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Acanthamoeba species are free-living amebae that can be found in almost every range of environments. Within this genus, numerous species are recognized as human pathogens, potentially causing Acanthamoeba keratitis (AK). AK is a corneal disease that is predominantly associated with contact lens use, the epidemiology of which is related to the specific genotype of Acanthamoeba. This study reports seven (7/16; 43.75%) positive cases. Detection of Acanthamoeba in corneal scrapings is based on cultivation and polymerase chain reaction (PCR) combined with the molecular taxonomic identification method. By PCR, seven samples were positive; cultivation was successful for five samples, probably because of the low quantity of samples. Genotype identification was carried out with a real-time fluorescence resonance energy transfer PCR assay based on sequence analysis of the 18S rRNA gene, and sensitivity and specificity were evaluated in comparison with traditional parasitological techniques. All seven detected Acanthamoeba strains belonged to the T4 genotype, the main AK-related genotype worldwide. These results confirmed the importance of a complete diagnostic protocol, including a PCR assay, for the clinical diagnosis of AK from human samples. Genotyping allowed the identification of all isolates in the T4 group, thus demonstrating the prevalence of this genotype in Hungary.

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Orvosi Hetilap
Authors: István Kucsera, Ildikó Vincze, József Danka, and Zsuzsanna Szénási

A tungiasis a homoki bolhának – Tunga penetrans (Linnaeus, 1758) – a gazda bőrébe behatoló nősténye által okozott bőrbetegség. Esetismertetés : 39 éves férfi beteg 2005 májusában jelentkezett vizsgálatra a bal láb I. ujján kialakult elváltozás miatt a Szent Rókus Kórház Bőr- és Nemibeteg Gondozójában (Budapest). A lábon jelentkező elváltozás keletkezésekor Brazíliában, a tengerparton tartózkodott, ahol gyakran sétált mezítláb a homokban. Ott-tartózkodása 6–7. napján, a bal láb I. ujján, kb. 6–7 mm átmérőjű, szélén vizenyős, középen barna pontozottságot mutató elváltozást észlelt. Vizsgálatkor a bal láb I. ujjának mediális felszínén 6 mm átmérőjű, kiemelkedő, klinikailag pustulának tűnő elváltozás volt látható, kb. 2 mm-es hyperaemiás szegéllyel. Az elváltozás megnyitásakor határozott nyomásra kb. 4 mm átmérőjű fehéres színű, nem feszes falú tok buggyant elő. A féreggyanús képletet az Országos Epidemiológiai Központ Parazitológiai Osztályán (Budapest) Tunga penetrans ként azonosították. Következtetés: Esetismertetésünkkel a hazai szakemberek figyelmét kívánjuk felhívni erre a Magyarországra is behurcolható egzotikus betegségre. Tudomásunk szerint ez Magyarországon az első diagnosztizált behurcolt humán tungiasis eset.

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Simple real-time PCR assay with one set of primer and probe for rapid, sensitive qualitative and quantitative detection of Entamoeba histolytica has been used. Consensus sequences were used to amplify a species-specific region of the 16S rRNA gene, and fluorescence resonance energy transfer hybridization probes were used for detection in a LightCycler platform (Roche). The anchor probe sequence was designed to be a perfect match for the 16S rRNA gene of Entamoeba species, while the acceptor probe sequence was designed for Entamoeba histolytica, which allowed differentiation. The performed characteristics of the real-time PCR assay were compared with ELISA antigen and microscopical detection from 77 samples of individuals with suspected clinical diagnosis of imported E. histolytica infection. Stool and liver abscess pus samples were examined with analytical sensitivity of 5 parasites per PCR reaction. The melting curve means Tms (standard deviation) in clinical isolates were 54°C. The real-time assay was 100% sensitive and specific for differentiation of Entamoeba histolytica, compared with conventional ELISA or microscopy. This real-time PCR assay with melting curve analysis is rapid, and specific for the detection and differentiation of Entamoeba histolytica. The suitability for routine use of this assay in clinical diagnostic laboratories is discussed.

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Acta Microbiologica et Immunologica Hungarica
Authors: Zorica Lepšanović, Dolores Opačić, Srđan Lazić, Mária Herpay, Szilárd Tóth, Mirjana Kostić, and István Kucsera

Shiga toxin-producing Escherichia coli (STEC) strains of O157:H7 serotype are a predominant cause of haemolytic uraemic syndrome (HUS) worldwide, but strains of non-O157 serotypes can also be associated with serious disease. Some of them are associated with outbreaks of HUS, others with sporadic cases of HUS, and some with diarrhoea but not with outbreaks or HUS. A large number of STEC serotypes isolated from ruminants and foods have never been associated with human disease. In this study we characterize a STEC strain belonging to serotype O171:H25 that is responsible for a case of HUS. This strain has a single Shiga toxin gene encoding Stx2 toxin, and hlyA gene, but is eae-negative.

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The transmission route of giardiasis not yet understood and why some infected individuals remain asymptomatic while others become quite ill. The drinking water quality is supposedly responsible for the prevalence of asymptomatic Giardia duodenalis infections in different areas, therefore asymptomatic giardiasis has been investigated in three water supply areas of Hungary: three hundred stool samples from inhabitants of Budapest, Füzér and Mátrafüred were examined by immunological and molecular methods for the presence of G. duodenalis infections. Individuals were asked to fill out a validated questionnaire at the time of stool collection and the interview covered demographic data, family life, education and travel history.In Budapest and in Mátrafüred in one stool sample G. duodenalis Assemblage A, whereas in Füzér once G. duodenalis Assemblage A, once Assemblage B and twice mixed infection were detected. We found higher prevalence rate of 4% of G. duodenalis infections of asymptomatic people in the village Füzér, where the removal of the Giardia cysts of the drinking water treatment plant was not effective. This study throws a light the need to look into the possibility of other risks of Giardia infections such as water transmission routes. To our knowledge, this is the first study evaluating the prevalence of G. duodenalis infections in asymptomatic persons in Hungary.

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Acta Microbiologica et Immunologica Hungarica
Authors: Erika Orosz, Nóra Szentmáry, Huba J. Kiss, Ágnes Farkas, István Kucsera, and Zoltán Zsolt Nagy

Acanthamoeba has a worldwide distribution in the environment and it is capable of causing a painful sight-threatening disease of the cornea designated as Acanthamoeba keratitis (AK). Nowadays, the cases of AK have surged all over the world along with its disease burden due to increasing use of contact lenses used not only for optical correction but also for cosmetic purposes. In our present work, epithelial abrasion of a 27-year-old female soft contact lens wearer with keratitis was examined. Genotype identification was carried out with a real-time fluorescence resonance energy transfer polymerase chain reaction (PCR) assay based on sequence analysis of the 18S rRNA gene. Genotyping allowed the identification of a T8 group isolate. The analysis confirmed the importance of a complete diagnostic protocol, including a PCR assay, for the clinical diagnosis of AK from human samples. Acanthamoeba T8 should be considered as potential causative organism in keratitis in human.

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Acta Microbiologica et Immunologica Hungarica
Authors: Erika Orosz, Ágnes Farkas, László Ködöböcz, Péter Becságh, József Danka, István Kucsera, and György Füleky

Acanthamoeba species are free-living amoebae that can be found in almost every range of environments. Within this genus, a number of species are recognized as human pathogens, potentially causing Acanthamoeba keratitis, granulomatous amoebic encephalitis, and chronic granulomatous lesions. Soil and water samples were taken from experimental station at Julianna Major of Plant Protection Institute of Centre for Agricultural Research, Hungarian Academy of Sciences (CAR HAS). We detected living Acanthamoeba spp. based on culture-confirmed detection combined with the molecular taxonomic identification method. Living Acanthamoeba spp. were detected in thirteen (65%) samples. The presence of Acanthamoeba spp. in the samples depends significantly on the rhizosphere plants. The most frequently identified living Acanthamoeba genotype was T4 followed by T11, T2/T6 and T17. Genotypes T4 and T11 of Acanthamoeba, are responsible for Acanthamoeba keratitis as well as granulomatous amoebic encephalitis, and should therefore be considered as a potential health risk associated with human activities in the environment.

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Orvosi Hetilap
Authors: Réka Andó, Kornél Dános, Lili Lakatos, Péter Fritz, István Kucsera, and László Tamás

Absztrakt:

A dirofilariosis egy élősködő fonalféreg által okozott fertőző betegség. Az emberi fertőzésekért – szúnyog csípésével közvetítetten – többnyire a Dirofilaria repens felelős, az eredeti behatolás közvetlen környezetétől nem messze kialakuló bőrdirofilariosist okozva (csomót). Az utóbbi időben az emberen észlelt dirofilariosis növekvő tendenciát mutat.

Esetismertetésünkben egy 35 éves nőbeteg néhány hete tartó halántéktáji fájdalmának és duzzanatának hátterében a bőr alatti zsírszövetbe és részben a temporalis izomba ágyazott fonalférget igazoltunk. A hosszas kivizsgálás alatt több lehetséges diagnózis is felmerült: orbánc, kezdődő herpes zoster fertőzés, arteritis temporalis. A végső eredményt a halántékrégió ultrahangvizsgálata szolgáltatta, mely helminthiasist véleményezett. Infektológus javaslatára sebészi feltárás és az elváltozás eltávolítása történt, melynek feldolgozása során egy nőstény fonalféreg igazolódott. Orv Hetil. 2018; 159(45): 1844–1847.

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Acta Microbiologica et Immunologica Hungarica
Authors: Katalin Glatz, József Danka, Zsuzsanna Tombácz, Tivadar Bányai, Andrásné Szilágyi, and István Kucsera

In a small village of Hungary, a human trichinellosis outbreak (affecting eight people) occurred in January–February, 2009. In the outbreak investigation (i) Trichinella spiralis larvae were detected in meat products derived from the pigs slaughtered in the backyard of one of the patients (a foxhunter) in December 2008, and in a brown rat captured in the same backyard; (ii) sera of 24 pigs held in 11 yards of the village and that of some dogs of the foxhunter were found Trichinella-positive; (iii) sera of five villagers who could not be infected in the particular outbreak were also found reactive in Trichinella-specific laboratory tests. The followings helped the rise of an outbreak: the geographical position and the presence of empty houses favoured the multiplication of rats; there was no extermination of rats in the previous years; there was no meat inspection; raw meat and improperly processed meat products were tasted at the pig-slaughter; villagers gave tastes to each other. People were informed on the symptoms, the way of transmission, and the possibilities of prevention of trichinellosis by experts. With the help of local authorities, all the properties including the grounds with empty houses were involved in the extermination of rodents.

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Orvosi Hetilap
Authors: Alexandra Juhász, Ádám Dán, Béla Dénes, István Kucsera, József Danka, and Gábor Majoros

Absztrakt

Az állatokban sok mételyfaj él, amelyek lárvája a gazda bőrén keresztül fertőzi azt. Ezek közül az ember szempontjából a legfontosabbak az emlősök vérmételyei, mert belőlük kerülnek ki az embert fertőzni képes vérmételyek is. Több fajuk a trópusi országok lakóinak rettegett schistosomosisát okozza, míg más fajok behatolnak ugyan az ember bőrébe, de adulttá nem válnak a testében. A mérsékelt égövben főleg az utóbbi, bőrgyulladás formájában jelentkező infekció fordul elő. A mételylárvák eredete legtöbbször nem tisztázható, ezért általában sem orvosok, sem állatorvosok nem foglalkoznak a fertőzés forrásával. Szarvasokban élő mételyfajról bizonyítottuk be, hogy a régen „vízi rühösség”-nek nevezett bőrbántalmat csigákból kirajzó cercariák okozzák. A Duna egyik árterén endemikus Schistosoma turkestanicum okozta dermatitis ritkán kerül orvos szeme elé, pedig informális közlések alapján úgy tűnik, hogy rendszeresen előforduló tünet a métely élőhelyén lévő vizekben halászó vagy fürdőző embereken. Ráutaló kórelőzmény esetén indokolt a humán vérmétely-fertőzöttséghez hasonló szerológiai reakciót adó cercaria dermatitis eredetét kivizsgáltatni. Orv. Hetil., 2016, 157(40), 1579–1586.

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