Killer systems and pathogenic fungi

Biotyping of Candida albicans and other fungi by yeast killer toxins sensitivity

Intraspecific differentiation of pathogenic microorganisms is a major need in epidemiological studies concerning the source and spread of infections. This requirement is paramount for those etiologic agents of infectious diseases, which are mainly grouped into one species within the genus, such as Candida albicans. Ideally, laboratory methods for biotyping purposes should be sensitive, reproducible, easy, and economical to perform. In addition, the methods should be flexible in their application to taxonomically unrelated pathogens. We have shown that the toxins produced by a selected panel of killer yeasts, each characterized by a wide spectrum of antimicrobial activity, may be used to discriminate strains belonging to the species of the genus Candida and to other species of eukaryotic and prokaryotic pathogenic microorganisms. The "yeast killer system," which may be sharply increased in sensitivity by addition of further standardized killer yeasts, has proven to be of value in the resolution of many cases of clinical and nosocomial fungal infections. Owing to its reliability, economy, and versatility, this phenotypic system can be used as an alternative biotyping method in laboratories lacking the financial and training resources necessary to perform more sophisticated and expensive molecular approaches.

Epidemiological and clinical aspects of mycoses in patients with AIDS-related pathologies

Mycological, cultural and/or serological studies were performed on 98 patients hospitalized in the Department of Infectious Diseases of the Catholic University in Rome with diagnoses of acquired immune deficiency syndrome (AIDS) or AIDS-related complex (ARC) diseases. The incidence of mycoses was evaluated by retrospectively analyzing the results of mycological examinations and comparing them with clinical manifestations. The presence of concomitant bacterial, viral and parasitic infections was also examined. For epidemiological purposes, the study was extended to include the biotyping of all yeasts isolated from patients hospitalized between September 1988 and February 1989 in the same Department. Antimycotic susceptibility was also determined for the first yeast isolate obtained from each of these patients. Oral candidiasis (50 cases) caused by Candida albicans was the most frequent mycosis, followed by esophageal candidiasis (13 cases) and cryptococcosis (6 cases). Four out of the 6 cryptococcosis patients had meningeal involvement. Systemic candidiasis (2 cases) and aspergillosis (1 case) were less common. Biotyping of yeasts isolated between September 1988 and February 1989 with the killer system revealed type 377 to be the most common among the C. albicans isolates. It represented 70% of all the yeasts isolated.