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Wu C.-J.,National Health Research Institute | Wu C.-J.,National Cheng Kung University | Lee H.-C.,National Cheng Kung University | Yang Y.-L.,Institute of Molecular Medicine and Bioengineering | And 15 more authors.
Clinical Microbiology and Infection | Year: 2012

To understand the status of oropharyngeal yeast colonization in human immunodeficiency virus (HIV) -infected outpatients in the era of highly active antiretroviral therapy (HAART), we conducted a prospective, cross-sectional study from October 2009 to January 2010 at a medical centre in southern Taiwan. Fungal cultures of the oropharyngeal swabs were performed on 327 enrolled patients. At enrolment, 258 (79%) patients had been receiving HAART, and 42 (12.8%), 73 (22.3%) and 212 (64.8%) patients had CD4 cell counts ≤200, 201-350, and >350 cells/mm 3, respectively. Oral yeast colonization was detected in 193 (59%) patients, among whom 157 (81.3%), 25 (13.0%), and 11 (5.7%) were colonized by a single, two and more than two species, respectively. Multivariate analysis showed that receipt of efavirenz-containing regiments and CD4 cell counts >200 cells/mm 3 were associated with lower risks of oral yeast colonization, while intravenous drug users were at a higher risk. Among the 241 isolates recovered, Candida albicans accounted for 69.7%, followed by C. dubliniensis (9.5%), C. glabrata (8.3%), C. tropicalis (3.3%), C. intermedia (2.1%), C. parapsilosis (1.7%), and 11 other species (5.4%). Overall, 230 (95.4%), 236 (97.9%) and 240 (99.6%) isolates were susceptible to fluconazole, voriconazole and amphotericin B, respectively. In conclusion, colonization by C. dubliniensis has emerged in recent years. In addition to a CD4 cell count ≤200cells/mm 3, which is a known risk factor for oropharyngeal yeast colonization in HIV-infected patients that was identified in our previous studies, two risk factors, non-receipt of efavirenz-based combinations and intravenous drug use, were first identified in the present study. Fluconazole remained effective in vitro against the yeasts colonizing the oropharynx in this population. © 2011 European Society of Clinical Microbiology and Infectious Diseases.

Chen C.-H.,Institute of Molecular Medicine and Bioengineering | Lin Y.-L.,Institute of Molecular Medicine and Bioengineering | Liu Y.-K.,Institute of Molecular Medicine and Bioengineering | He P.-J.,National Chiao Tung University | And 8 more authors.
International Journal of Nanomedicine | Year: 2012

The aim of vaccination is to induce appropriate immunity against pathogens. Antibody-mediated immunity is critical for protection against many virus diseases, although it is becoming more evident that coordinated, multifunctional immune responses lead to the most effective defense. Specific antibody (Ab) isotypes are more efficient at protecting against pathogen invasion in different locations in the body. For example, compared to other Ab isotypes, immunoglobulin (Ig) A provides more protection at mucosal areas. In this study, we developed a cationic lipopolymer (liposome-polyethylene glycol-polyethyleneimine complex [LPPC]) adjuvant that strongly adsorbs antigens or immunomodulators onto its surface to enhance or switch immune responses. The results demonstrate that LPPC enhances uptake ability, surface marker expression, proinfammatory cytokine release, and antigen presentation in mouse phagocytes. In contrast to Freund's adjuvant, LPPC preferentially activates Th1-immunity against antigens in vivo. With lipopolysaccharides or CpG oligodeoxynucleotides, LPPC dramatically enhances the IgA or IgG2A proportion of total Ig, even in hosts that have developed Th2 immunities and high IgG1 serum titers. Taken together, the results demonstrate that the LPPC adjuvant not only increases the immunogenicity of antigens but also modulates host immunity to produce an appropriate Ab isotype by combining with immunomodulators. © 2012 Chen et al.

Yang Y.L.,Institute of Molecular Medicine and Bioengineering | Yang Y.L.,National Chiao Tung University | Leaw S.N.,National Health Research Institute | Wang A.H.,National Health Research Institute | And 4 more authors.
Medical Mycology | Year: 2011

Opportunistic yeast pathogens may switch from harmless commensal to pathogenic relationships with the host under different conditions. They usually cause superficial infections, but may be the agents of more significant infections in immunocompromised patients. To investigate yeast colonization in the oral cavities of clinically healthy individuals, we collected oral swabs from 323 students and staff at the National Health Research Institutes, Taiwan. A total of 49 (15.2%) volunteers were colonized by low levels of yeasts and of these, only 3 (6.1%) were co-colonized by more than one species. Among the 52 isolates, comprising seven fungal genera and 13 species, Candida albicans (57.7%) was the dominant species, followed by Candida parapsilosis (15.4%). There was only one isolate of C. parapsilosis that showed, in vitro, a high (2 μg/ml) minimum inhibitory concentration (MIC) to amphotericin B. There were six (11.5%) isolates with fluconazole MICs ≥ 64 μg/ml and all of them were non-Candida species. With the exception of Cryptococcus albidus, the remaining five isolates had voriconazole MICs ≥ 4 μg/ml. In addition, there was one C. albicans isolate with relatively high fluconazole (32 μg/ml) and voriconazole (4 μg/ml) MICs. © 2011 ISHAM.

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