemical stability, tinctorial strength, and water solubility when complexed with appropriate agents.

Screening of Potential Leads from Diverse Microbial Sources

Bacterial Biological Control Images

Spartamycins produced by M. spartanea were isolated from a potted soil with A. officinalis L. plants (Nair et al. 1992). Between the two spartamycin analogs A and B, the latter showed better antimicrobial activity against several microorganisms. The minimum inhibitory concentration (MIC) of spartamycin B on Aspergillus, Cladosporium, Cryptococcus, Rhodotorula, and Candida albicans ranged from 0.2 to 1 mgmP1. However, spartamycin B was not effective against the Staphylococcus aureus, Escherichia coli and Citrobacter spp. In view of antifungal activity and structural similarity of the anthracycline antibiotics, their analogs having different glycoside moieties may be worthwhile to examine their antifungal activity against various plant pathogenic fungi.

Pichia Apicola Anamorph

2 Candida apicola, synonyms Torulopsis apicola, Torulopsis bacillaris 3 Candida boidinii, assimilates methanol 4 Candida glabrata, synonym Torulopsis glabrata 5 Candida holmii, anamorph of Saccharomyces exiguus 6 Candida lactis-condensi, synonym Torulopsis lactis-condensi 7 Candida milleri 8 Candida parapsilosis 9 Candida pseudolambica 10 Candida sake, synonym Torulopsis sake 11 Candida tenuis 12 Candida tropicalis 13 Candida versatilis, synonym Torulopsis versatilis 14 Candida wickerhamii, synonym Torulopsis wickerhamii 16 Debaryomyces hansenii, synonyms Candida famata, Torulopsis candida 21 Issatchenkia orientalis, synonym Candida krusei 22 Kluyveromyces lactis, synonyms Candida sphaerica, Kluyveromyces marxianus var. lactis 23 Kluyveromyces marxianus, synonym Candida kefyr 24 Pichia anomala, synonyms Hansenula anomala, Candida pelliculosa 25 Pichia burtonii, synonyms Hyphopichia burtonii, Endomycopsis burtonii, Candida variabilis 26 Pichia canadensis, synonyms Hansenula canadensis,...

TABLE 2311 Drugs that Can Cause Hypocalcemia

Hypocalcemia Causes

Idiopathic Hypoparathyroidism Idiopathic hypoparathyroidism is probably an autoimmune disorder in which pernicious anemia, exostoses, moniliasis, Hashimoto disease, sterility, and Addison disease may be seen. This syndrome may also be associated with cataracts, mental retardation, intracranial calcifications, and papilledema due to increased intracranial pressure.

Regioselective Carbohydrate Acylation

The potential of lipases as catalysts for the acylation of carbohydrates is currently of considerable interest, as the reaction occurs selectively at the primary hydroxyl group of the sugar. The need for protection and deprotection steps of the nonfavorable secondary hydroxyl groups is avoided, allowing a reduction in the number of steps. In recent years, various reports have been published on the enzymatic transesterifications of carbohydrates using activated donors, such as trihaloethyl, vinyl, and oxime esters or acid anhydrides (31). For example, 6-0-acyl derivatives of alkyl glucopyranosides, useful as biodegradable nonionic surfactants, were synthesized from fatty acids and the corresponding 1-0-ethyl-glucopyranosides in the presence of a thermostable lipase from Candida antarctica (CAL) (32,33) (see Subheading 3.7.). This lipase also catalyzed the regioselective acylation of 1-0-octyl-a-D-glucopyranoside by ethyl acrylate using zeolite CaA for selective adsorption of the...

TABLE 785 Pruritus

Infectious agents that have to be considered as causes of pruritus ani include bacteria, viruses, fungi, spirochetes, and parasites. More common bacterial infections, such as staphylococci and streptococci, in addition to all sexually transmitted organisms, will cause pruritus, if not actual pain. Pinworms ( enterobius vermicularis) are the most common cause of anal pruritus in children. Candida albicans is commonly found on the perianal skin but is not usually associated with pruritus the Trichophyton species, on the other hand, are always associated with pruritus.

Skin Disorders Affecting The Nipple And Breast

Colonization of the nipples or the lactiferous ducts by Candida albicans may cause chronically sore nipples during or after lactation. The appearance of the nipple may be normal however, more commonly, scaling, fissuring, and erythema are present. Predisposing factors for candidal colonization include antibiotic use, vaginal candidiasis, mastitis, and nipple trauma occurring in the early lactation period. Definitive diagnosis may be made by fungal culture, but that should not be necessary. The nipples may be treated with topical antifungal creams.4 Vaginal candidiasis in the patient, as well as any clinically evident oral candidiasis in the infant, should also be treated.

Clinical Features

The typical presentation is erythema and maceration with surrounding small erythematous papules or pustules Fig. 240-2 (Pjate . 25) . These satellite pustules are a characteristic finding differentiating candida intertrigo from other inflammatory disorders affecting the skin folds. Patients will complain of burning or itching. The other inflammatory disorders listed in T b. 2.4.0 l should be considered in the differential diagnosis. FIG. 240-2 (Plate.25). Candida intertrigo. Note the bright-red erythema, erosions, and satellite papules and pustules in this striking example of inframammary candida intertrigo. A KOH examination will confirm the diagnosis.

Utilization Of Fruit And Vegetable Processing Wastes Via Solidstate Fermentation

Apple pomace was directly used as a feed for cows and sheep, but its value as an animal feed is less than 7 per ton (47). Apple pomace is a poor animal feed supplement because of its low protein content. The nutritional value of apple pomace was improved by solid-state fermentation with a food yeast, Candida utilis (62). Yeast fermentation resulted in a 2.5-fold increase in protein, 3.4-fold increase in niacin, 10-fold increase in pantothenic acid, 1.5-fold increase in riboflavin, and 1.2-fold increase in thiamine (62). An improved stock feed was produced from apple pomace by solid-state fermentation with Kloeckera apiculate and C. utilis (63,64).

Automated reading and processing of agglutination results

Microplate agglutination techniques are commonly used for the quantitative or qualitative isotypic analysis of specific antibodies, but require optical reading by the researcher and, therefore, can be quite subjective. Aubert and colleagues have used an automatic reader scanning each of the wells of a standard microtiter plate. The advantages of the automatic reader were additionally maximized by coupling it to a dedicated computer running customized software designed to process data coming on-line from the spectrophotometer. This approach was applied to the diagnosis of human toxoplasmosis and candidiasis. Suspensions of Toxoplasma gondii tachyzoites or of sensitized erythrocytes were used for the determination of IgG antibodies or the quantitation of IgM-, IgA- or IgE-specific isotypes.

Food Biotechnology References

Optimization of citric acid production from Candida lipolytica Y-1095 using n-paraffin. J. Biotechnol. 89 27-40, 2001. 13. Aiba, S., M Matsuoka. Citrate production from n-alkane by Candida lipolytica in reference to carbon fluxes in vivo. Eur. J. Appl. Microbiol. 5 247-261, 1978. Marchal, R., J.P. Vandecasteele, M. Metche. Regulation of the central metabolism in relation to citric acid production in Saccharomyces lipolytica. Arch. Microbiol. 113 99-104, 1977. Treton, B., M.T. Le Dall, H Heslot. Excretion of citric and isocitric acids by the yeast Saccharomyces lipolytica. Eur. J. Appl. Microbiol. Biotechnol. 6 67-77, 1978. Behrens, U., E. Weissbrodt, W. Lehmann. Kinetics of citric acid production in Candida lipolytica. Zeitschrift fur Allgemeine Mikrobiologie 18 549-558, 1978. Terasawa, M., T. Nagata, J. Takahashi. Utilization of a-olefins by yeasts, part 1 production of citric acid from 1-tetradecene and n-tetradecene. Agric. Chem. Soc. Jap. 53 227-232,...

Lesions of the Tongue

MEDIAN RHOMBOID GLOSSITIS Median rhomboid glossitis is believed to be a developmental defect of the dorsal surface of the tongue. It appears as a small 1 by 2 cm ovoid erythematous area just anterior to the circumvallate papillae. The area is devoid of papillae and usually asymptomatic. Recently, it has been suggested that this lesion represents an area of erythematous candidiasis. No treatment is necessary. 20

Enzymatic Approaches to the Chiral Tetrahydrofuran Sulfonate 5 21 Enzymatic Desymmetrization of RTriol

As the hydrolysis of the dibutyrate 12b was being developed, continued screening under nonaqueous conditions finally identified an enzyme displaying useful levels of the desired pro-S selectivity. Treatment of fRj-triol 8 with Novo SP435 (Candida antarctica lipase B) in EtOAc or MeCN with vinyl acetate as the acylating agent formed the monoacetate (R,S)-11 with 94-97 de, the selectivity being better in MeCN (Table 1).

Salt Induced Activation of Enzymes in Organic Solvents

Et al. demonstrated that adding buffer salts or KCl also increased the catalytic activity of lyophilized Candida antarctica lipase fourfold over that with no added salt (6). Moreover, Bedell et al. found that including KCl in the lyophilizate dramatically enhanced thermolysin-catalyzed peptide synthesis in tert-amyl alcohol (7). These findings suggest that salt-induced activation of enzyme catalysis in organic solvents may be a general phenomenon, at least for hydrolytic enzymes. Furthermore, Bedell et al. also found that the enhancement in catalytic activity for both thermolysin and subtilisin Carlsberg is not a result of reduced substrate diffusional limitations in a suspended enzyme particle, but rather the result of to a mechanism inherent to the biocatalyst itself. 1. Other enzymes can also be activated. Enzyme activation by salts has been shown to occur for other proteases such as chymotrypsin and thermolysin, as well as a variety of lipases including those from Candida...

Gastrointestinal Complications

Oral lesions are common in HIV-infected patients and frequently contribute to malnutrition. Oral candidiasis or thrush affects more than 80 percent of AIDS patients. The tongue and buccal mucosa are commonly involved, and the plaques characteristically can be easily scraped from an erythematous base. Differentiation from hairy leukoplakia (usually manifested as adherent, white, thickened lesions on the lateral tongue borders) may be challenging for the inexperienced, but microscopic examination on potassium hydroxide smear confirms the diagnosis. The development of oral candidiasis is a poor prognostic sign and is predictive of progression to AIDS. Most oral lesions can be managed symptomatically on an outpatient basis. Clotrimazole or nystatin suspension or troches (five times daily) are the preferred treatment. Refractory or recurrent disease can be managed with oral fluconazole. Amphotericin B is reserved for severe cases. Esophageal involvement may occur with Candida, herpes...

Identification of E faecalis in GPCPCPositive Blood Culture Bottles

The number of candidemia cases has increased during the past decade because of the increasing population of immunocompromised patients, organ transplantations, and the common use of intravascular devices. Furthermore, species distribution is changing such that the prevalence of C. albicans is decreasing because of the emergence of other Candida species, in particular Candida glabrata and Candida parapsilosis. 18 Whereas C. albicans is often susceptible to fluconazole, C. glabrata and other emerging species, such as Candida krusei, have a different resistance pattern. Therefore rapid and accurate methods for species identification of yeast in blood cultures are important for the selection of appropriate antifungal therapy. Rapid identification of C. albicans and differentiation from other yeast species are particularly important as they allow the majority of cases caused by C. albicans to be treated safely and cost-effectively with fluconazole, such that only the remaining cases caused...

Direct Effects Of Invertebrates On Fungi Mycophagy


Mycelia growing across the surface of soil can be completely destroyed by high intensity invertebrate grazing, but less intense grazing can result in dramatic changes in mycelial growth and activity (e.g. Kampichler et al., 2004 Harold et al., 2005 Bretherton et al., 2006 Tordoff et al., 2006 Wood et al., 2006 Figure 1). Despite the plethora of studies on fungal-invertebrate interactions, only recently has attention turned to saprotrophic Basidiomycota, and then largely to cord-formers (Chapter 1) grazed by Collembola. Mycelial morphology and foraging patterns often change dramatically as a result of grazing, changes varying depending on fungal species (Tordoff et al., 2006 Figure 1), resource status (Harold et al., 2005), grazing intensity (density) and invertebrate (Collembola) species (Kampichler et al., 2004). For example, Folsomia candida had a large impact, Proisotoma minuta often a similar impact, but Protaphorura armata often had little impact (G.M. Tordoff et al.,...

MagNA Pure Lc Instrument

Our group 10 demonstrated that the MagNA Pure technique provides rapid automated DNA isolation from numerous pathogenic fungi revealing high sensitivity and purity. Although the fungal cell wall is highly resistant to mechanical, chemical, and enzymatical treatment, we could achieve a sensitivity of 1 colony forming unit mL blood for Candida albicans.

Notes Organic Solvent

Pancreatin can be replaced by lipase SP 382 from Novo-Nordisk (Denmark), which is mixture of the lipases A and B from Candida antarctica or as found later by the pure B lipase from C. antartica (Novozyme 435 from Novo-Nordisk) however, this is at the expense of the yield of 2. 16. Lipase B from Candida antarctica (Novozym 435) gave similar results in tetrahydrofuran and tert-butyl methyl ether as solvents. 22. Other lipases such as pancreatin, lipases A and B from Candida antarctica (SP 382 from Novo Nordisk), or lipase from Mucor miehei (Lipozyme from Novo Nordisk) are not useful.

Effects On Invertebrate Behaviour

Figure 2 Preferential grazing by invertebrates in interaction zones. (a-e) Interactions between mycelia growing from 2 x 2 x 2 cm wood inocula across compressed non-sterile soil. (a) Considerable grazing by Folsomia candida (Collembola) of Resinicium bicolor (left) in the region of interaction with Hypholoma fasciculare. (b) Localized F. candida grazing (arrowed) of H. fasciculare near interaction front. (c) Grazing by F. candida of both H. fasciculare (left) and R. bicolor in the interaction zone. (d) F. candida grazing of Phanerochaete velutina and R. bicolor. Note that grazing of P. velutina is largely in regions (arrowed) where cords of R. bicolor had overgrown P. velutina. The R. bicolor cords in these regions were completely removed by grazing. (e) Fungus gnat grazing (arrowed) largely in the interaction zone between non-mating compatible homokaryons of Stereum gausapatum in agar culture. Note grazed regions (arrowed) in interaction zone. (f) Grazing (arrowed) by F. candida in...

TABLE 612 Interpretation of Purified Protein Derivative Skin Test

A competent immune system is required to yield a positive response to the PPD if there has been exposure to M. tuberculosis. Therefore, individuals with abnormal immune systems, such as in HIV, may lose their ability to mount a delayed-type hypersensitivity reaction required to produce a positive PPD reaction. Although the Centers for Disease Control (CDC) no longer recommend routine anergy testing among HIV-positive individuals, 16 some clinicians utilize control agents such as mumps or candida to assess at-risk patients for anergy. Controls are placed on the opposite forearm, and failure to respond with induration may indicate anergy and thus an unreliable PPD. False negatives have also been demonstrated with improper PPD administration. Nonreactivity to a PPD has been occasionally reported in patients with active culture-positive tuberculosis therefore, a PPD test may occasionally be unreliable in acute stages of the disease.

Propionic Acid Propionates

Up to 1 propionic acid (pjKa 4.87) is produced naturally in Swiss cheese by Propionibacterium freudenreichii ssp. shermanii. Propionic acid and sodium, potassium, and calcium propionates are used primarily against molds however, some yeasts and bacteria are also inhibited. Propionates (0.1-5.0 ) retard the growth of E. coli, Staphylococcus aureus, Sarcina lutea, Salmonella,Proteus vulgaris, Lactobacillus plantarum, and Listeria monocytogenes, and the yeasts Candida and Saccharomyces cer-evisiae (7). Rope-forming bacteria in bread dough (B. subtilis) are inhibited by propionic acid at pH 5.6 to 6.0 (7).

Miniaturized Microbiological Techniques

The miniaturized methods have been used to study large numbers of isolates from foods (37-39) and to develop bacteriological media and procedures (40-43). Many useful microbiological media were discovered through this line of research. For example, an aniline blue Candida albicans medium was developed and marketed by Difco under the name Candida Isolation Agar. The sensitivity and specificity were 98.0 and 99.5 , respectively, with a predictive value of 99.1 (44).

TABLE 1393 Stages of HIV Infection

Early symptomatic infection is characterized by conditions that are more common and more severe in the presence of HIV infection but, by definition, are not AIDS indicator conditions. Examples include thrush, persistent vulvovaginal candidiasis, peripheral neuropathy, cervical dysplasia, recurrent herpes zoster infection, and idiopathic thrombocytopenic purpura. These conditions occur with increased frequency as the CD4 cell count drops below 500 cells pL.

Methods for Yeast Characterization

Yeast Identification

The analysis of mitochondrial DNA restriction fragment length polymorphisms (mtDNA-RFLP) has long been used as a method for characterizing wine yeast strains (Vezinhet et al. 1990). However, due to the complexity associated with the procedure required to isolate a sufficient amount of mtDNA, its use for routine analysis was limited until quite recently. The last decade has seen improvements in the process (Querol et al. 1992b), removing the need for specialized equipment and reducing the complexity and time scale, while retaining the discriminatory power and reproducibility (Figure 3). This simplified technique has been used successfully to characterize yeast strains of species belonging to genera Brettanomyces, Candida, Debaryomyces, Kluyveromyces, Saccharomyces, and Zygosaccharomyces (see Table 2). Chromosomal DNA profile analysis (electrophoresis karyotyping). The analysis of chromosomal DNA polymorphisms due to chromosome rearrangements has proved to be useful for the...

Common Adverse Effects Of Antimicrobial Agents

Adverse Drug Reactions Antimicrobials

The normal body microbial flora is altered with use of antimicrobial agents. Patients taking antimicrobial agents are at risk for infection with a number of resistant pathogens. The oral and other mucosal surfaces may become infected with Candida albicans. Alteration of the gastrointestinal flora may result in pseudomembranous colitis from superinfection by Clostridium difficile. The antibiotics most commonly associated with pseudomembranous colitis are cephalosporins, penicillins, and clindamycin.

TABLE 951 Common Bacterial Pathogens in Short Term Catheter Associated Urinary Tract Infection

Most catheter-related UTIs experienced in the emergency department setting are seen in patients with long-term indwelling catheters. It has been estimated that as many as 100,000 patients in nursing homes in the United States are catheterized at any given time. The prevalence of bacteriuria in this population is 100 percent, with as many as 95 percent of patients growing two or more strains of bacteria. Pathogens present in long-term catheterized patients are similar to those present in the short-term catheterization population, with the addition of Providencia stuartii, Morganella morganii, Pseudomonas sp., and Candida sp.

Microbiologic Diagnosis Blood Cultures

Candida species cause approximately 50 of proven cases of fungal endocarditis. Although blood cultures are thought to have poor sensitivity for detection of candidemia, more specialized blood culture media have no advantage over standard blood culture bottles for detection of Candida species. Special fungal blood culture media such as Bactec Myco-F-lytic bottles are superior in supporting growth of filamentous fungi such as Aspergillus species, and could be considered for use in immunocompromised patients or known IV drug users with suspected IE. The lysis-centrifugation (Isolator) method is superior to other available processes for detection of Histoplasma capsulatum from blood samples. Emboli leading to operative intervention are seen relatively commonly in cases of fungal endocarditis given the typically large vegetation size. Because blood cultures are frequently negative in fungal endocarditis, these emboli can provide crucial information about the causative organism, and they...

Fungal Endocarditis

Simplistically, fungi are classified as yeasts or moulds. Yeasts are facultatively anaerobic, unicellular, non-filamentous fungi that are typically spherical or oval in shape. The most common yeasts involved in fungal endocarditis (FE) are the Candida spp. 338,339 , although FE with the other opportunistic yeasts (e.g., Cryptococcus spp. 340-342 , Saccharomyces spp. 343 , Trichosporon spp. 344-347 , and Rhodotorula spp. 348,349 ) have been sporadically reported. Moulds are aerobic, filamentous fungi. The predominant moulds involved in FE are the Aspergillus spp. 339 . Dimorphic fungi are those organisms that exist as moulds (mycelial form) when incubated at room temperature under laboratory conditions and yeast phase, yeast-like cells, or spherule form when grown in human tissue or incubated at 37 C on synthetic laboratory media. Histoplasma capsu-latum is the most commonly reported dimorphic fungus involved in FE 339,350 . The development of antifungal therapies with diverse...

Acquired Immunodeficiency Syndrome

There are numerous oral manifestations of HIV infection. Primary HIV infection, occurring from 1 to 6 weeks after contact, is an acute viral syndrome but may have associated intraoral findings such as a sore throat, mucosal erythema, and focal ulceration. Persistent generalized lymphadenopathy, particularly of the cervical lymph nodes, is present in 70 percent of otherwise asymptomatic HIV-infected patients. The presentation of acquired immunodeficiency syndrome (AIDS) is highly variable, and numerous oral manifestations can occur. Oropharyngeal candidiasis is the most common oral finding and may lead to the initial diagnosis of AIDS. HIV-related gingivitis is distinctive, presenting as a 2- to 3-mm linear band of erythema along the gingival free margin. Periodontitis among the HIV-infected population is common and usually more aggressive and painful in its presentation. Such necrotizing periodontitis is distinguished from acute necrotizing ulcerative gingivitis, which is also a...

Food and health applications of probiotics translational aspects

Lactic acid bacteria have been considered detrimental to oral health since they ferment sugars into lactic acid, but lactic acid production may not be the whole story. Unlike S. mutans, L. reuteri produces lactic acid, but its presence does not result in the release of calcium from hydroxylapatite (Nikawa, 2004). This difference may be caused by variations in bioavailability of lactic acid and other factors that may counteract or neutralize the presence of lactic acid. Also, many lactic acid bacteria are consumed in dairy products that have excellent buffering capacity and contain calcium to enhance remineralization of the enamel. Probiotic research in the oral cavity has focused on Bifidobacterium bifidum, L. acidophilus, L. casei, and L. reuteri. Some strains of Lactobacillus and Bifidobacterum may lower the propensity of individuals to initiate caries formation, reduce the overall risk of dental caries, and act as a prophylactic agent for Candida spp. infection (Ahola, 2002...

Organosilicon Compounds as Novel Substrates

Comparative studies were made by the use of organosilicon compounds having a different chain length between hydroxyl group and the silicon atom Me3Si(CH2)nOH, n 0, 1, 2, and 3 and the corresponding carbon compounds Me3C(CH2)nOH, n 0, 1, and 2) as another substrate (acyl acceptor) in the enantioselective esterification of 2-(4-chlorophenoxy)propanoic acid, whose ( )-enantiomer is useful as a herbicide, with lipase OF 360 of Candida cylindracea (Fig. 1) in benzene. The effects of the silicon atom on the enzymatic reaction in connection with the distance between the hydroxyl group and the silicon atom are discussed (8). Organosilicon compounds and the carbon counterparts examined in this study, except for the case of n 0 (trimethylsilylmethanol and 1,1-dimethylethanol), served as the substrates. In particular, trimethylsilylmethanol (n 1) was found to be a particularly superior substrate, that is, the reaction rate was much higher than that with the corresponding carbon compound, and the...

Invertebrate Effects On Fungal Physiology And Metabolism

There seems to have been little research performed on effects of invertebrates on Basidiomycota physiology and metabolism, yet such effects are sometimes likely to be large, in view of the dramatic changes to morphology mentioned above. Grazing by F. Candida altered the partitioning of 15N added to soil close to the wood inoculum (G.M. Tordoff et al., unpublished) less 15N was transferred to new mycelial growth in grazed systems than in ungrazed systems, presumably related to slower growth and altered mycelial morphology. Changes in extracellular enzyme activity have been noted P. velutina and Stereum hirsutum exhibited differential responses to the presence of the nematode Panagrellus redividus (Dyer et al., 1992). Protease activity increased while esterase and acid phosphotase activities were reduced in P. velutina. In contrast, there was increased protease and acid phosphotase activity in S. hirsutum.

Treatment regimens for yeast vaginitis

Factors that predispose to complicated infection include uncontrolled diabetes, immunosuppression, and a history of recurrent vulvovaginal candidiasis. Women with severe inflammation or complicated infection require seven to 14 days of topical therapy or two doses of oral therapy 72 hours apart.

Chapter References

Andersen GM, Barrat J, Bergan T A comparison of single-dose oral fluconazole with 3-day intravaginal clotrimazole in the treatment of vaginal candidiasis Report of an international multicentre trial. Br J Obstet Gynaecol 96 226, 1989. 8. Droegemueller W, Adamson DG, Brown D, Cibley L Three-day treatment with butoconazole nitrate for vulvovaginal candidiasis. Obstet Gynecol 64 530, 1984.

Autoimmune features of vitiligo

Vitiligo can be found in autoimmune families in association with Addison disease, alopecia areata, pernicious anemia, or mucocutaneous candidiasis, with an incidence 10-15 times higher than in the general population. Antibodies to thyroid, adrenal gland and gastric parital cells can be demonstrated in vitiligo patients using modern techniques, antibodies reactive with melanocytes have been consistently-found in vitiligo patients' sera. The levels of these antibodies are greatest in patients with actively progressing disease and in vitiligo patients with other autoimmune disease. Both melanocyte-specific antibodies and antibodies reactive to other cells in addition to melanocytes have been identified. Some of these antibodies are specific for proteins involved in melanization such as tyrosinase and tyrosinase-related protein 1. Antibodies to a melanocyte-specific 85 kDa antigen have been described in dogs, cats and horses with vitiligo. Similar antibodies are found in a chicken model...

Clinical phenotype of human SCID

Swot Analyse Pflege

As expected from the severe defects affecting both cellular and humoral immunity, SCID patients commonly have persistent and recurrent infections. Patients with SCID often present with oral candidiasis, diarrhea, otitis, sepsis, cutaneous infections and pneumonia. Failure to thrive is observed secondary to chronic infection, malabsorption and diarrhea. Patients often suffer from infections by opportunistic microorganisms including Pneumocystis carinii, Cryptosporidia and Candida albicans. Herpes virus, adenovirus and cytomegalovirus often cause lethal systemic infections. Live vaccines such as BCG, oral polio vaccine, and varicella vaccine are contradicted in patients with SCID. Since SCID patients lack the ability to reject foreign tissue, chronic GVHD (graft-versus-host disease) caused by maternal T cells that cross the placenta may occur in affected infants. Similarly, nonirradiated blood transfusions can cause GVHD.

Immunodeficiencies and oral health

The oral cavity can be considered a window to the health and immune status of an individual. Although the oral cavity is anatomically unique, it enjoys both the benefits and liabilities of systemic immunity. Perturbations of the T cell compartment of the immune system are often indicated by oral mucosal infections by opportunistic microorganisms, resulting in oral ulcerations. Children with severe combined immune deficiency (SCID) have rampant growth of Candida albicans on their oral mucosal surfaces. Most individuals with T cell deficiencies, as in major histocompatibility complex (MHC) class II deficiency, DiGeorge anomaly, ataxia telangiectasia, Wiskott-Aldrich syndrome and HIV-1 infections, develop oral opportunistic infections most often candidiasis. Infants before the complete development of the T cell response are prone to develop oral thrush, C. albicans infection of the oral mucosa. Boys with a deficiency of the CD40 ligand are unable to develop leukocytosis in response to a...

Granulocytopenia Immunosuppression And Infection

Both the frequency of infection and the mortality rate increase significantly when the circulating granulocyte pool is below 1000 to 1500 pL. Cancer patients are at risk for a variety of bacterial, viral, and fungal infections. Frequently encountered infections include pneumococcal sepsis and pneumonia Staphylococcus aureus infection enteric gram-negative pneumonia or sepsis, including Pseudomonas infections and localized or disseminated varicella-zoster viral and cytomegalovirus infections. Immunosuppression predisposes to invasion by organisms that are normally held at bay by host defenses and biocompetition from normal body flora. Such opportunistic infections include Pneumocystis carinii pneumonia (protozoal), disseminated candidiasis, aspergillosis, cryptococcal meningitis, pulmonary nocardiosis, and histoplasmosis. Recent trends include a decreasing incidence of Pseudomonas and an increasing incidence of methicillin-resistant staphylococci and the emergence of gram-positive...

Eosinophils in disease

Eosinophils are able to phagocytose immune complexes and microorganisms (e.g. Escherichia coli, Candida albicans, Trypanosoma cruzi), but these capabilities are generally not as great as those of other phagocytes. The ability to release toxic-substances against nonphagocytosable surfaces is probably of greater importance. By this mechanism, eosinophils are able to kill certain metazoan parasites. There is also some evidence to suggest that eosinophil infiltration of tumors increases patient survival in certain types of cancer (and cures certain experimental cancers in mice).

Endocrine Abnormalities

INSULIN Most of the systemic complications of diabetes are related to the microangiopathy caused by the disease.19 Oral manifestations are associated more commonly with insulin-dependent diabetes mellitus but may be associated with non-insulin-dependent diabetes mellitus. Periodontal disease is more common and more aggressive in the diabetic patient. Wound healing postoperatively is delayed, and diabetics are prone to infections secondary to impairment of neutrophil function. In the poorly controlled diabetic patient, gingival erythema and proliferation are common. 37 The poorly controlled diabetic patient is more susceptible to oral candidiasis. Erythematous candidiasis with its central papillary atrophy of the tongue is reported in up to 30 percent of diabetic patients. An increased incidence in benign migratory glossitis is seen in insulin-dependent diabetes. Diabetic sialadenosis, or diffuse nontender enlargement of the parotid salivary glands, is not uncommon. Xerostomia is a...

Staphylococcal infection

Huge pedunculated vegetation (V) on the aortic valve caused by secondary candida infection in a young women with a variable course after treatment for enterococcal infection on a floppy mitral valve. Transoesophageal view LA, left atrium Ao, aorta. Figure reproduced courtesy of Dr Petros Nihoyannopoulos. Figure 11.3. Huge pedunculated vegetation (V) on the aortic valve caused by secondary candida infection in a young women with a variable course after treatment for enterococcal infection on a floppy mitral valve. Transoesophageal view LA, left atrium Ao, aorta. Figure reproduced courtesy of Dr Petros Nihoyannopoulos.

Simple Procedure for the Screening of Enzyme Reactions

The following enzymes (100mg of each) (1) Lipase AP6 (Aspergillus niger, Amano), (2) lipase AY-30 (Candida cylindracea, Amano), (3) Candida cylindracea lipase (Meito-Sangyo), (4) lipase GC4 (Geotrichum candidum, Amano), (5) lipase MAP (Mucor meihei, Amano), (6) lipase MAP (Mucor meihei, Amano), (7) lipase N (Rhizopus niveus, Amano), (8) Lipase OF (Candida cylindracea, Meito-Sangyo), (9) Lipase R (Humicola sp., Amano), (10) Lipase R-10 (Humicola lanuginosa, Amano), (11) Candida rugosa lipase (Sigma, L1754), (12) PPL type II (Sigma, L-3126).

Ophthalmologic Infections

Ophthalmologic infections in the IVDU are usually the result of hematogenous seeding from a primary source of infection, such as endocarditis, or of opportunistic infections associated with coincident HIV disease. Bacterial endophthlamitis often presents acutely, with rapid progression of pain, redness, lid swelling, and decrease in visual acuity.46 Inflammation is usually present in the anterior and posterior chambers. White-centered, flame-shaped hemorrhages (Roth spots), cotton wool exudates, and macular holes may be present. S. aureus is the most commonly isolated organism, followed by Streptococcus sp. A rare but rapidly destructive infection has been reported with Bacillus cereus. Treatment involves subconjunctival and systemic antibiotic therapy surgical intervention may be needed. Fungal endophthalmitis, usually due to Candida, is more common than bacterial endophthalmitis. The clinical picture is often indolent, progressing over days to weeks. Symptoms include blurred vision,...

Diagnostic studies

Measurement of vaginal pH should always be determined. The pH of the normal vaginal secretions is 4.0 to 4.5. A pH above 4.5 suggests bacterial vaginosis or trichomoniasis (pH 5 to 6), and helps to exclude candida vulvovaginitis (pH 4 to 4.5). B. Saline microscopy should look for candidal buds or hyphae, motile trichomonads, epithelial cells studded with adherent coccobacilli (clue cells), and polymorphonuclear cells (PMNs). The addition of 10 potassium hydroxide to the wet mount is helpful in diagnosing candida vaginitis. Culture for candida and trichomonas may be useful if microscopy is negative. Candidal Vaginitis

Applications in Biology and Medicine

The diagnostic power was attributed to differences in the cell membrane lipid composition, which was in agreement with known biology. Thompson et al. (44) used a similar approach to discriminate between spores and vegetative cells of Bacillus megaterium. In a model drug-cell interaction experiment Cliff et al. (45) imaged frozen hydrated Candida glabrata yeast cells incubated in the presence of the antibiotic clofazimine. The drug was detected only on the outside of unfractured cells, implying that it does not penetrate the cell wall. This study suggests that TOF-SIMS analysis of pharmaceuticals on cell surfaces and within cells could provide a valuable new tool for pharmacological studies.

Specific immunity Antibody

Although it is difficult to draw definite conclusions, for most of the mycoses there is little evidence to suggest that specific antibodies are critical to host defense. In marked contrast to patients with impaired cell-mediated immunity, those with hypogammaglobulinemia are not particularly predisposed to the development of invasive fungal infections. The principal role of antibody may be to enhance binding of fungi to phagocytic cells via Fc receptors. In the case of crytococcosis, specific antibody enhances the activity of most effector cell populations in in vitro systems and passive administration of antibody has been shown to be beneficial in animal models of infection. Some evidence from mouse models also suggests a role for humor,al immunity in resistance to systemic candidiasis. Specific antibodies are also important in the pathogenesis of allergic responses to inhaled fungi. For example, IgE-mediated immediate hypersensitivity reactions to fungal allergens may play a part in...

Clinical evaluation

A new sexual partner increases the risk of acquiring sexually transmitted diseases, such as trichomonas, chlamydia, or Neisseria gonorrheae. Trichomoniasis often occurs during or immediately after the menstrual period candida vulvovaginitis often occurs during the premenstrual period. C. Antibiotics and high-estrogen oral contraceptive pills may predispose to candida vulvovaginitis increased physiologic discharge can occur with oral contraceptives pruritus unresponsive to antifungal agents suggests vulvar dermatitis.

Cutaneous Manifestations

Intertriginous infections with either Candida or Trichophyton are often seen in patients with HIV and can be diagnosed by microscopic examination of potassium hydroxide preparations of lesion scrapings. Treatment includes topical imidazole creams, such as clotrimazole, miconazole, or ketoconazole. Scabies occurs in about 20 percent of HIV-infected patients, but classic intertriginous lesions are less common. Any patient with a scaly, persistent pruritic eruption should have lesions scraped and examined histologically for scabies mites. Treatment is with permethrin 5 cream or lindane lotion. Human papillomavirus infections occur with increased frequency in immunocompromised patients. Treatment is cosmetic or symptomatic and may include cryotherapy, topical therapy, or laser therapy. Other dermatologic conditions that occur with increased frequency among HIV-infected patients include psoriasis, atopic dermatitis, and alopecia. Referral for dermatologic consultation is appropriate.

Neurologic Complications

It is reported that between 19 and 47 percent of all adult liver transplant patients have a neurologic complication at some time during their posttransplant course. Neurologic complications in children, however, are much less common (8 percent).14 Common presenting problems include headache, seizure, and mental status changes. The etiology is more likely to be noninfectious than infectious. Common noninfectious etiologies are hemorrhage, immunosuppressive toxicity, and metabolic derangement. Central nervous system (CNS) infection is most common in the first few months, with viral and fungal etiologies predominating. CNS CMV infection is rare and CNS herpesvirus infection is seen with the same frequency as in the general population. Bacterial etiologies include Listeria, Klebsiella, S. aureus, Nocardia, and Escherichia coli. Aspergillus, Candida, and Cryptococcus sp. are the more common fungal agents involved. Cryptococcal disease is most common between 2 and 7 months.16 Patients...

Cerealbased Fermented Food

(a) Chinese Minchin This is made from wheat gluten and used as a solid condiment. The fungal species involved in fermentation include Aspergillus sp., Chadosporium sp., Fusarium syncephalastum, and Paecilomyces sp. (Padmaja and George 1999) (b) Chinese red rice (Anka) This is produced by fermenting rice with various strains of M. purpureus Went. It is used to color foods such as fish, rice wine, red soybean cheese, pickled vegetables, and salted meats. To make Anka, polished rice is washed, steamed, cooled, inoculated with M. purpureas, and allowed to ferment for a few weeks. Anka has been reported to be effective in treating indigestion and dysentery (Su and Wang 1977) (c) Jalabies These are syrup-filled confectionery available in India, Nepal, and Pakistan made from wheat flour. Saccharomyces bayanus and bacteria are involved in fermentation (Padmaja and George 1999) (d) Indian Kanji This is made from rice and carrots. It is a sour liquid added to vegetables. H. anomala is involved...

Haematological malignancies

An RCT compared fluconazole, 400 mg day, with placebo in patients after bone-marrow transplantation treated for up to 75 days. Systemic fungal infections were found in 10 (7 ) of 152 fluconazole-treated patients and in 26 (18 ) of 148 placebo-treated patients (P 0-004). No C. albicans infections occurred in fluconazole recipients, compared with 18 in placebo recipients (P


The gut is the major reservoir for Candida yeasts, without causing clinical disease. Newborn babies are normally not colonised. Follow up studies showed that the most important and rapid route of colonisation is from mother to child.1 Among the elderly, 36-78 are colonised with Candida denture wearing, smoking and poor oral hygiene are risk factors for the presence of the yeasts.2 The incidence and prevalence of cutaneous Candida i nfections in the general population is unknown, nor is the frequency of clinically manifest oral or genital candidiasis.

Design of a Mixed Culture System

For this purpose, screen the microorganisms from some sources such as fermented food, because the fermented food is a good source for bacteriocin producing LAB as well as lactic acid-assimilating yeasts and bacteria. For nisin production, the carbon source is maltose and a yeast K. marxianus was isolated from kefir grains. For another candidate, the carbon source is lactose and a yeast Candida vinaria was isolated from cheese. This design is important step for a successful application of the method to other bacteriocin production process.

Fermented Meat Products Sausages

The starter culture used in meat fermentation may have bacteria, the yeasts Deboryomyces hansanii and Candida famata and the fungi Penicillium chrysogenum and P. nalgiovense. Yeasts encourage color development and improve aroma in sausages. Molds contribute to the characteristic aroma. During fermentation, the fall in pH due to glycolysis by lactic acid bacteria helps to preserve the fermented product and inhibit the growth of pathogenic microorganisms, and the production of nitric oxide due to activity of the nitrate and nitrite reducing bacteria results in the production of nitrosomyoglobin that accounts for the odor of the meat product. During ripening, proteolytic activity due to enzymes in meat and bacterial starter cultures, and lipolytic enzymes in molds and yeasts lead to products which may contribute to flavor (Hammes and Knauf 1994).

Acquired immune deficiency syndrome AIDS

In Africa, for example, where the general prevalence of infection is high, opportunistic infections tend to occur early in the course of HIV illness and with similar organisms to those encountered commonly in the general population such as tuberculosis, pyogenic infections and salmonellosis. In contrast, in Western countries infections occur later, with Pneumocystis pneumonia, toxoplasma encephalitis, cryptococcal meningitis, cryptosporidial diarrhea and local candidal infections, being the most commonly encountered. As the disease progresses, multiple simultaneous infections may occur with any of the above and in addition atypical mycobacterial infections and CMV infections of the retina and gastrointestinal tract. See also Acquired immune deficiency syndrome (AIDS) Bone marrow and hematopoiesis Candida, infection and immunity Cryptosporidiosis Cytomegalovirus, infection and immunity Epstein-Barr virus, infection and immunity Graft-versus-host reaction Haemophilus, infection...

Hematologic malignancy

Focal sepsis in neutropenic patients commonly affects the lungs, oropharyngeal mucosa, perineum and skin. Invasive mycotic infections with Candida spp. or Aspergillus spp. commonly occur in patients with prolonged neutropenia. These are usually associated with intensive cytotoxic therapy - which also impairs cell-mediated immunity, and prolonged antibiotic therapy - which reduces the so-called 'colonization resistance' afforded by normal commensals.

Bone Marrow Transplants

Emergency physicians are unlikely to encounter the acute complications of bone marrow transplantation because these patients often are kept in the hospital for several weeks following their transplant until engraftment occurs. However, emergency physicians should be aware of the long-term complications and consequences of bone marrow transplantation. Like solid-organ transplant recipients, bone marrow recipients are at increased risk of infection. This risk is not just confined to the period of granulocytopenia preceding engraftment. Even with a normal neutrophil count, bone marrow transplant patients have a residual cellular and humoral immunodeficency that persists for 12 to 24 months after transplantation. Return of immune function generally is slower in allogeneic transplant recipients than in autologous transplant recipients. Bone marrow transplant patients are at particular risk of infection from encapsulated bacteria, Pneumocystis carinii, cytomegalovirus (CMV),...

Relative Likelihood of Endotoxin Occurrence in Parenteral Drugs

A central question that arose upon the proposal to replace the rabbit pyrogen test with the LAL test, and one that deserves serious consideration, is How can one be sure in testing only for endotoxin that other microbial pyrogens will not be allowed to go undetected in the parenteral manufacturing process We have answered the question in part by considering the ubiquity, stability, and relative pyrogenicity of gram-negative bacterial endotoxin. But also the minimal growth requirements of gram-negative bacteria allow their growth in the cleanest of water. Conversely, the answer can be found by disqualifying from undue concern each type of non-gram-negative organism that could occur in parenteral manufacturing operations including (i) the environmental predisposition of organisms that prevent them from proliferating in largely water-based parenteral manufacturing processes, (ii) the relative ease of degradation of their by-products (except heat-stable exotoxins of gram-positive bacteria...

Economic Considerations

That savings could be gained, even though wastewater would still have to be purified. Comparison of different treatment methods for molasses stillage showed that aerobic Candida yeast growth was the most suitable option. The same method was proposed for sulfite waste liquor and wood hydrolysis stillages (Maiorella et al. 1983).

Case presentation 1 continued

In the immunocompetent individual without acute symptoms of TB, the test approaches 100 sensitivity.10 Among patients with acute TB, false negatives of 25 have been reported. Such anergy may be specific for M. tuberculosis, or there may be a general anergy to multiple antigens. Anergy is more common among HIV-positive and other immunocompromized patients, or among the malnourished. Although individuals anergic to multiple antigens can be identified by testing intracutaneous responses to Candida, tetanus, mumps, or other common antigens, these tests have poor reproducibility and are no longer recommended.85 Tuberculin testing is recommended to aid diagnosis (see previous discussion) and to identify asymptomatic infected individuals who may be candidates for treatment of LTBI. When contacts of an active case are investigated, a skin test of 5 mm indicates recent exposure and 5 risk of active TB. Such patients have been shown to benefit from monotherapy with INH, as discussed later in...

Lactoferrin and Other Iron Binding Proteins

Lactoferricin B is a small peptide (25 amino acids) produced by acid-pepsin hydrolysis of bovine lactoferrin (81). The compound is inhibitory to Shigella, Salmonella, Yersinia enterocolitica, E. coli 0157 H7, Staphylococcus aureus, L. monocytogenes, and Candida species at concentrations ranging from 1.9 to 125 mg mL (82). Another iron-binding molecule, ovotransferrin or conalbumin, occurs in egg albumen. Each ovotransferrin molecule has two iron-binding sites and, like lactoferrin, it binds an anions, such as bicarbonate or carbonate with each ferric iron bound. Ovotransferrin is inhibitory against both Grampositive and Gram-negative bacteria, but the former are generally more sensitive, with Bacillus and Micrococcus species being particularly sensitive (75). Some yeasts are also sensitive.

Purification of Lipase

Commercial lipase from Candida rugosa is purified according to the method of Basri et al. (15). The purification procedures employed are the conventional method and the one-step gel filtration on Superose 6 column using fast performance liquid chromatography (FPLC). The conventional method consists of the following steps water extraction, ammonium sulfate

Fermented Milk Products

To the aroma with Lactobacilli found in 108g21 (Mahmoud 1977) (b) Russian Kefir is an acidic, mildly alcoholic milk made from cow, goat, or sheep milk that is able to keep longer. The predominant yeasts involved in fermentation include T. holmii and S. delbrueckii although Candida kefir and S. cerevisiae are the yeasts that are commonly isolated (Marshall 1984). During the preparation of kefir, Kefir grains are added to pasteurized milk and incubated at 18-25 C for 1-2 days. The mixture contains Kefir grains, which consist of yeasts and lactic acid bacteria held together with the help of a polysaccharide gum and these are removed by sieving (c) Russian Koumiss This is produced from ass milk, camel milk, or mare milk. Lactic acid bacteria and the lactose fermenting yeasts Torula kumiss and Saccharomyces lactis cause fermentation (Kosikowski 1982). Fresh milk is first heated at about 90 C for 5 min and cooled before inoculation of starter and incubation at 28 C. The incubate is agitated...

Alcoholic Food And Beverages Mostly Cerealbased

The peeled bananas are mixed with grass and the juice is forced out by squeezing by hand. A roasted flour mixture made from maize, sorghum and millet is mixed with the banana juice and fermented in the covered pit for half a day or one (Harkishor 1977) (c) African Kaffir (Kaffircorn) (Sorghum) Beer This has a sour, yogurt-like flavor. The brewing process involves lactic acid fermentation and an alcoholic fermentation. Lactic acid fermentation by lactic acid bacteria causes souring. The yeast S. cerevisiae is used for alcoholic fermentation (Hesseltine 1979) (d) Nigerian Pito This is a slightly bitter, sweet-sour beverage with a fruity flavor produced by fermentation of maize or sorghum. The molds Rhizopus oryzae, Aspergillus flavus, Penicillium funiculosum, and Penicillium citrinum play an undefined role in Pito fermentation. The bacteria Leuconotoc sp. and Lactobacillus sp. and the yeasts Saccharomyces and Candida spp. are also present during fermentation. Amylases from the...

Evasive strategies by the organism

Adhesion is an important initial step in infection of epithelial or mucosal sites. In this regard, Candida organisms have been shown to express three types of adhesion molecules. After adhesion of the organisms, other potentially important virulence factors of Candida which may assist in promoting invasive disease include lytic enzymes, hyphal formation, and contact sensing. One lytic enzyme, an aspartyl proteinase, may assist penetration into the stratum corneum. Another enzyme, a keratinase, allows invading organisms to use keratin as a source of nutrients. Hyphal formation appears to be useful both in establishing colonization of surfaces and in tissue invasion but may not be absolutely essential for invasion. Contact sensing (also called thigmotropism), may also be a possible mechanism by which Candida organisms distribute and align themselves in order to penetrate surfaces. Infection of superficial sites such as the skin, mucous membranes and nails may also be a method by which...

Antifungal and antiviral agents

Polyene antibiotics such as amphotericin and nystatin (both produced by species of Streptomyces) act on the sterol components of membranes their use is limited, because human cells can also be affected by their action (to use a term we learnt earlier in this chapter, they have a low therapeutic index). Nystatin is used topically against Candida infections, while amphotericin B is generally used against systemic infections of fungal origin. The latter substance can have a wide range of serious side-effects, but in some cases infections are so severe that the physician is faced with no alternative. Synthetic compounds such as the imidazoles have a similar mode of action to the polyenes they are effective against superficial mycoses (fungal infections of the skin, mouth and urino-genital tract). Griseofulvin, a natural antibiotic produced by a species of Penicillium, is another antifungal agent whose use is restricted it works by interfering with mitosis and not surprisingly has a range...

Preparation of Cell Suspensions see Note

Candida Electron Microscope

Candida albicans yeast cells attached to the surface of a poly-L-lysine coated microscope slide. Specimen was prepared as described in Subheading 3.1.1. Bar 10 pm. Fig. 1. Candida albicans yeast cells attached to the surface of a poly-L-lysine coated microscope slide. Specimen was prepared as described in Subheading 3.1.1. Bar 10 pm.

Enantioselective Esterification of Methyl Branched Carboxylic Acids

Commercial extracellular lipase (E.C. from Candida rugosa (CRL) with a specific activity stated as 900 U mg solid and 4865 units mg protein (obtained from Sigma, St. Louis, MO). One unit is the amount hydrolyzing 1.0 mol h of olive oil at pH 7.2 and 37 C. Store the lipase at 4 C and dry conditions.

Invertebrate Effects On Fungal Community Structure

Invertebrates have differential effects on different species of fungi, resulting from different extents and sites of grazing, secretion of various chemicals including antibiotics, and from physical effects. Consequently, they can affect the species balance within fungal communities. For example, Collembola grazing alters the vertical distribution of Marasmius androsaceus and Mycena galopus in spruce (Picea sitchensis) needle litter (Newell, 1984a, 1984b) Onychiurus latus fed preferentially on M. androsaceus in laboratory and field tests caused the restriction of this species to the uppermost litter horizon. In inter-specific mycelial confrontations in agar culture and trays of soil in the laboratory, the balance was shifted in favour of one species over another when grazed by the Collembola F. candida for example, in the absence of F. candida, R. bicolor overgrew P. velutina, whereas with Collembola grazing P. velutina was able to breach the R. bicolor advancing front (T.D. Rotheray...

Aims of treatment and relevant outcomes

Treatment normally aims at complete relief of any symptoms caused by the yeasts. On the skin, cultures should be negative for the presence of Candida yeasts after treatment. Apart from controlled studies, however, the latter is proved in only a minority of patients. Possible outcomes of any studies are therefore complete clearing of the clinical manifestations and or (repeated) demonstration of the lack of Candida yeasts in the appropriate specimen.

Opportunistic mycoses

The opportunistic mycoses include the infections due to Candida, Aspergillus and zygomycete fungi of the genera Rhizopus, Rhizomucor and Absidia amongst others. Infection affecting the skin is uncommon and these infections seldom present to a dermatologist any skin involvement has to be set against the background of widespread and life-threatening disease. These infections often occur in patients with severe defects of either neutrophil numbers or function, such as recipients of stem cell transplants and cancer patients. Candida also affects seriously ill patients in intensive care or after abdominal surgery, neonates and after prolonged intravenous feeding. Isolated cases of cutaneous aspergillosis and zygomycosis have been recognised following abrasion at a specific site. Disseminated candidosis rarely affects the skin either in the neutropenic subject or the intravenous drug abuser. Systemic cryptococcus infection has been extensively evaluated in at least 13 randomised controlled...

Vaccination and immunotherapy

The defects in host immunity associated with serious fungal infections are being defined and some progress has been made in attempts to boost or reconstitute the immune response. Examples include IFN7 in patients with chronic granulomatous disease and granulocyte colony-stimulating factor and GM-CSF in neutropenic patients. In the case of cryptococcosis, monoclonal antibodies to capsular glucuronoxylomannan have been shown to confer protection when passively administered to mice infected with C. neoformans. This, despite the fact that specific antibodies appear to play a limited role in normal host defense against C. neoformans. Increased understanding of the complex network of cytokines regulating the cellular immune response has raised additional therapeutic possibilities. Soluble I1.-4 receptor and antibody against IL-10 have been shown to be beneficial in murine candidiasis and II.-12 has been shown to be beneficial in animals models of cryptococcosis and histoplasmosis....

Intravascular catheterrelated infection

Coagulase-negative staphylococci, S. aureus, and Candida are the most commonly encountered pathogens. Decisions regarding type and duration of antibiotic therapy depend on the patient's clinical condition, the organism grown, and the type of catheter. Whether or not a permanent line need be removed in the presence of a suspected infection can be a difficult decision. In the case of a suspected catheter-related infection, it is best to seek the diagnosis and request microbiology consultation for guidance of empirical therapy.

Enzymatic Preparation of Optically Active Organosilicon Compounds in Organic Solvents

Hydrolases lipase OF 360 from Candida cylindracea (Meito Sangyo), lipase Saiken 100 from Rhizopus japonicus (Osaka Saikin Kenkyusho, Osaka, Japan), lipase (Steapsin) from hog pancreas (Tokyo Kasei, Tokyo, Japan), lipoprotein lipase Type A from Pseudomonas sp. (Toyobo), and cholesterol esterase Type A from Pseudomonas sp. (Toyobo).

Prosthetic Valve Endocarditis

Early PVE is most often related to intraoperative contamination of the surgical field or postoperative bacteremia. As such, the bacterial flora of the skin and hospital-associated pathogens predominate. CoNS (most frequently S. epidermidis) are responsible for about 30-50 of PVE within this group, s. aureus (with an increasing proportion of MRSA) causes 15-20 , and Gram-negative bacilli causes 10-20 . Fungi (Candida species), diph-theroids and enterococci (with rare cases of VRE) each cause at least 5 of early PVE cases, and the streptococci are very rare causes of PVE in the early postoperative period.

Distinguishing Chemical From Enzymatic Interesterification

Costs aside, does treatment by means of chemical or enzymatic interesterifi-cation in identical applications result in the same final product Kalo et al. 117 compared the changes in triacylglycerol composition and physical properties of but-terfat interesterified using either sodium methoxide or a nonspecific lipase from Candida cylindracae and found only small differences in both interesterified butterfats. The compositional changes induced by both chemical and enzymatic means were similar, with the trisaturate triacylglycerol content being slightly higher in the en-zymatically modified product. In terms of physical properties, the chemically inter-esterified butterfat was slightly harder than its enzymatically modified counterpart. Hence, for randomization purposes, the methods appeared to yield similar results for the modification of butterfat. However, the product's butter flavor must be taken into account. The harsh process conditions of chemical interesterification result in...


Enzyme a soluble or immobilized lipase (e. g., lipases PS and F free , PS-C and PS-D immobilized from Amano Japan or immobilized Mucor miehei Lipozyme IM-60 and Candida antarctica Novozyme 435 lipases from Novo (see Note 6). These immobilized enzymes are also currently marketed by Bohringer Mannheim (Germany).

Immunodeficiency Primary

The first cases of SCID were described in Switzerland in the 1950s, hence the original term 'Swiss type agammaglobulinemia', although later it became apparent that cellular immunity was severely compromised. A better understanding of the condition had to await the discovery of T and B lymphocyte markers in the 1970s. Since then the condition has been subclassified, and in most cases the disorder is understood at a molecular level. SCID occurs in about 1 50 000 live births. The syndrome is characterized by severe opportunistic fungal, viral, protozoal and bacterial infections. Affected infants fail to thrive, have chronic diarrhea due to enteric viruses and parasites, have extensive mucosal candidiasis, and develop Pneumocystis carinii pneumonia. These clinical features, together with the finding of very low numbers of circulating T cells, negative delayed hypersensitivity skin reactions, poor or absent T lymphocyte transformation in vitro with mitogens and thymic dysplasia (without...

Leukoplakia and Erythroplakia

Leukoplakia is defined by the World Health Organization as a white patch or plaque that cannot be scraped off or characterized clinically or histopathologically as any other disease.21 Leukoplakia is the most common oral precancer however, only 2 to 4 percent of leukoplakic lesions are carcinoma.22 The prevalence is approximately 20 to 39 per 1000 persons, affecting males twice as frequently as females. Etiology is unknown, but tobacco, alcohol, ultraviolet radiation, candidiasis, human papillomavirus, tertiary syphilis, and trauma have all been implicated. The most common intraoral site involved is the buccal mucosa. Other sites of involvement include the hard and soft palates, maxillary gingiva, and lip mucosa. Biopsy is mandatory for all persistent leukoplakic lesions, yet most demonstrate no dysplastic changes histologically. Leukoplakic lesions of the floor of the mouth, tongue, and vermilion border are most likely associated with malignancy. Lesions demonstrating dysplastic...

Organosilicon Compounds as Novel Substrates of Hydrolases in Organic Solvents

Lipase OF 360 from Candida cylindracea (Meito Sangyo, Tokyo, Japan) (see Note 1). 6. Hydrolases lipase OF 360 from Candida cylindracea (Meito Sangyo), lipase KLIP-100 from Pseudomonas sp. (Kurita Kogyo, Tokyo, Japan), lipoprotein lipase Type A from Pseudomonas sp. (Toyobo, Osaka, Japan), and cholesterol esterase Type A from Pseudomonas sp. (Toyobo).

Immune responses of the host

Candida species are found commonly in the environment, and can be recovered from the soil. They are normal flora in the human gastrointestinal tract, and can often be found at other mucosal sites and on diseased skin. The initial host defenses are the nonspecific barriers including intact skin and mucosal epithelium, as well as the indigenous bacterial flora that competes for binding sites. Breakdown of these barrier functions, (e.g. from burns or indwelling intravascular devices) allows for invasive Candida infections. Once the organisms invade past the nonspecific defenses, the major cellular mechanism against Candida infections is through neutrophils. These cells are capable of phagocytosing Candida spores as well as damaging the pseudohyphae. Intracellular killing appears to be primarily through oxidative mechanisms. Other cells of the immune system (monocytes and eosinophils) are also able to phagocytose and kill Candida organisms. Even so, the initial response in the tissues is...

Microbial associations with animals

Another example of a host's staple diet being indigestible without the assistance of resident microorganisms is provided by the brightly coloured African bird the honey guide. The honey guide eats beeswax, and relies on a two-stage digestion process by bacteria (Micrococcus cerolyticus) and yeast (Candida albicans) to render it in a usable form.

Statistical Analysis of the Phylogenetic Tree

Eosinophil Phylogenetic Tree

Once the phylogenetic tree has been generated, the next step is to statistically test its topology. One method that is commonly used to test phylogenetic tree topologies is the statistical method of bootstrapping (12). This method calculates the variability of the tree topology by resampling (with replacement) the original multiple sequence alignment a set number of times (i.e., a number between 100 and 2000) to generate a new set of artificial multiple alignments. This new data set is in turn used to generate a set of trees, from which a consensus tree is produced. In the resulting consensus tree, at each branch node on the tree, the fraction of bootstrap trials (referred to as the bootstrap value) that confirmed that node is shown. For example in Fig. 1, 96 of 100 bootstrap trials found that the asexual yeast species (referred to as the anamorph) Candida holmii and its sexual form (referred to as the teleomorph) Saccharomyces exiguus were distinct from all other species examined in...

Non Valvular Cardiovascular Infections

Genic (e.g., catheterization, angioplasty), and anatomic abnormalities (e.g., aneurysm infection, infection of infarcted myocardium, infection of myxoma) 452 . S. aureus is the most frequently reported bacterial isolate in patients with MAs other causes include streptococci, C. perfringens, Bacteroides spp., E. coli, Candida spp., and Aspergillus spp. 452,453 . Fungal MAs are more common in immunocompromised patients. Paravalvular MAs are usually recognized in the context of endocarditis that is failing to improve or clinically deteriorating. Non-paravalvular MAs are usually subtle, with most previous cases diagnosed at autopsy. The major complication of MAs is rupture. In MAs that develop in an area of recent myocardial infarction, the risk of rupture is increased sevenfold 454 . Rupture can result in tamponade, hemopericardium, and or purulent pericarditis. Other complications include fistulae, cardiac arrhythmias, or septic shock. Although conduction disturbances detected by serial...

Medium Chain Fatty Acids

Polyhydric alcohol fatty acid esters have great potential for use as emulsifiers in food formulations (Razani-Rohani and Griffiths 1994). They also possess antifungal properties and, therefore, may exert a preservative effect in foods. Kato and Shibasaki (1975) demonstrated strong fungistatic activity of glycerol monocaprate and glycerol monolaurate toward Aspergillus niger, Penicillum citrinum, Candida utilis, and Saccharomyces cervisiae. Sucrose monocaparte and sucrose monolaurate were found to be slightly inhibitory to a spoilage film-forming yeast inoculated into a soy sauce substrate (Kato 1981). Six sucrose esters substituted to different degrees with a mixture of palmitic and stearic acids were examined by

Physical examination

The vulva usually appears normal in bacterial vaginosis. Erythema, edema, or fissure formation suggest candidiasis, trichomoniasis, or dermatitis. Trichomonas is associated with a purulent discharge candidiasis is associated with a thick, adherent, cottage cheese-like discharge and bacterial vaginosis is associated with a thin, homogeneous, fishy smelling discharge. The cervix in women with cervicitis is usually erythematous and friable, with a mucopurulent discharge. Abdominal or cervical motion tenderness is suggestive of PID.

Clinical applications

The test is most commonly used to investigate suspected immunodeficiency in patients with unusual susceptibility to certain infectious diseases. Patients with severe immune deficiencies such as severe combined immunodeficiency (SCID) have little or no lymphocyte transformation responses to mitogens or antigens, even when they have normal numbers of lymphocytes in their blood. In other disorders, such as chronic mucocutaneous candidiasis, responses to mitogens may be normal, but the patients' lymphocytes do not respond to antigens, especially antigens from Candida albicans. responses. In these cases (such as patients with recurrent vaginal candidiasis, chronic mycobacterial infections or Hodgkin's disease) the proliferation responses are normal in normal serum but subnormal in autologous serum.

Critically ill patients

In another group of ill high-risk surgical patients, an RCT on 49 patients revealed candidiasis in two patients who received intravenous fluconazole 400 mg day and in seven patients who received placebo (P 0-06). Fluconazole was well tolerated, and adverse events occurred at similar frequencies in both treatment groups.11 An RCT addressed the safety and efficacy of fluconazole therapy in 143 liver-transplant recipients. Seventy-six patients received oral fluconazole, 100 mg day, and 67 received nystatin 4 x106 units day) for the first 28 days after transplantation. Candida colonisation occurred in 25 and 53 of patients in the fluconazole and nystatin groups, respectively (P 0-04), and 13 and 34 of patients respectively had Candida infections (P 0-022). Of these patients, 10-5 in the fluconazole group and 25-3 in the nystatin group had superficial Candida infections (P 0-024). Invasive candidiasis developed in two patients in the fluconazole group (2-6 ) and six in the nystatin group...

Immunological activities of transfer factors

The immunologic consequences of administration of transfer factors have been described in clinical and experimental settings. The earliest reports concerned patients with the Wiskott-Aldrich syndrome, chronic coccidioidomycosis or chronic mucocutaneous candidiasis. Similar results were observed in each group of patients. The recipients acquired the ability to express the delayed-type hypersensitivity responses

Tuber Cropbased Fermented Food

Washed, cut up, soaked in water to release HCN into water, disintegrated, and sieved. The filtered starchy particles are allowed to settle and collected, rolled into balls, cooked, and formed into a paste called fufu. S. cerevisiae and various bacteria are involved in the fermentation (Padmaja and George 1999) (b) West African Gari This is made from cassava roots and eaten as a staple food. Candida sp. and bacteria are involved in fermentation. Roots are fermented, broken up, sun-dried, milled into flour and made into a paste with boiling water before consumption (Padmaja and George 1999). (c) Nigerian Lafun This is a fine, powdery cassava product. Candida sp. and bacteria are involved in fermentation (Padmaja and George 1999) (d) Indonesian Tape This is a staple food made from cassava roots. To make Tape, cassava roots are peeled, cut up, boiled to soften, cooled, spread in trays, inoculated, covered with banana leaves, and fermented for a couple of days. The microorganisms involved...

Characteristics of the organism and its antigens

Infections due to organisms in the genus Candida are relatively common, with a variety of different manifestations of disease in both humans and animals. These organisms all grow as yeast and most of the individual species also have filamentous forms, which are either pseudohyphae or true hyphae. There are over 150 species of Candida, but only 10 are significant pathogens for humans. These species include C. albicans, C. glabrata (formerly Torul-opsis glabrata), C. parapsilosis, C. krusei, C. guiller-mondii, C. Stellatoidea (now considered C. albicans), C. tropicalis, C. pseudotropicalis, C. lusitaniae and C. rugosa. Of these, C. albicans is the primary pathogen for humans. Candida can produce a wide variety of human infections that can be generally divided into superficial and deep infections. Superficial Candida infections involve skin, nails or mucous membranes of the mouth and vagina. Deep Candida infections include candidemia, localized infections of various deep tissues, and...

Integrating Bcpd With Other Alternatives

Infiltration of apples with calcium chloride alone reduced blue mold decay by approximately half (Conway and Sams 1983), but in combination with the antagonist, P. syringae, resulted in greater reduction of fruit decay than either treatment alone (Janisiewicz et al. 1998). The effects of calcium treatment were greatest on more mature fruit, inoculated after 3 or 6 months in storage, when the effectiveness of biocontrol declines (Conway et al. 1999). Combining biocontrol with a calcium treatment complements each other to overcome the shortcomings of each, and may allow for reduced amounts of both products to be used without compromising decay control. In addition, applying lower calcium concentrations would reduce potential calcium injury, while maintaining other benefits, including alleviating storage maladies, such as bitter pit. The addition of calcium chloride to the yeast antagonist Candida sp. also improved control of blue mold and gray mold on apples (McLaughlin et al. 1990...

Natural Remedy For Yeast Infections

Natural Remedy For Yeast Infections

If you have ever had to put up with the misery of having a yeast infection, you will undoubtedly know just how much of a ‘bummer’ it is.

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