Clinical effectiveness of posaconazole versus fluconazole as antifungal prophylaxis in hematology-oncology patients: a retrospective cohort study.

In preventing invasive fungal disease (IFD) in patients with acute myelogenous leukemia (AML) or myelodysplastic syndrome (MDS), clinical trials demonstrated efficacy of posaconazole over fluconazole and itraconazole. However, effectiveness of posaconazole has not been investigated in the United States in real-world setting outside the environment of controlled clinical trial. We performed a single-center, retrospective cohort study of 130 evaluable patients ≥18 years of age admitted to Duke University Hospital between 2004 and 2010 who received either posaconazole or fluconazole as prophylaxis during first induction or first reinduction chemotherapy for AML or MDS. The primary endpoint was possible, probable, or definite breakthrough IFD. Baseline characteristics were well balanced between groups, except that posaconazole recipients received reinduction chemotherapy and cytarabine more frequently. IFD occurred in 17/65 (27.0%) in the fluconazole group and in 6/65 (9.2%) in the posaconazole group (P = 0.012). Definite/probable IFDs occurred in 7 (10.8%) and 0 patients (0%), respectively (P = 0.0013). In multivariate analysis, fluconazole prophylaxis and duration of neutropenia were predictors of IFD. Mortality was similar between groups. This study demonstrates superior effectiveness of posaconazole over fluconazole as prophylaxis of IFD in AML and MDS patients. Such superiority did not translate to reductions in 100-day all-cause mortality.

A polysaccharide extracted from sphagnum moss as antifungal agent in archaeological conservation

On the basis of the well-known preservative properties of Sphagnum moss, a potential opportunity to use moss polysaccharides (Sphagnan) in art conservation was tested. Polysaccharides were extracted from the moss (S. palustre spp.) in the amount of 4.1% of the Sphagnum plant dry weight. All lignocelluloses were removed from this extract as a result of the treatment of the moss cellulose with sodium chlorite. The extracted polysaccharide possessed a strong acidic reaction (pH 2.8) and was soluble in water and organic solvents. The extract was tested on laboratory bacterial cultures by the disk-diffusion method. The antibacterial effect was demonstrated for E. coli and P. aeruginosa (both gram-negative) while Staphylococcus aurelus (gram-positive) was shown to be insensitive to Sphagnum polysaccharides. The antifungal effect of Sphagnum extract was tested by the disk-diffusion method on the spores of seventeen fungal species. These fungi were isolated from ethnographic museum objects and from archaeological objects excavated in the Arctic. Twelve of these isolates appeared susceptible to the extract. The inhibiting effect of the extract was also tested by the modified broth-dilution method on the most typical isolate (Aspergillus spp.). In this experiment, in one ml of the nutritious broth, 40µl of 3% solution of polysaccharides in water killed 10,000 fungal spores in 6 hours. The inhibiting effect was not connected to the acidity or osmotic effect of Sphagnum polysaccharides. As an example of the application of Sphagnum polysaccharides in art conservation, they were added as preservative agents to conservation waxes. After three weeks of exposure of microcrystalline wax to test fungi (Aspergillus spp.), 44% of wax was consumed. When, however, ~ 0.1% (w/w) of Sphagnum extract was mixed with wax, the weight loss of wax was only 4% in the same time interval. On the basis of this study it was concluded that Sphagnum moss and Sphagnum products can be recommended for use in art conservation as antifungal agents.

Impact of antibiotics on conjugational resistance gene transfer in Staphylococcus aureus in sewage.

Ohlsen K, Ternes T, Werner G, Wallner U, Löffler D, Ziebuhr W, Witte W, Hacker J. Institute for Molecular Biology of Infectious Diseases, The University of Würzburg, Röntgenring 11, D-97070 Würzburg, Germany. knut.ohlsen@mail.uni-wuerzburg.de The growing rate of microbial pathogens becoming resistant to standard antibiotics is an important threat to public health. In order to assess the role of antibiotics in the environment on the spread of resistance factors, the impact of subinhibitory concentrations of antibiotics in sewage on gene transfer was investigated using conjugative gentamicin resistance (aacA-aphD) plasmids of Staphylococcus aureus. Furthermore, the concentration of antibiotics in hospital sewage was measured by high-performance liquid chromatography (HPLC)-electrospray tandem mass spectrometry. Several antibiotics were found to be present in sewage, e.g. ciprofloxacin up to 0.051 mgl(-1) and erythromycin up to 0.027 mgl(-1). Resistance plasmid transfer occurred both on solidified (dewatered) sewage and in liquid sewage in a bioreactor with a frequency of 1.1x10(-5)-5.0x10(-8). However, low-level concentrations of antibiotics measured in sewage are below concentrations that can increase plasmid transfer frequencies of gentamicin resistance plasmids of staphylococci.

First report of a novel plant lysozyme with both antifungal and antibacterial activities.

A novel lysozyme exhibiting antifungal activity and with a molecular mass of 14.4 kDa in SDS–polyacrylamide gel electrophoresis was isolated from mung bean (Phaseolus mungo) seeds using a procedure that involved aqueous extraction, ammonium sulfate precipitation, ion exchange chromatography on CM-Sephadex, and high-performance liquid chromatography on POROS HS-20. Its N-terminal sequence was very different from that of hen egg white lysozyme. Its pI was estimated to be above 9.7. The specific activity of the lysozyme was 355 U/mg at pH 5.5 and 30 °C. The lysozyme exhibited a pH optimum at pH 5.5 and a temperature optimum at 55 °C. It is reported herein, for the first time, that a novel plant lysozyme exerted an antifungal action toward Fusarium oxysporum, Fusarium solani, Pythium aphanidermatum, Sclerotium rolfsii, and Botrytis cinerea, in addition to an antibacterial action against Staphylococcus aureus.