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In this study, the antibiotic resistance pattern and the presence of genes encoding several virulence factors in 91 Enterococcus faecalis strains isolated from different human clinical sources in Sardinia were investigated. Genotypic determination of virulence genes (gelE, esp, agg, ace, cylA,B,M,L(L),L(S), efaA, fsrB) was carried out by PCR. The production of gelatinase and haemolytic activity were also determined. Antimicrobial susceptibility tests were performed by an automated microdilution test (Vitek). The strains examined in this study contained at least one and up to as many as all virulence genes investigated. Examining the distribution of these factors in the different groups of clinical strains, we found that all but one virulence determinant were detected more frequently among urinary isolates. The detection of some factors by PCR did not always correlate with its phenotypic expression. Antibiotic susceptibilities among the Enterococcus faecalis strains investigated in our study were typical for the species, with expected levels of acquired resistance. Faecal isolates had the highest percentage of resistance, especially to high level-gentamicin, ciprofloxacin and norfloxacin. In summary, a wide variety of genes encoding virulence factors have been detected among our clinical Enterococcus faecalis strains, and those isolated from UTI were characterized by a higher virulence potency compared with strains from other clinical sources. Silent virulence genes (cyl or gelE) were frequently detected, therefore both the genotypic and phenotypic assays seem necessary for a better characterization of the strains. Our results may serve as a basis for additional surveillance studies of infections caused by this microorganism.

Two hundred sixty three Candida isolates were obtained from specimens of patients hospitalized in a Intensive Care Unit. Candida albicans was the predominant species, followed by C. tropicalis, C. krusei, C. glabrata e C. parapsilosis. For C. albicans isolates, amphotericin B was the more efficient antifungal (2.3% of resistant strains), while voriconazole was the more efficient for C. krusei and C. glabrata, known for their lower susceptibility to fluconazole. RAPD-PCR technique with CDU primer was used for the molecular characterization of 48 C. albicans strains isolated from 10 patients. Genetic similarity at 90% level was observed for some Candida strains isolated from the same patient, indicating a possible colonization from the original strain. Moreover the high similarity coefficient observed between isolates from different patients may indicate an exogenous colonization originating from hospital-endemic strains or inadequate manipulation by health care workers.

Applicazioni dell'ecografia nella patologia del rene e nel trapianto renale

In recent years the measurement of mold spore concentrations in working environments where workers spend long periods of time has acquired considerable importance because of the diffusion of diseases caused by fungi. On this basis, the aim of the research was to evaluate the level of environmental fungal pollution and contamination by mites in three factories producing seasoned foods, i.e., hams, sausages and cheeses. We also studied the occurrence of fungal species in the upper respiratory tract of workers operating in the washing and brushing areas, which was compared with the environmental concentrations in these areas, where contamination with fungal spores was visibly high. The results showed high and widespread fungal pollution in most of the working environments sampled and a significant presence of the same species in the upper respiratory tract of the workers. The data obtained indicate that the environments sampled can constitute a possible health risk factor for workers.

The occurrence of pollens and molds in the atmosphere of Cagliari, Italy over a 3-year period (1986-88) is reported. Pollen grains are present in the air from February to July, with a maximum in May. Urticaceae and Cupressaceae were the major contributors to the total pollen airspora, followed by Graminaceae, Oleaceae, Pinaceae, Cheno-Amaranthaceae, and Fagaceae. Fungal spores showed two periods of high sporulation, from April to June and in September-October, and two marked decreases, during winter and August. Cladosporium was by far the most abundant spore identified, followed by Basidiomycetes, Alternaria, and Fusarium.

The hygienic level of the raw materials is prevailing in the determination of microbial quality of finished product in food production. Not all alimentary products have the same possibilities of being contaminated. They develop, with a series of intermediate passages, from products that can not be contaminated to products that can be easily attached from micro-organisms. It is essential to locate the points of possible pollution and monitor them with appropriate modalities for a good quality of finished products. The "starters" and "coagulants" of dairy industry may be carrier of microbial pollution if they are improperly handled during the processing and storage. 202 samples of starters and 128 of coagulants, produced by large and small industries have been examined in this work. Total viable count, total Coliforms, anaerobic bacteria and Yeasts have been determined. A quantitative valuation has been also carried out above the lactic bacteria in all samples of starters. The starters results have shown a clean quantitative difference between the industrial products and natural cultures about the lactic microflora value, as well as more high frequency of pollution in samples in which lactic acid bacteria were found below standard. Among the coagulants, no microbial pollution has been detected in the commercial enzymes, whereas serious hygienic problems have shown up in the "rennets"; they have also presented an high anaerobic bacteria number/gr. of product. According to the related data, the AA. think starters and coagulants can have not unfavourable influence on dairy production only is some hygienic operations requirements are followed in their preparation.

Fungal air spores can play a significant role in several allergic manifestations. Therefore, the identification of geographic areas of mould distribution could be helpful to the clinician, especially if associated with fungal air spore recording in homes or working environments of sensitized subjects, in determining the real clinical importance of sensitization to fungi. On this basis, we studied the occurrence of airborne fungi at two urban sites and at two rural sites in the South of Sardinia, from May 1987 to April 1988, using the gravity plate method. Our survey has pointed out a significant difference about the occurrence of airborne spores in the areas sampled. Spore concentrations were lower at the urban sites during all the survey period. On the whole 6319 fungal colonies belonging to 28 different genera have been found. Cladosporium, Alternaria, Penicillium and Aspergillus, represented by a range of species, were the most common fungi identified in all sites examined. Remarkable the incidence of Yeasts, represented by the genera Candida, Saccharomyces, Rhodotorula and Sporobolomyces. Aureobasidium, Stemphilium, Botrytis, Chaetomium, Mucor and Rhizopus have been found in all sites but they have not been steadily isolated during the survey. Several other genera have been found only sporadically. Our results seem to confirm that fungal air spores, because of its quantity and variety, can represent a serious problem for human health in Sardinia.

Over a three years period, 472 Candida isolates were obtained from specimens of patients hospitalized either in "at risk", Bone Marrow Transplant Unit and Intensive Care Unit, or in conventional wards, Pneumological Divisions of the "Binaghi" Hospital of Cagliari (Italy). Antifungal susceptibility profile to amphotericin B, voriconazole, fluconazole and ketoconazole was determined. Candida albicans was the predominant species while Candida krusei was the most frequent non-albicans species. C. krusei was significantly more common among Bone Marrow Transplant Unit and Intensive Care Unit than Pneumological Divisions patients (17.9% and 14.1% vs. 6.0%; p0.05). No significant differences were observed when the same distribution was analysed with regard to the other Candida species or when Bone Marrow Transplant Unit and Intensive Care Unit were compared. The profiles of susceptibility to the antifungal drugs among isolates from the different hospital wards showed no significant differences, even though most of MIC values were higher for Intensive Care Unit isolates compared to those for Bone Marrow Transplant Unit and Pneumological Divisions. For C. albicans isolates, amphotericin B was the more efficient antifungal (97.7% S), while fluconazole (6.1% R [Resistant] and 2.6% SDD [Susceptible Dose Dependent]) and ketoconazole (4.1% R and 3.2% SDD) showed the lowest activity. Voriconazole was the more efficient antimycotic for C. krusei (96.7% S) and Candida glabrata (100% S [Sensible]) isolates. This study has shown a significantly higher presence of non-albicans Candida in at risk wards as well as a decreased susceptibility to the older azoles (ketoconazole and fluconazole) among C. albicans isolates.