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Akos Somoskövi

Publications and source records attributed to Akos Somoskövi.

10 recordsLinked to original sources

Molecular epidemiology of drug-resistant tuberculosis in Hungary.

Sixty-eight drug-resistant Mycobacterium tuberculosis isolates (44.2% of all resistant cases) were analyzed by IS6110 restriction fragment length polymorphism fingerprinting and spoligotyping to provide a deeper insight into the status of drug-resistant tuberculosis in Hungary. A total of 54.4% of the drug-resistant cases and 75% of the multidrug-resistant cases could be clustered. Analysis of the spoligotyping patterns of the strains revealed a high rate (66.2%) of infection by the Haarlem genotype, while none of the patients were infected by the Beijing genotype. The magnitude and the dynamics of drug-resistant tuberculosis are underestimated in Hungary.

DNA Fingerprinting↗

[Tuberculosis due to multidrug resistant Mycobacterium tuberculosis Beijing genotype identified by DNA fingerprinting: the first case identified in Hungary].

In a 28 years old Mongolian woman in whom pulmonary tuberculosis was diagnosed a poly- and multidrug (isoniazid, rifampicin, pyrazinamide, ethambutol, streptomycin) resistant Mycobacterium tuberculosis was isolated from sputum in 2002. Since the patient was from a country with high tuberculosis incidence it was conceivable that she had been infected by a strain with primary resistance in Mongolia. In order to confirm the origin of the strain an IS6110-based DNA fingerprint test was performed on the isolate. The assay revealed that the isolated M. tuberculosis strain belonged to the so-called Beijing family which was never detected in Hungary before.

Adult↗

Laboratory diagnostic aspects of drug resistant tuberculosis.

Multi-drug resistant strains of Mycobacterium tuberculosis (MDR-TB) are present world wide, and in many areas constitute a serious threat to the efficacy of TB control programs. The most effective strategies to limit further spread of MDR-TB are rapid detection of drug resistance followed by prompt and effective therapy. Routine laboratory diagnosis of drug resistance in TB requires a viable, pure culture of M. tuberculosis. Use of liquid media has decreased the turn around time for susceptibility test results however, because of the slow growth of M. tuberculosis these assays can still take 10 to 14 days. Alternatively, an increased understanding of the molecular basis for resistance to the antituberculosis drugs can greatly contribute to further decreasing turn around time. Based on this information, more precise and rapid molecular testing can be developed and lead to more appropriate and timely treatment regimens. In this review, we discuss methods for, and problems encountered in, performing TB drug susceptibility assays. Descriptions of routine protocols will be followed by recent developments in molecular detection of drug resistance.

Animals↗

[Chronic necrotizing pulmonary aspergillosis in an immunocompromised patient].

A case with chronic necrotizing pulmonary aspergillosis that was mimicking the radiomorphology of malignant tumor was reported. The patient was admitted to hospital with progression of a left upper lobe infiltrate which was known and under regular observation for 8 years, and haemoptoe. Computer tomography scan showed a spiculated abnormality in the left upper lobe with mediastinal lymphadenomegaly. Based on this finding pulmonary malignancy was suspected and, therefore, the patient was referred to surgical intervention. The post surgical histology revealed aspergillus in the specimen. Since signs of vascular invasion could not be detected microscopically and the disease developed in immunocompromised patient (due to diabetes mellitus and long term steroid treatment) the clinical condition was determined as chronic necrotizing aspergillosis. It is very likely that the pathogen infected the patient during his daily work in a bakery. The present paper also summarizes the clinical aspects, differential diagnosis and therapy of different forms of pulmonary aspergillosis with emphasis on chronic necrotizing pulmonary aspergillosis.

Adrenal Cortex Hormones↗

Conventional and molecular epidemiology of tuberculosis in homeless patients in Budapest, Hungary.

In Hungary the incidence of tuberculosis among the homeless population was 676 per 100,000 in 2002. Sixty-nine percent (140 patients) of all homeless tuberculosis patients were notified in Budapest (the capital). Therefore, a retrospective study that included 66 homeless tuberculosis patients notified in Budapest in 2002 was conducted to determine the rate of recent transmission of the disease and medical risk factors and to identify transmission pathways by means of conventional and molecular epidemiologic methods. IS6110 DNA fingerprinting revealed that 71.2% of the isolates could be clustered. Thirty-four (51.5%) patients belonged to five major clusters (size, from 4 to 11 individuals), and 13 (19.7%) belonged to six smaller clusters. Additional analysis of patient records found that 2 (18%) of the 11 patients in cluster A, 3 (37.5%) of the 8 patients in cluster B, and 2 (33%) of the 6 patients in cluster C were residents of the same three homeless shelters during the diagnosis of tuberculosis. Review of the database of the National Tuberculosis Surveillance Center (NTSC) revealed that 21.2% of the cases have not been reported to the NTSC. These findings indicate that the screening and treatment of tuberculosis among the homeless need to be strengthened and also warrant the review of environmental control steps in public shelters. Improvement of adherence of clinicians to surveillance reporting regulations is also necessary.

Adult↗

[Treatment of bronchial asthma in pregnancy].

The prevalence of bronchial asthma, similarly to the normal population, is also increasing among pregnant women. Asthma a chronic inflammatory disease of the airways, is one of the most common medical problems that can complicate pregnancy. The cornerstone of asthma management in pregnancy is to implement such treatment strategies that can maintain normal maternal pulmonary function and prevent fetal complications. The aim of the present article is to summarize the recent publications and guidelines on the safety and efficacy issues of asthma treatment during pregnancy.

Administration, Inhalation↗

Pulmonary tuberculosis due to Mycobacterium bovis subsp. caprae in captive Siberian tiger.

We report the first case of pulmonary tuberculosis caused by Mycobacterium bovis subsp. caprae in a captive Siberian tiger, an endangered feline. The pathogen was isolated from a tracheal aspirate obtained by bronchoscopy. This procedure provided a reliable in vivo diagnostic method in conjunction with conventional and molecular tests for the detection of mycobacteria.

Animals↗

Rapid and simple approach for identification of Mycobacterium tuberculosis complex isolates by PCR-based genomic deletion analysis.

Although the virulences and host ranges differ among members of the Mycobacterium tuberculosis complex (TBC; M. tuberculosis, M. africanum, M. canettii, M. microti, M. bovis, and M. bovis BCG), commercially available molecular assays cannot differentiate these organisms because of the genetic identities of their 16S rRNA gene sequences. Comparative genomic analyses with the complete DNA sequence of M. tuberculosis H37Rv has provided information on regions of difference (RD 1 to RD 16) deleted in members of the TBC other than M. tuberculosis. To determine whether deletion analysis could accurately differentiate members of TBC, we used PCR to assess the presence or absence of specific regions of the genome in 88 well-characterized isolates of M. tuberculosis, M. africanum, M. microti, M. bovis, and M. bovis BCG. The identifications obtained by use of the specific deletion profiles correlated 100% with the original identifications for all TBC members except M. africanum, but further characterization resulted in profiles specific for all members. Although six RD regions were used in the analyses with the original 88 isolates, it was found that the use of RD 1, RD 9, and RD 10 was sufficient for initial screenings, followed by the use of RD 3, RD 5, and RD 11 if the results for any of the first three regions were negative. When 605 sequential clinical isolates were screened, 578 (96%) were identified as M. tuberculosis, 6 (1%) were identified as M. africanum, 8 (1%) were identified as M. bovis, and 13 (2%) were identified as M. bovis BCG. Since PCR-based assays can be implemented in most clinical mycobacteriology laboratories, this approach provides a rapid and simple means for the differentiation of members of TBC, especially M. bovis and M. tuberculosis, when it is important to distinguish between zoonotic sources (i.e., cattle and unpasteurized dairy products) and human sources of tuberculosis disease.

Animals↗

A population-based case-control study on the effect of bronchial asthma during pregnancy for congenital abnormalities of the offspring.

Bronchial asthma is one of the most common maternal diseases complicating pregnancy. We assessed the risks of congenital abnormalities in a case-control population-based analysis using the dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities between 1980 and 1996. Of the 22,843 cases with congenital abnormalities, 511 (2.2%) had mothers with bronchial asthma, while of the 38,151 matched control subjects without congenital abnormalities 757 (2.0%) had mothers with bronchial asthma (unadjusted prevalence odds ratios [POR] 1.2; 95% CI: 1.0-1.3). In all mothers with bronchial asthma, a higher incidence of respiratory tract infections and higher drug intake could be observed. In the case group of medically recorded bronchial asthma, a slightly increased risk for club foot has been revealed. However, this weak association could be explained by the higher proportion of preterm births in this group. The main limitation of the analysis was that at the time of data collection only a small proportion of pregnant mothers were using anti-asthma medications recommended by the actual guidelines.

Adult↗