M.D. in 1990, Ph.D. in 1997, works part-time as principal investigator and part-time as routine mycologist in University Hospital.
My aim is to work for rapid translation of new scientific knowledge into clinical microbiology practice for the benefit of patient. I also strive to supplement this translational research by basic research focused on medically relevant topics in yeasts. Individual topics pursued are as follows:
Hypoxia-response in Cryptococcus neoformans Ability to adapt to oxygen limitation was identified as a signal for unbudded G2-arrest in this obligate aerobic pathogenic yeast. Furthermore, a role of hypoxia response in cryptococcal virulence has emerged recently. Therefore, we focus on characterisation of cryptococcal hypoxia response useful for development of a cultivating system that should serve as a model for cryptococcal growth in human tissue.
Identification and typing of medically relevant yeasts Recently, the technology of high resolution melting analysis of double-stranded DNA (typically PCR amplicons) is gradually more affordable to routine clinical microbiology laboratories. Therefore, we focus on developing competitive amplification systems which should best cover the whole spectrum of medically important yeast, enabling for their rapid species identification and possibly also strain typing in a convenient automated or semi-automated way. The McRAPD and PCR-HRMA approaches are at the center of our efforts, including development of multi-purpose software QAS useful for quantitative comparison of complex melting data (melting curves).
Abstract: BACKGROUND: Cryptococcus neoformans is an obligate aerobic pathogenic yeast causing lung infection typically followed by spread to the central nervous system. During pathogenesis, it relies on well-established virulence factors. This review focuses on the emerging role of cryptococcal adaptation to hypoxia in pathogenesis. METHODS AND RESULTS: We examined the MedLine database for information on the cryptococcal hypoxia response. While several recent papers describe components of two presumable hypoxia-sensing pathways including description of their target genes, a link of this system to the hypoxic tuning of proliferation is still missing. In addition, an interpretation of this knowledge in respect to the general picture of microbial pathogenesis is lacking. CONCLUSIONS: There seems to be a striking parallel between biofilm formation in bacteria, which results in chronic dormant infection with the potential for acute outbreaks, and the dormant state of primary infection followed by secondary outbreaks in C. neoformans. We propose a hypothesis that cryptococcal response to hypoxia might be the driving force for developing a state of dormant infection which is characterized by slowed proliferation and extensive changes in transcriptome and phenotype. This state enables C. neoformans to survive in host and possibly develop life-threatening acute outbreaks later. Hence, conventional well-aerated planktonic culture is not a good in vitro model for studying the pathogenesis of infection and we advocate the development of a more adequate model. Our further conclusion is that the ability of the immune system and antifungal agents to cope with hypoxia-adapted cells is crucial for the successful eradication of cryptococcal infection.
Abstract: Cryptococcus neoformans was grown in 96-well microtiter plates sealed by foil which is less than 0.01 % permeable to oxygen. On day 14 of the cultivation, we observed peculiar clusters of small droplike daughter cells arranged around < or = 4 % of mother cells. The fact that most of the other cells had died indicates that few cells had been able to survive hypoxic conditions and escape the cell-cycle arrest. However, their daughters were unable to separate from them and to continue their proliferation under such conditions.
Abstract: Growth patterns of Cryptococcus neoformans submerged culture in different culture volumes, intensity of agitation and types of sealing were evaluated to better understand the physiological role of hypoxia response in this yeast. When low intensity agitation was set at high culture volumes and air exchange between the cultivation vessel and external environment was not abolished completely, the cells proliferated slowly but steadily. On the other hand, when the intensity of agitation was high but the vessel was withheld from fresh air supply, the cells first proliferated rapidly, then arrested completely and finally died. Therefore, the central strategy of C. neoformans here seems to lie in its proliferation-rate adjustment to the available oxygen levels and not in its capacity to survive under anoxia. The data support the opinion that the cultures grown under limited aeration (even though not completely withheld from fresh air supply) are much closer to the real cryptococcal life in human tissues than conventional well-aerated exponential cultures.
Abstract: ABSTRACT: BACKGROUND: Rapid, easy, economical and accurate species identification of yeasts isolated from clinical samples remains an important challenge for routine microbiological laboratories, because susceptibility to antifungal agents, probability to develop resistance and ability to cause disease vary in different species. To overcome the drawbacks of the currently available techniques we have recently proposed an innovative approach to yeast species identification based on RAPD genotyping and termed McRAPD (Melting curve of RAPD). Here we have evaluated its performance on a broader spectrum of clinically relevant yeast species and also examined the potential of automated and semi-automated interpretation of McRAPD data for yeast species identification. RESULTS: A simple fully automated algorithm based on normalized melting data identified 80% of the isolates correctly. When this algorithm was supplemented by semi-automated matching of decisive peaks in first derivative plots, 87% of the isolates were identified correctly. However, a computer-aided visual matching of derivative plots showed the best performance with average 98.3% of the accurately identified isolates, almost matching the 99.4% performance of traditional RAPD fingerprinting. CONCLUSION: Since McRAPD technique omits gel electrophoresis and can be performed in a rapid, economical and convenient way, we believe that it can find its place in routine identification of medically important yeasts in advanced diagnostic laboratories that are able to adopt this technique. It can also serve as a broad-range high-throughput technique for epidemiological surveillance.
Abstract: Pichia fabianii, a yeast rarely causing human infections, was isolated from the blood of a patient with aortic valve endocarditis. The isolates were initially identified biochemically as Candida pelliculosa, but based on direct sequencing of the ITS2 region of rRNA, they were subsequently reidentified as P. fabianii. Antifungal therapy with fluconazole and later with voriconazole led to the development of resistant variants which had high MIC values to both antifungals. Strong biofilm formation by this yeast could also have played a role in the development of its resistance and allowed for its persistence on the infected valve during antifungal therapy. To our knowledge, this is the first published case of endocarditis and the fourth human infection caused by this yeast species.
Abstract: A rather fast and complicated progression of an infection caused by some strains of Staphylococcus aureus could be associated with the expression and co-action of virulence factor complexes in these strains. This study screened the antibiotic susceptibility and prevalence of virulence markers in isolates of meticillin-resistant S. aureus (MRSA) obtained from patients hospitalized at the University Hospital in Olomouc, Czech Republic. A total of 100 isolates was screened for 13 genes encoding extracellular virulence determinants (tst, pvl, eta, etb, sea, seb, sec, sed, see, seg, seh, sei and sej) and for their distribution in sample types. Eighty-nine isolates were positive for at least one of the genes. Genes for etb, pvl, see and seh were not detected in any of the MRSA isolates. No statistically significant differences in the occurrence of the determinants studied among sample types were found.
Abstract: Currently, invasive candidal infections represent an increasing cause of morbidity and mortality in seriously ill hospitalised patients. Because the accurate diagnosis of candidiasis remains difficult, a fast and reliable assay for characterization of fungal pathogens is critical for the early initiation of adequate antifungal therapy and/or for introduction of preventive measures. As novel molecular genetic techniques are continuously introduced, their role in the management of infectious diseases has also been growing. Today, molecular strategies complement conventional methods and provide more accurate and detailed insight. It can be expected that future technical development will improve their potential furthermore. In this article, we provide a critical review on the value and limitations of molecular tools in pathogenic Candida species identification and strain typing regarding their sensitivity, discriminatory power, reproducibility, cost and ease of performance.
Abstract: Despite advances in antifungal prophylaxis and therapy, morbidity and mortality incurred by yeasts remain a significant burden. As pathogenic yeast species vary in their susceptibilities to antifungal agents, clinical microbiology laboratories face an important challenge to identify them rapidly and accurately. Although a vast array of phenotyping and genotyping methods has been developed, these are either unable to cover the whole spectrum of potential yeast pathogens or can do this only in a rather costly or laborious way. Random amplified polymorphic DNA (RAPD) fingerprinting was repeatedly demonstrated to be a convenient tool for species identification in pathogenic yeasts. However, its wider acceptance has been limited mainly due to special expertise and software needed for analysis and comparison of the resulting banding patterns. Based on a pilot study, we demonstrate here that a simple and rapid melting curve analysis of RAPD products can provide data for identification of five of the most medically important Candida species. We have termed this new approach melting curve of random amplified polymorphic DNA (McRAPD) to emphasize its rapidity and potential for automation, highly desirable features for a routine laboratory test.
Abstract: Cryptococcus neoformans was grown first to OD 4 under moderate aeration, then diluted 2.5 times with fresh medium, and grown under limited aeration for 5 h. Oxygen concentration decreased from 5-6 mg l(-1) to 1.5 mg l(-1) 1 h after the shift to limited aeration, and remained at a similar level thereafter. In all the eleven strains examined the shift caused unbudded G(2)-arrest in more than half of the cells. In three strains more than 80% of the cells were arrested in unbudded G(2), and, therefore they were selected for synchrony experiments. After being shifted to extensive aeration again, the cells resumed growth by synchronous budding, followed by synchronous nuclear division. This method has turned out to be a good tool to prepare synchronized culture in C. neoformans, especially when a large amount of synchronized cells is needed. This is worthy of attention, since synchronous cultures after release from G(2)-arrest have not been reported yet in any yeast species.
Abstract: Production of secreted aspartate proteinases was determined in a set of 646 isolates of Candida and non-Candida yeast species collected from 465 patients of the University Hospital in Olomouc (Czechia) in the period 1995-2002, and Candida samples obtained from 64 healthy volunteers using solid media developed for this purpose. Using random amplified polymorphic DNA analysis (RAPD) 79 Candida isolates from blood were analyzed to show potential relationships between clustering of the fingerprints and extracellular proteolytic activity of these strains. C. albicans, C. tropicalis and C. parapsilosis possess always proteolytic activity while non-Candida species did not display any proteolysis. A tight relationship between fingerprints and extracellular proteolysis in the Candida isolates was not shown. A remarkable consistency between fingerprint clusters and proteolysis occurred in a subset of C. parapsilosis samples. Suboptimal pH of the growth medium was shown to facilitate the investigation of potential co-incidence of genotypic and phenotypic traits.
Abstract: A partial cDNA fragment of the Cryptococcus neoformans homologue of the main cell cycle control gene CDC28/cdc2 was isolated using degenerate primer RT-PCR. A subsequent search in the C. neoformans genome database identified several sequences similar to CDC28/cdc2. A part of the sequence which showed the highest similarity to CDC28/cdc2 turned out to be identical to the partial cyclin-dependent kinase (Cdk) cDNA fragment isolated by degenerate RT-PCR. The full-length coding region of this Cdk homologue was amplified by RT-PCR using primers designed to target regions around start and stop codons, and the gene was named CnCdk1. To determine its function, an analysis of deduced amino acid sequence of the CnCdk1 was performed and its ability to rescue Saccharomyces cerevisiae cdc28-temperature sensitive mutants was tested. S. cerevisiae cdc28-4 and cdc28-1N strains transformed with the pYES2- CnCdk1 construct exhibited growth at 36.5 degrees C in galactose-raffinose medium, but not in glucose medium. Results of the sequence analysis and the fact that CnCdk1 is able to complement the S. cerevisiae cdc28-ts mutation support its assumed role as the CDC28/cdc2 homologue in C. neoformans.
Abstract: We have developed a method for preparation of synchronous culture in Cryptococcus neoformans. The method is based on age fractionation of exponentially growing asynchronous culture through differential sedimentation in 10-20% (w/v) lactose gradient. C. neoformans capsule thickness should be reduced to a minimum to ensure most accurate age fractionation, which is necessary to obtain a higher degree of synchrony. The C. neoformans synchronous culture system has revealed important characteristics with respect to cellular morphology, DNA content and cell volume distribution. The method can be used for further cell cycle studies.
Abstract: Calcofluor-allied optical brightener Rylux BSU stimulated spore germination rate in Trichophyton mentagrophytes and Aspergillus fumigatus both if supplemented into Sabouraud glucose agar and if used for pretreatment of spore suspension prior to inoculation at low concentrations. Maximum stimulation of germination was obtained if 0.2% Rylux BSU was used for pretreatment in aqueous solution for 1 d prior to inoculation (130% in T. mentagrophytes and 150% in A. fumigatus, respectively). Pretreatment with 1% Rylux BSU provided strong protection against UV-irradiation and resulted in increased yields of cultural variants after UV-irradiation.
Abstract: Cryptococcus neoformans exhibited diphasic growth when grown under limited aeration. First, it grew exponentially, but at OD 1, the concentration of dissolved oxygen in culture decreased to 1 mg l(-1) and a second phase of slow growth was started. This phase was characterized by a shift of budding from S to G(2), a sharp decrease in budding index and a sharp increase in the proportion of unbudded G(2) cells to 80%. Thus, a deficit in oxygen was demonstrated to delay the timing of budding, prolong the G(2) phase and cause accumulation of cells after DNA synthesis, but before commitment to budding.
Abstract: Primary cell wall is synthesized in the growth zone of hyphal apex in fungi and rigidified during maturation along the newly formed hypha. Cross-linking of cell-wall components and self-assembly of individual polysaccharide chains into microfibrils are supposed to be involved in the rigidification process. We determined the relative chitin content in the cell wall of hyphal tips and distal walls of three fungal species and demonstrated a general increase in relative chitin content in mature cell walls. Thus, this increase can be supposed to raise cell-wall rigidity as the principal role of chitin in the determination of cell-wall rigidity is beyond doubt.
Abstract: We initially tested 20 primers for their ability to amplify genomic DNA of Trichophyton verrucosum using RAPD. Six of these were selected for further study aimed at discrimination of wild type and vaccination strains of T. verrucosum. The results indicate that RAPD successfully distinguished all strains included in the study. In addition, results of corrected cluster analysis were consistent with the fact that the avirulent vaccination strains (T. verrucosum TV-M9 and T. verrucosum TV-M-130) were prepared by ultraviolet (UV) light induced mutagenesis of the standard wild type strain T. verrucosum Strádznice. No marker for a/virulence was detected. These outcomes suggest new possibilities for epidemiological analyses, for discrimination among different vaccination strains and studies of fungal population in vaccinated/infected hosts.
Abstract: Rylux BSU and congo red bind to chitin, interfere with proper cell-wall assembly, and stimulate chitin synthesis by increasing, most probably, chitin synthase 3 (ChS3) levels in Saccharomyces cerevisiae. On the other hand, the antibiotic nikkomycin Z inhibits chitin synthesis competitively. As ChS3 is the critical target of nikkomycin Z, its effect was tested in cells inhibited in growth by Rylux BSU or Congo red. Nikkomycin Z counteracted this inhibition but did not counteract aberrant cell-wall formation. These results indicate that chitin synthesis stimulation is the key step in Rylux BSU and congo red inhibition and support the idea that increase in chitin synthesis represents a compensatory response to damaged cell-wall structure. As Rylux BSU and congo red bind to newly synthesized chitin, further damage is caused in the wall and the response works in this case contrariwise. Nikkomycin Z breaks this vicious circle by counteracting the chitin synthesis stimulation.
Abstract: The budding yeast Saccharomyces cerevisiae has long proved to be a very useful model in cell biology. Its cell morphology is established and maintained at least in part by the cell wall, a rigid but dynamic structure that affords mechanical protection. Although fungal cell walls represent an unique phenomenon, recent progress in research has shown striking parallels between yeast and mammalian cells in the area of cell morphogenesis and proliferation. Further studies promise to shed common light on the processes of cell morphogenesis including the intersections with proliferation control. This review focuses on the recent progress in this promising area in the yeast Saccharomyces cerevisiae. The process of cell wall synthesis in Saccharomyces cerevisiae was reviewed by several authors recently. Briefly, the cell wall represents a complex structure of cross-linked chitin, beta-(1,6)-d-glucan, beta-(1,3)-D-glucan and mannoproteins. Chitin and beta-(1,3)-D-glucan are synthesized by enzymatic complexes at the cell membrane and extruded into the periplasmic space, mannoproteins are synthesized along the yeast secretory pathway, and the site of beta-(1,6)-D-glucan synthesis is still unknown. The principal motif which interconnects individual cell wall constituents was recently identified by Kollár et al. The mechanisms of cross-linking of the polymers in the wall remain unknown, however. Recently, nevertheless, substantial progress has been achieved in understanding the signalling pathways which target the cell wall construction.
Abstract: In Basidiobolus ranarum an artificial cell dimorphism was found if cultivated in presence of Rylux BSU previously. We have found an increase of glucosamine content in purified cell walls of Basidiobolus ranarum grown in presence of Rylux BSU in SGA. The relative increase in glucosamine content did correspond with the increase of Rylux BSU present in SGA. The results are discussed with the conclusion that not only the chitin synthesis but also the mechanisms of polarized growth are influenced if Basidiobolus ranarum is cultivated in presence of Rylux BSU.
Abstract: The fluorescence brightener Rylux BSU (RBSU) showed an affinity for polysaccharide components of cell walls and accumulated in the extension zones of hyphal apices in Basidiobolus ranarum. It inhibited the polarized growth of mycelial hyphae and induced isotropic growth resulting in spherical thick-walled cells up to 456 microm in diameter. On the inner cell wall surface, massive protuberances were formed. The cell wall and protuberances were positive in PAS and the Grocott method and stained with fluorochromes Blankophor BA, Calcofluor, Uvitex 2B, Rylux BSU and FITC-labeled WGA- and ConA-lectins. The WGA-FITC fluorescence intensity of the wall's outermost layer, if not connected with neighbouring cells, and the fluorescence intensity of the innermost layer and of some protuberances mainly in their apical parts were on the average twice higher than the fluorescence intensity of the remaining wall material. RBSU binding to the cell wall material was stable. The process of converting from polarized to isotropic growth was reversible, depending upon contact with RBSU-containing medium. Repeated transfers of cells from RBSU-containing medium to an RBSU-free medium resulted in the development of apical swollen dumbbell-shaped cells.
Abstract: The authors describes a fluorescence microscopic method using fluorochrome Blankophor (Bayer) which binds to chitin of the cell walls of yeasts and filamentous fungi. The authors processed, using this method, 50 specimens of sputum and compared the results with those of cultivation examinations. In five instances, where cultivation was negative by the microscopic method large numbers of fungi were detected. The method is suitable for quantitative assessment of yeasts and other fungi in sputum and other clinical specimens (urine, irrigation of cavities etc.). The author discusses the interpretation of microscopic findings.
