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Spectrum and the In Vitro Antifungal Susceptibility Pattern of Yeast Isolates in Ethiopian HIV Patients with Oropharyngeal Candidiasis. Int J Microbiol 2016; 2016:3037817. [PMID: 26880925 PMCID: PMC4736391 DOI: 10.1155/2016/3037817] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 12/15/2015] [Indexed: 11/22/2022] Open
Abstract
Background. In Ethiopia, little is known regarding the distribution and the in vitro antifungal susceptibility profile of yeasts. Objective. This study was undertaken to determine the spectrum and the in vitro antifungal susceptibility pattern of yeasts isolated from HIV infected patients with OPC. Method. Oral pharyngeal swabs taken from oral lesions of study subjects were inoculated onto Sabouraud Dextrose Agar. Yeasts were identified by employing conventional test procedures and the susceptibility of yeasts to antifungal agents was evaluated by disk diffusion assay method. Result. One hundred and fifty-five yeast isolates were recovered of which 91 isolates were from patients that were not under HAART and 64 were from patients that were under HAART. C. albicans was the most frequently isolated species followed by C. glabrata, C. tropicalis, C. krusei, C. kefyr, Cryptococcus laurentii, and Rhodotorula species. Irrespective of yeasts isolated and identified, 5.8%, 5.8%, 12.3%, 8.4%, 0.6%, and 1.3% of the isolates were resistant to amphotericin B, clotrimazole, fluconazole, ketoconazole, miconazole, and nystatin, respectively. Conclusion. Yeast colonization rate of 69.2% and 31% resistance to six antifungal agents was documented. These highlight the need for nationwide study on the epidemiology of OPC and resistance to antifungal drugs.
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Li L, An M, Shen H, Huang X, Yao X, Liu J, Zhu F, Zhang S, Chen S, He L, Zhang J, Zou Z, Jiang Y. The non-Geldanamycin Hsp90 inhibitors enhanced the antifungal activity of fluconazole. Am J Transl Res 2015; 7:2589-2602. [PMID: 26885259 PMCID: PMC4731659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 11/21/2015] [Indexed: 06/05/2023]
Abstract
The molecular chaperone heat shock protein 90 (Hsp90) is highly conserved in eukaryotes and facilitates the correct folding, productive assembly and maturation of a diverse cellular proteins. In fungi, especially the most prevalent human fungal pathogen Candida albicans, Hsp90 influences development and modulates drug resistance. Here, we mainly explore the effect of non-Geldanamycin Hsp90 inhibitor HSP990 on the activity of fluconazole (FLC) against Candida albicans and investigate the underlying mechanism. We demonstrate that HSP990 has potent synergistic antifungal activity with FLC against FLC-resistant C. albicans through the checkerboard microdilution assay,agar diffusion tests and time-kill curves, and shows low cytotoxicity to human umbilical vein endothelial cells. Further study shows that the activity of FLC against C. albicans biofilm formation in vitro is significantly enhanced when used in combination with HSP990. In a murine model of disseminated candidiasis, the therapeutic efficacy of FLC is also enhanced by the pharmacological inhibition of C. albicans Hsp90 function with HSP990. Thus, the combined use of small molecule compound and existing antifungal drugs may provide a potential therapeutic strategy for fungal infectious disease.
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Affiliation(s)
- Liping Li
- Shanghai Tenth People’s Hospital, and Department of Pharmacology, Tongji University School of Medicine1239 Siping Road, Shanghai 200092, China
| | - Maomao An
- Shanghai Tenth People’s Hospital, and Department of Pharmacology, Tongji University School of Medicine1239 Siping Road, Shanghai 200092, China
| | - Hui Shen
- Department of Laboratory Medicine, Changhai Hospital, The Second Military Medical UniversiyShanghai, China
| | - Xin Huang
- Shanghai Tenth People’s Hospital, and Department of Pharmacology, Tongji University School of Medicine1239 Siping Road, Shanghai 200092, China
| | - Xueya Yao
- Department of Anesthesiology, Changzheng Hospital, Second Military Medical University415 Fengyang Road, Shanghai 200433, China
| | - Jian Liu
- Shanghai Tenth People’s Hospital, and Department of Pharmacology, Tongji University School of Medicine1239 Siping Road, Shanghai 200092, China
| | - Fang Zhu
- Shanghai Tenth People’s Hospital, and Department of Pharmacology, Tongji University School of Medicine1239 Siping Road, Shanghai 200092, China
| | - Shiqun Zhang
- Shanghai Tenth People’s Hospital, and Department of Pharmacology, Tongji University School of Medicine1239 Siping Road, Shanghai 200092, China
| | - Simin Chen
- Shanghai Tenth People’s Hospital, and Department of Pharmacology, Tongji University School of Medicine1239 Siping Road, Shanghai 200092, China
| | - Lijuan He
- New Drug Research and Development Center, School of Pharmacy, Second Military Medical UniversityShanghai, China
| | - Jundong Zhang
- Shanghai Tenth People’s Hospital, and Department of Pharmacology, Tongji University School of Medicine1239 Siping Road, Shanghai 200092, China
| | - Zui Zou
- Department of Anesthesiology, Changzheng Hospital, Second Military Medical University415 Fengyang Road, Shanghai 200433, China
| | - Yuanying Jiang
- Shanghai Tenth People’s Hospital, and Department of Pharmacology, Tongji University School of Medicine1239 Siping Road, Shanghai 200092, China
- New Drug Research and Development Center, School of Pharmacy, Second Military Medical UniversityShanghai, China
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Abastabar M, Shokohi T, Rouhi Kord R, Badali H, Hashemi SJ, Ghasemi Z, Ghojoghi A, Baghi N, Abdollahi M, Hosseinpoor S, Rahimi N, Seifi Z, Gholami S, Haghani I, Jabari MR, Pagheh A. In vitro activity of econazole in comparison with three common antifungal agents against clinical Candida strains isolated from superficial infections. Curr Med Mycol 2015; 1:7-12. [PMID: 28680998 PMCID: PMC5490275 DOI: 10.18869/acadpub.cmm.1.4.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background and Purpose: Candida species are the most common organisms involved in superficial fungal infections, worldwide. Although econazole is among the most frequently used topical formulations for the treatment of candidiasis, no information is available regarding the susceptibility profiles of Candida species in Iran. Materials and Methods: In vitro susceptibility of 100 clinical Candida isolates belonging to 6 species from superficial candidiasis of Iran towards to econazole was compared with three other common antifungal agents including itraconazole, fluconazole, and miconazole. Minimum inhibitory concentrations (MICs) values were analyzed according to the Clinical and Laboratory Standards Institute (CLSI) M38-A3 document. All isolates were previously identified to the species level, using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) on ITS region. Results: The MIC of econazole, itraconazole, miconazole, and fluconazole were within the range of 0.016-16, 0.032-16, 0.016-16, and 0.25-64 μg/ml, respectively. In general, econazole and miconazole were more active against Candida isolates, compared to the other two agents. Conclusion: The present study demonstrated that for Candida albicans isolates, miconazole and econazole had the best effect, but in non-albicans Candida species, itraconazole and miconazole displayed more activity than other antifungal agents.
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Affiliation(s)
- M Abastabar
- Invasive Fungi Research Center (IFRC), Department of Medical Mycology and Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - T Shokohi
- Invasive Fungi Research Center (IFRC), Department of Medical Mycology and Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - R Rouhi Kord
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - H Badali
- Invasive Fungi Research Center (IFRC), Department of Medical Mycology and Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - S J Hashemi
- Department of Medical Parasitology and Mycology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Z Ghasemi
- Department of Medical Parasitology and Mycology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - A Ghojoghi
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - N Baghi
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - M Abdollahi
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Microbiology and Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - S Hosseinpoor
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - N Rahimi
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Z Seifi
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - S Gholami
- Invasive Fungi Research Center (IFRC), Department of Medical Mycology and Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - I Haghani
- Invasive Fungi Research Center (IFRC), Department of Medical Mycology and Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - M R Jabari
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - A Pagheh
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran.,Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
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Dar MS, Sreedar G, Shukla A, Gupta P, Rehan AD, George J. An in vitro study of antifungal drug susceptibility of Candida species isolated from human immunodeficiency virus seropositive and human immunodeficiency virus seronegative individuals in Lucknow population Uttar Pradesh. J Oral Maxillofac Pathol 2015; 19:205-11. [PMID: 26604498 PMCID: PMC4611930 DOI: 10.4103/0973-029x.164534] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Candidiasis is the most common opportunistic infection in human immunodeficiency virus (HIV) seropositive patients, starting from asymptomatic colonization to pathogenic forms and gradual colonization of non-albicans in patients with advanced immunosuppression leads to resistance for azole group of antifungal drugs with high rate of morbidity and mortality. OBJECTIVES To isolate the Candida species and determine of antifungal drug susceptibility against fluconazole, itraconazole, nystatin, amphotericin B, and clotrimazolein HIV seropositive and control individuals, with or without clinical oropharyngeal candidiasis (OPC). MATERIALS AND METHODS Includes samples from faucial region of 70 subjects with and without clinical candidiasis in HIV seropositive and controls were aseptically inoculated onto Sabaraud's Dextrose Agar media and yeasts were identified for the specific species by Corn Meal Agar, sugar fermentation and heat tolerance tests. Antifungal drug susceptibility of the isolated species was done against above-mentioned drugs by E-test and disc diffusion method. RESULTS The commonly isolated species in HIV seropositive and controls were Candida albicans, Candida glabrata and Candida tropicalis Candida guilliermondii and Candida dubliniensis isolated only in HIV seropositive patients. Susceptibility against selected antifungal drugs was observed more in HIV-negative individuals whereas susceptible dose-dependent and resistance were predominant in HIV-positive patients. CONCLUSION Resistance is the major problem in the therapy of OPC, especially in HIV seropositive patients due to aggressive and prolonged use of antifungal agents, therefore, our study emphasizes the need for antifungal drug susceptibility testing whenever antifungal treatment is desired, especially in HIV-infected subjects.
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Affiliation(s)
- Mohammad Shafi Dar
- Department of Oral and Maxillofacial Pathology, Babu Banarasi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India
| | - Gadiputi Sreedar
- Department of Oral and Maxillofacial Pathology, Babu Banarasi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India
| | - Abhilasha Shukla
- Department of Oral and Maxillofacial Pathology, Babu Banarasi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India
| | - Prashant Gupta
- Department of Microbiology, King George Medical College, Lucknow, Uttar Pradesh, India
| | - Ahmad Danish Rehan
- Department of Oral and Maxillofacial Pathology, Babu Banarasi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India
| | - Jiji George
- Department of Oral and Maxillofacial Pathology, Babu Banarasi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India
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Local, systemic, demographic, and health-related factors influencing pathogenic yeast spectrum and antifungal drug administration frequency in oral candidiasis: a retrospective study. Clin Oral Investig 2015; 20:1477-86. [PMID: 26481235 DOI: 10.1007/s00784-015-1631-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 10/12/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVES In order to identify oral candidiasis patients being at risk of carrying potentially drug-resistant Candida, the aim of the study was to detect local, systemic, demographic, and health-related factors influencing (I) yeast spectrum composition and (II) antifungal administration frequency. Additionally, the aim was to investigate (III) species shift occurrence. MATERIALS AND METHODS Data from 798 patients (496 females, 302 males; mean age 59.7) with oral candidiasis diagnosed based on positive clinical and microbial findings (species identification and CFU count) between 2006 and 2011 were retrospectively analyzed using Pearson's chi(2) test and regression analysis. RESULTS Among 958 isolates, Candida albicans was the most frequently detected (76.8 %). Also, species intrinsically resistant to azoles were frequently isolated (15.8 and 17.7 % of isolates and patients). (I) Infections only caused by C. albicans were significantly associated with the use of inhalation steroids (p = 0.001) and antibiotics (p = 0.04), super-infection of lichen planus (p = 0.002), and the absence of removable dentures (p < 0.001). (II) Anti-mycotics were significantly more frequently administered in patients using inhalation steroids (p = 0.001), suffering from asthma/COPD, or smoking heavily (p = 0.003) and if C. albicans and non-albicans species were detected together (p = 0.001). (III) Pathogen composition did not change over time within the examined period (p = 0.239). CONCLUSIONS Different variables enhance the presence of certain Candida and the antifungal prescription frequency. No species shift was evident. CLINICAL RELEVANCE The major pathogen in oral candidiasis remains C. albicans. Nevertheless, therapeutic problems may be caused by the frequent presence of species intrinsically resistant to azoles, especially in patients wearing dentures.
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Leelahavanichkul A, Somparn P, Bootprapan T, Tu H, Tangtanatakul P, Nuengjumnong R, Worasilchai N, Tiranathanagul K, Eiam-ong S, Levine M, Chinampon A, Srisawat N. High-dose ascorbate with low-dose amphotericin B attenuates severity of disease in a model of the reappearance of candidemia during sepsis in the mouse. Am J Physiol Regul Integr Comp Physiol 2015; 309:R223-34. [PMID: 25994956 DOI: 10.1152/ajpregu.00238.2014] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Amphotericin B (Ampho B) isa fungicidal drug that causes cell wall injury. Pharmacological ascorbate induces the extracellular prooxidants, which might enter the Ampho B-induced cell wall porosity and act synergistically.W e tested low-dose Ampho B with a short course of pharmacological ascorbate using a mouse model of sepsis preconditioned with an injection of Candida albicans 6 h prior to cecal ligation and puncture (CLP). In this model, candidemia reappeared as early as 6 h after CLP with a predictably high mortality rate. This characteristic mimics sepsis in the phase of immunosuppression inpatients. Using the model, at 12- and 18-h post-CLP, we administered isotonic (pH neutralized) pharmacological ascorbate intravenously with low-dose Ampho B or sodium deoxycholate, vehicle-controlled, administered IP. The survival rate of low-dose Ampho B plus ascorbate was 53%, compared with < 11% for low-dose Ampho B or high-dose Ampho B alone. In addition, a beneficial effect was demonstrated in terms of kidney damage,liver injury, spleen histopathology, and serum markers at 24 h after CLP. Kidney injury was less severe in low-dose Ampho B plus ascorbate combination therapy due to less severe sepsis. Moreover, ascorbate enhanced the effectiveness of phagocytosis against C. albicans in human phagocytic cells. Taken together, the data indicate that the new mouse model simulates sepsis-induced immunosuppression and that the combination of pharmacological ascorbate with an antifungal drug is a potentially effective treatment that may reduce nephrotoxicity, and perhaps also increase fungicidal activity in patients with systemic candidiasis caused by Candida albicans.
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Gaitán-Cepeda LA, Sánchez-Vargas O, Castillo N. Prevalence of oral candidiasis in HIV/AIDS children in highly active antiretroviral therapy era. A literature analysis. Int J STD AIDS 2015; 26:625-32. [PMID: 25156369 DOI: 10.1177/0956462414548906] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 08/03/2014] [Indexed: 02/05/2023]
Abstract
SummaryHighly active antiretroviral therapy has decreased the morbidity and mortality related to HIV infection, including oral opportunistic infections. This paper offers an analysis of the scientific literature on the epidemiological aspects of oral candidiasis in HIV-positive children in the combination antiretroviral therapy era. An electronic databases search was made covering the highly active antiretroviral therapy era (1998 onwards). The terms used were oral lesions, oral candidiasis and their combination with highly active antiretroviral therapy and HIV/AIDS children. The following data were collected from each paper: year and country in which the investigation was conducted, antiretroviral treatment, oral candidiasis prevalence and diagnostic parameters (clinical or microbiological). Prevalence of oral candidiasis varied from 2.9% in American HIV-positive children undergoing highly active antiretroviral therapy to 88% in Chilean HIV-positive children without antiretroviral therapy. With respect to geographical location and antiretroviral treatment, higher oral candidiasis prevalence in HIV-positive children on combination antiretroviral therapy/antiretroviral therapy was reported in African children (79.1%) followed by 45.9% reported in Hindu children. In HIV-positive Chilean children on no antiretroviral therapy, high oral candidiasis prevalence was reported (88%) followed by Nigerian children (80%). Oral candidiasis is still frequent in HIV-positive children in the highly active antiretroviral therapy era irrespective of geographical location, race and use of antiretroviral therapy.
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Affiliation(s)
- Luis Alberto Gaitán-Cepeda
- Laboratory of Oral Pathology, Postgraduate and Research Division, Dental School, National Autonomous University of Mexico, Coyoacan, México
| | - Octavio Sánchez-Vargas
- Laboratory of Microbiology, Pathology and Biochemical, Faculty of Stomatology, Autonomous University of San Luis Potosi, San Luis Potosí, México
| | - Nydia Castillo
- Microbiology area, Health Sciences Center, Autonomous University of Baja California, Valle de las Palmas, Tijuana, Baja California, México
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Synergistic antifungal activity of berberine derivative B-7b and fluconazole. PLoS One 2015; 10:e0126393. [PMID: 25992630 PMCID: PMC4438075 DOI: 10.1371/journal.pone.0126393] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 04/01/2015] [Indexed: 12/27/2022] Open
Abstract
Our previous study demonstrated berberine (BBR) and fluconazole (FLC) used concomitantly exhibited a synergism against FLC-resistant Candida albicans in vitro. We also suggested BBR played a major antifungal role in the synergism of FLC and BBR, while FLC increased intracellular BBR concentrations. Our following systematic structural modification and reconstruction of BBR core identified the novel scaffold of N-(2-(benzo[d][1,3]dioxol-5-yl)ethyl)-2-(substituted phenyl)acet-amide derivatives 7a-i, including B-7b and B-7d exhibiting remarkable synergistic antifungal activity and low cytotoxicity. Here, the study mainly investigated the synergistic activity of FLC and B-7b and the underlying mechanism. In vitro interaction of FLC and B-7b was investigated against 30 FLC-resistant clinical isolates of C. albicans and non-C. albicans species, including Candida tropicalis, Candida parapsilosis, Candida glabrata, Candida krusei and Cryptococcus neoformans. The potent synergistic activity of B-7b in combination with FLC against FLC-resistant C. albicans was found through the checkerboard microdilution assay. The findings of agar diffusion tests and time-kill curves confirmed its better synergism with FLC. And as expected, B-7b exhibited much lower cytotoxicity than BBR to human umbilical vein endothelial cells. In contrast to BBR, we found that endogenous ROS augmentation was not involved in the synergism of FLC and B-7b. According to the results from our present comparative proteomic study, it seemed that the disruption of protein folding and processing and the weakening of cells' self-defensive ability contributed to the synergism of FLC and B-7b. Together, these results suggested novel scaffold BBR derivative B-7b could be a promising synergist in combination with FLC for the treatment of invasive fungal infections.
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Hristova Y, Wanner J, Jirovetz L, Stappen I, Iliev I, Gochev V. Chemical composition and antifungal activity of essential oil ofHyssopus officinalisL. from Bulgaria against clinical isolates ofCandidaspecies. BIOTECHNOL BIOTEC EQ 2015. [DOI: 10.1080/13102818.2015.1020341] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Berberi A, Noujeim Z, Aoun G. Epidemiology of Oropharyngeal Candidiasis in Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome Patients and CD4+ Counts. J Int Oral Health 2015; 7:20-3. [PMID: 25878473 PMCID: PMC4385720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2014] [Accepted: 12/28/2014] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The present study was directed to evaluate the forms of oropharyngeal candidiasis (OPC) and their correlation with CD4+ cell counts in human immunodeficiency virus (HIV) patients. MATERIALS AND METHODS This was a descriptive and analytical cross-sectional study carried out for a 2-year period, in which quantitative data collection methods were used. 50 patients with HIV infection were evaluated. Relationship between OPC and CD4+ was investigated. RESULTS Five different clinical forms were noticed on examination: pseudomembranous candidiasis 20/38 (P) was the most common one (52.6%) followed by erythematous 5/38 (13.15%), angular cheilitis 5/38 (13.15%) (AC), a combination of AC and E 4/38 (10.52%) or AC, E and P 4/38 (10.52%). Candida albicans was the most frequent specie isolated in 35 cases of OPC (92%). Candida tropicalis was isolated in 2 cases (5.26%) and Candida glabrata in 1 case (2.64%). The majority of patients with OPC had cell counts 28/38 (73%) <200 cells/mm(3), followed by 9/38 (23%) at CD4+ cell counts of 201-499 cells/mm(3). CONCLUSION Oral Candida colonization and invasive infection occur more frequently in HIV-positive patient and is significantly more common in patients with CD4+ cell counts <200 cell/mm(3).
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Affiliation(s)
- Antoine Berberi
- Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, Lebanese University, Beirut, Lebanon,Correspondence: Dr. Berberi A. Department of Oral Surgery, School of Dentistry, Lebanese University, Beirut, Lebanon. Tel: +961-3-731173, Fax: +961-4-533060.
| | - Ziad Noujeim
- Lecturer and Director Postgraduate Program of Oral Pathology, Departments of Oral and Maxillofacial Surgery and Pathology and Diagnosis Science, School of Dentistry, Lebanese University, Beirut, Lebanon
| | - Georges Aoun
- Assistant Professor, Department of Pathology and Diagnosis Science, School of Dentistry, Lebanese University, Beirut, Lebanon
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Components of the calcium-calcineurin signaling pathway in fungal cells and their potential as antifungal targets. EUKARYOTIC CELL 2015; 14:324-34. [PMID: 25636321 DOI: 10.1128/ec.00271-14] [Citation(s) in RCA: 119] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
In recent years, the emergence of fungal resistance has become frequent, partly due to the widespread clinical use of fluconazole, which is minimally toxic and effective in the prevention and treatment of Candida albicans infections. The limited selection of antifungal drugs for clinical fungal infection therapy has prompted us to search for new antifungal drug targets. Calcium, which acts as the second messenger in both mammals and fungi, plays a direct role in controlling the expression patterns of its signaling systems and has important roles in cell survival. In addition, calcium and some of the components, mainly calcineurin, in the fungal calcium signaling pathway mediate fungal resistance to antifungal drugs. Therefore, an overview of the components of the fungal calcium-calcineurin signaling network and their potential roles as antifungal targets is urgently needed. The calcium-calcineurin signaling pathway consists of various channels, transporters, pumps, and other proteins or enzymes. Many transcriptional profiles have indicated that mutant strains that lack some of these components are sensitized to fluconazole or other antifungal drugs. In addition, many researchers have identified efficient compounds that exhibit antifungal activity by themselves or in combination with antifungal drugs by targeting some of the components in the fungal calcium-calcineurin signaling pathway. This targeting disrupts Ca(2+) homeostasis, which suggests that this pathway contains potential targets for the development of new antifungal drugs.
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Mohamadi J, Motaghi M, panahi J, Havasian MR, Delpisheh A, Azizian M, Pakzad I. Anti-fungal resistance in candida isolated from oral and diaper rash candidiasis in neonates. Bioinformation 2014; 10:667-70. [PMID: 25512681 PMCID: PMC4261109 DOI: 10.6026/97320630010667] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2014] [Accepted: 10/28/2014] [Indexed: 11/23/2022] Open
Abstract
The purpose of the present study is to evaluate the sensitivity of Candida species isolated from oral candidiasis and diaper dermatitis infections in children. The children referring to private and public clinics in Ilam, Iran were exmined for oral candidiasis and diaper dermatitis. In this study, 248 oral candidiasis and diaper dermatitis samples were collected and cultured.Candida species were identified by using standard methods. Resistance and sensitivity to amphotericin B, nystatin, ketoconazole, fluconazole, itraconazole, clotrimazole, and posaconazole were determined using the CLSI M44-A standard disk diffusion method. From the 248 studied samples, 149 were positive for Candida, among which the Candida albicans was the most prevalent (64.4%). The resistance of different Candida species to nystatin, itraconazole, fluconazole, ketoconazole, clotrimazole, voriconazole, and posaconazole were 4, 43, 34.2, 34.9, 21.5, 6, and 6.7%, respectively. No resistance to amphotericin B was observed. Considering rather low resistance to nystatin, this drug is the best choice for oral candidiasis and diaper dermatitis.
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Affiliation(s)
- Jasem Mohamadi
- Department pediaterics, Faculty of Medicine, Ilam University of Medical Sciences, Ilam/ Iran
| | - Mahsa Motaghi
- Department Microbiology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam/ Iran
| | - Jafar panahi
- Student research of committee, Ilam University of Medical Sciences, Ilam/ Iran
| | | | - Ali Delpisheh
- Department Epidemiology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam/ Iran
| | - Mitra Azizian
- Department Microbiology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam/ Iran
| | - Iraj Pakzad
- Department Microbiology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam/ Iran
- Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam/ Iran
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Minea B, Nastasa V, Moraru RF, Kolecka A, Flonta MM, Marincu I, Man A, Toma F, Lupse M, Doroftei B, Marangoci N, Pinteala M, Boekhout T, Mares M. Species distribution and susceptibility profile to fluconazole, voriconazole and MXP-4509 of 551 clinical yeast isolates from a Romanian multi-centre study. Eur J Clin Microbiol Infect Dis 2014; 34:367-83. [PMID: 25224578 DOI: 10.1007/s10096-014-2240-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 08/27/2014] [Indexed: 01/22/2023]
Abstract
This is the first multi-centre study regarding yeast infections in Romania. The aim was to determine the aetiological spectrum and susceptibility pattern to fluconazole, voriconazole and the novel compound MXP-4509. The 551 isolates were identified using routine laboratory methods, matrix-assisted laser desorption ionisation time-of-flight mass spectrometry (MALDI-TOF MS) and DNA sequence analysis. Susceptibility testing was performed using the European Committee for Antimicrobial Susceptibility Testing (EUCAST) method and breakpoints. The yeasts originated from superficial infections (SUP, 51.5 %), bloodstream infections (BSI, 31.6 %) and deep-seated infections (DEEP, 16.9 %), from patients of all ages. Nine genera and 30 species were identified. The 20 Candida species accounted for 94.6 % of all isolates. C. albicans was the overall leading pathogen (50.5 %). Lodderomyces elongisporus is reported for the first time as a fungaemia cause in Europe. C. glabrata and Saccharomyces cerevisiae, as well as the non-Candida spp. and non-albicans Candida spp. groups, showed decreased fluconazole susceptibility (<75 %). The overall fluconazole resistance was 10.2 %. C. krusei accounted for 27 of the 56 fluconazole-resistant isolates. The overall voriconazole resistance was 2.5 % and was due mainly to C. glabrata and C. tropicalis isolates. Fluconazole resistance rates for the three categories of infection were similar to the overall value; voriconazole resistance rates differed: 4 % for BSI, 3.2 % for DEEP and 1.4 % for SUP. The antifungal activity of MXP-4509 was superior to voriconazole against C. glabrata and many fluconazole-resistant isolates. There was a large percentage of non-albicans Candida isolates. A large part of the high fluconazole resistance was not acquired but intrinsic, resulting from the high percentage of C. krusei.
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Affiliation(s)
- B Minea
- Advanced Research Centre for Bionanoconjugates and Biopolymers, Institute of Macromolecular Chemistry "Petru Poni", 700487, Iasi, Romania
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Sławiński J, Pogorzelska A, Żołnowska B, Kędzia A, Ziółkowska-Klinkosz M, Kwapisz E. Synthesis and anti-yeast evaluation of novel 2-alkylthio-4-chloro-5-methyl-N-[imino-(1-oxo-(1H)-phthalazin-2-yl)methyl]benzenesulfonamide derivatives. Molecules 2014; 19:13704-23. [PMID: 25185072 PMCID: PMC6271044 DOI: 10.3390/molecules190913704] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 08/13/2014] [Accepted: 08/25/2014] [Indexed: 11/16/2022] Open
Abstract
Pathogenic fungi are one of the main causes of hospital-related infections. Since conventional antifungals have become less effective because of the increasing fungal resistance to the standard drugs, the need for new agents is becoming urgent. Herein we report a synthesis of a series of novel N-[imino-(1-oxo-(1H)-phthalazin-2-yl)methyl]-benzenesulfonamide derivatives with in vitro activity against yeast-like fungi isolated from the oral cavity and respiratory tract of patients with candidiasis. These compounds were synthesized by the one-step or two-step reactions of 1-(2-alkylthiobenzensulfonyl)-2-aminoguanidines with the appropriate ortho-carbonyl benzoic acids. The biological study revealed that new derivatives have shown significant growth-inhibitory activity, superior or comparable, than those of the reference drug fluconazole. The most promising activities were observed against Candida albicans, with inhibition at least 1-3 (12.5%-37.5%) of the eight tested strains at the low MIC level of ≤6.2-25 µg/mL.
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Affiliation(s)
- Jarosław Sławiński
- Department of Organic Chemistry, Medical University of Gdańsk, Al. Gen. J. Hallera 107, Gdańsk 80-416, Poland; E-Mails: (A.P.); (B.Ż.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +48-58-349-1098; Fax: +48-58-349-1277
| | - Aneta Pogorzelska
- Department of Organic Chemistry, Medical University of Gdańsk, Al. Gen. J. Hallera 107, Gdańsk 80-416, Poland; E-Mails: (A.P.); (B.Ż.)
| | - Beata Żołnowska
- Department of Organic Chemistry, Medical University of Gdańsk, Al. Gen. J. Hallera 107, Gdańsk 80-416, Poland; E-Mails: (A.P.); (B.Ż.)
| | - Anna Kędzia
- Department of Oral Microbiology, Medical University of Gdańsk, ul. Do Studzienki 38, Gdańsk 80-227, Poland; E-Mails: (A.K.); (M.Z.-K.); (E.K.)
| | - Marta Ziółkowska-Klinkosz
- Department of Oral Microbiology, Medical University of Gdańsk, ul. Do Studzienki 38, Gdańsk 80-227, Poland; E-Mails: (A.K.); (M.Z.-K.); (E.K.)
| | - Ewa Kwapisz
- Department of Oral Microbiology, Medical University of Gdańsk, ul. Do Studzienki 38, Gdańsk 80-227, Poland; E-Mails: (A.K.); (M.Z.-K.); (E.K.)
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Javed F, Ahmed HB, Mehmood A, Saeed A, Al-Hezaimi K, Samaranayake LP. Association between glycemic status and oral Candida carriage in patients with prediabetes. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 117:53-8. [PMID: 24332327 DOI: 10.1016/j.oooo.2013.08.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 08/16/2013] [Accepted: 08/24/2013] [Indexed: 11/18/2022]
Abstract
OBJECTIVE This study assessed the association between glycemic status and oral Candida carriage among patients with prediabetes. STUDY DESIGN This was a comparative study of oral Candida carriage among individuals with prediabetes. Oral yeast samples were collected from 150 individuals: group A was 43 patients with prediabetes (fasting blood glucose levels and hemoglobin A1c, 100 to 125 mg/dL and ≥5%, respectively); group B was 37 individuals previously considered prediabetic but having fasting blood glucose levels <100 mg/dL and hemoglobin A1c <5%; and group C was 70 medically healthy individuals. Oral yeasts were identified using standard techniques. Unstimulated whole salivary flow rate and number of missing teeth were recorded. RESULTS Oral Candida was isolated from 100% of patients with prediabetes and from 65.7% of control participants. Candida albicans carriage was higher among patients with prediabetes (48.7%) (P < .01) and patients in group A (51.2%) (P < .01) than among controls (25.7%). Candida carriage, unstimulated whole salivary flow rate, and number of missing teeth were similar in groups A and B. CONCLUSIONS Oral Candida carriage was higher in patients with prediabetes than in controls and was independent of glycemic status in patients with prediabetes.
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Affiliation(s)
- Fawad Javed
- Engineer Abdullah Bugshan Research Chair for Growth Factors and Bone Regeneration, 3D Imaging and Biomechanical Laboratory, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
| | | | - Abid Mehmood
- Department of Dentistry, Jinnah Postgraduate Medical Center, Karachi, Pakistan
| | - Anwar Saeed
- Department of Public Health Dentistry, Liaquat College of Medicine and Dentistry, Karachi, Pakistan
| | - Khalid Al-Hezaimi
- Engineer Abdullah Bugshan Research Chair for Growth Factors and Bone Regeneration, 3D Imaging and Biomechanical Laboratory, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia; Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabi
| | - Lakshman P Samaranayake
- Oral Biosciences, Faculty of Dentistry, Prince Philip Dental Hospital, University of Hong Kong, Hong Kong
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Combination of fluconazole with non-antifungal agents: A promising approach to cope with resistant Candida albicans infections and insight into new antifungal agent discovery. Int J Antimicrob Agents 2014; 43:395-402. [DOI: 10.1016/j.ijantimicag.2013.12.009] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 12/18/2013] [Accepted: 12/19/2013] [Indexed: 12/29/2022]
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Morais MI, Pinto MEA, Araújo SG, Castro AHF, Duarte-Almeida JM, Rosa LH, Rosa CA, Johann S, Lima LARDS. Antioxidant and antifungal activities ofSmilax campestrisGriseb. (Smilacaceae). Nat Prod Res 2014; 28:1275-9. [DOI: 10.1080/14786419.2014.895728] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Zimmerman KO, Smith PB. Current Epidemiology and Management of Invasive Candidiasis in Infants. CURRENT FUNGAL INFECTION REPORTS 2014. [DOI: 10.1007/s12281-013-0167-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Maley AM, Arbiser JL. Gentian violet: a 19th century drug re-emerges in the 21st century. Exp Dermatol 2013; 22:775-80. [PMID: 24118276 PMCID: PMC4396813 DOI: 10.1111/exd.12257] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2013] [Indexed: 12/18/2022]
Abstract
Gentian violet (GV) has a long and varied history as a medicinal agent. Historically used as an antibacterial and antifungal, recent reports have shown its utility as an antitypranosomal, antiviral and anti-angiogenic agent. The objective of this article is to summarize evidence regarding the efficacy and safety of GV use in dermatology. Recent discoveries have found novel targets of GV, namely NADPH oxidase in mammalian cells and thioredoxin reductase 2 in bacterial, fungal and parasitic cells. These discoveries have expanded the use of GV in the 21st century. Given that GV is well tolerated, effective and inexpensive, its use in dermatology is predicted to increase.
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Affiliation(s)
- Alexander M Maley
- Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA; Atlanta Veterans Administration Hospital, Atlanta, GA, USA
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Dos Santos Abrantes PM, McArthur CP, Africa CWJ. Multi-drug resistant oral Candida species isolated from HIV-positive patients in South Africa and Cameroon. Diagn Microbiol Infect Dis 2013; 79:222-7. [PMID: 24726686 DOI: 10.1016/j.diagmicrobio.2013.09.016] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 08/31/2013] [Accepted: 09/02/2013] [Indexed: 01/30/2023]
Abstract
Candida species are a common cause of infection in immune-compromised HIV-positive individuals, who are usually treated with the antifungal drug, fluconazole, in public hospitals in Africa. However, information about the prevalence of drug resistance to fluconazole and other antifungal agents on Candida species is very limited. This study examined 128 Candida isolates from South Africa and 126 Cameroonian Candida isolates for determination of species prevalence and antifungal drug susceptibility. The isolates were characterized by growth on chromogenic and selective media and by their susceptibility to 9 antifungal drugs tested using the TREK™ YeastOne9 drug panel (Thermo Scientific, USA). Eighty-three percent (82.8%) of South African isolates were Candida albicans (106 isolates), 9.4% were Candida glabrata (12 isolates), and 7.8% were Candida dubliniensis (10 isolates). Of the Cameroonian isolates, 73.02% were C. albicans (92 isolates); 19.05% C. glabrata (24 isolates); 3.2% Candida tropicalis (4 isolates); 2.4% Candida krusei (3 isolates); 1.59% either Candida kefyr, Candida parapsilopsis, or Candida lusitaneae (2 isolates); and 0.79% C. dubliniensis (1 isolate). Widespread C. albicans resistance to azoles was detected phenotypically in both populations. Differences in drug resistance were seen within C. glabrata found in both populations. Echinocandin drugs were more effective on isolates obtained from the Cameroon than in South Africa. A multiple-drug resistant C. dubliniensis strain isolated from the South African samples was inhibited only by 5-flucytosine in vitro on the YO9 panel. Drug resistance among oral Candida species is common among African HIV patients in these 2 countries. Regional surveillance of Candida species drug susceptibility should be undertaken to ensure effective treatment for HIV-positive patients.
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Affiliation(s)
| | - Carole P McArthur
- Department of Oral and Craniofacial Science, School of Dentistry, University of Missouri-Kansas City, Kansas City, USA
| | - Charlene Wilma Joyce Africa
- Oral Microbiology Group, Department of Medical Biosciences, University of the Western Cape, Cape Town, South Africa.
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