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Marques MJAM, Alves F, Sousa MHS, Guimarães FEG, Kurachi C. Morphological aspects and the effectiveness of photodynamic inactivation against Rhizopus oryzae in different life cycles. Photochem Photobiol Sci 2024; 23:1323-1339. [PMID: 38806860 DOI: 10.1007/s43630-024-00597-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 05/18/2024] [Indexed: 05/30/2024]
Abstract
Mucormycosis is an extremely aggressive fungal disease with a high mortality rate, especially in people with compromised immune systems. Most cases of mucormycosis are caused by the fungus Rhizopus oryzae. The treatments used are based on high doses of antifungals, associated with surgical resections, when it is possible. However, even with this aggressive treatment, the estimated attributable mortality rate is high. There is therefore a need to develop adjuvant treatments. Photodynamic Inactivation (PDI) may be an auxiliary therapeutic option for mucormycosis. Due to the lack of reports in the literature on the morphology and photodynamic inactivation of R. oryzae, characterization of the fungus using Confocal Microscopy and Transmission Electron Microscopy, and different protocols using Photodithazine® (PDZ), a chlorin e6 compound, as a photosensitizer, were performed. The fungus growth rate under different concentrations and incubation times of the photosensitizer and its association with the surfactant Sodium Dodecyl Sulphate (SDS) was evaluated. For the hyphae, both in the light and dark phases, in the protocols using only PDZ, no effective photodynamic response was observed. Meanwhile with the combination of SDS 0.05% and PDZ, inhibition growth rates of 98% and 72% were achieved for the white and black phase, respectively. In the conidia phase, only a 1.7 log10 reduction of the infective spores was observed. High concentration of melanin and the complex and resistant structures, especially at the black phase, results in a high limitation of the PDI inactivation response. The combined use of the SDS resulted in an improved response, when compared to the one obtained with the amphotericin B treatment.
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Affiliation(s)
- M J A M Marques
- São Carlos Institute of Physics, University of São Paulo, São Carlos, Brazil
| | - F Alves
- São Carlos Institute of Physics, University of São Paulo, São Carlos, Brazil
| | - M H S Sousa
- São Carlos Institute of Physics, University of São Paulo, São Carlos, Brazil
| | - F E G Guimarães
- São Carlos Institute of Physics, University of São Paulo, São Carlos, Brazil
| | - C Kurachi
- São Carlos Institute of Physics, University of São Paulo, São Carlos, Brazil.
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2
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Fiala J, Roach T, Holzinger A, Husiev Y, Delueg L, Hammerle F, Armengol ES, Schöbel H, Bonnet S, Laffleur F, Kranner I, Lackner M, Siewert B. The Light-activated Effect of Natural Anthraquinone Parietin against Candida auris and Other Fungal Priority Pathogens. PLANTA MEDICA 2024; 90:588-594. [PMID: 38843798 PMCID: PMC11156500 DOI: 10.1055/a-2249-9110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 01/05/2024] [Indexed: 06/10/2024]
Abstract
Antimicrobial photodynamic therapy (aPDT) is an evolving treatment strategy against human pathogenic microbes such as the Candida species, including the emerging pathogen C. auris. Using a modified EUCAST protocol, the light-enhanced antifungal activity of the natural compound parietin was explored. The photoactivity was evaluated against three separate strains of five yeasts, and its molecular mode of action was analysed via several techniques, i.e., cellular uptake, reactive electrophilic species (RES), and singlet oxygen yield. Under experimental conditions (λ = 428 nm, H = 30 J/cm2, PI = 30 min), microbial growth was inhibited by more than 90% at parietin concentrations as low as c = 0.156 mg/L (0.55 µM) for C. tropicalis and Cryptococcus neoformans, c = 0.313 mg/L (1.10 µM) for C. auris, c = 0.625 mg/L (2.20 µM) for C. glabrata, and c = 1.250 mg/L (4.40 µM) for C. albicans. Mode-of-action analysis demonstrated fungicidal activity. Parietin targets the cell membrane and induces cell death via ROS-mediated lipid peroxidation after light irradiation. In summary, parietin exhibits light-enhanced fungicidal activity against all Candida species tested (including C. auris) and Cryptococcus neoformans, covering three of the four critical threats on the WHO's most recent fungal priority list.
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Affiliation(s)
- Johannes Fiala
- Department of Pharmacognosy, Institute of Pharmacy, Center for Molecular Biosciences Innsbruck, University of Innsbruck, Austria
| | - Thomas Roach
- Department of Botany, University of Innsbruck, Austria
| | | | - Yurii Husiev
- Leiden Institute of Chemistry, Leiden University, Netherlands
| | - Lisa Delueg
- Department of Pharmacognosy, Institute of Pharmacy, Center for Molecular Biosciences Innsbruck, University of Innsbruck, Austria
| | - Fabian Hammerle
- Department of Pharmacognosy, Institute of Pharmacy, Center for Molecular Biosciences Innsbruck, University of Innsbruck, Austria
| | - Eva Sanchez Armengol
- Department of Technology, Institute of Pharmacy, Center for Molecular Biosciences Innsbruck, University of Innsbruck, Austria
| | | | | | - Flavia Laffleur
- Department of Technology, Institute of Pharmacy, Center for Molecular Biosciences Innsbruck, University of Innsbruck, Austria
| | - Ilse Kranner
- Department of Botany, University of Innsbruck, Austria
| | - Michaela Lackner
- Institute of Hygiene und Medical Microbiology, Medical University of Innsbruck, Austria
| | - Bianka Siewert
- Department of Pharmacognosy, Institute of Pharmacy, Center for Molecular Biosciences Innsbruck, University of Innsbruck, Austria
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Huma ZE, Saleem S, Imran M, Jabeen K, Arshad F, Amar A. Screening of C. auris among Candida isolates from various tertiary care institutions in Lahore by VITEK 2 and real time PCR based molecular technique. PLoS One 2023; 18:e0293390. [PMID: 37874842 PMCID: PMC10597507 DOI: 10.1371/journal.pone.0293390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 09/20/2023] [Indexed: 10/26/2023] Open
Abstract
Candida auris is a multidrug-resistant pathogen, that is a well-known cause of nosocomial infections. This pathogen is being identified using advanced diagnostic approaches and epidemiological typing procedures. In underdeveloped nations, several researchers developed and validated a low-cost approach for reliably identifying Candida auris. The goal of this study was to assess the burden of Candida auris in different teaching hospitals of Lahore and to limit its spread to minimize hospital-related illnesses. Candida isolates were obtained from various tertiary care institutions in Lahore in the form of culture on various culture plates. Sabouraud agar culture plates were used to culture the Candida spp. Fluconazole-resistant Candida species were chosen for further identification using VITEK 2 Compact ID and molecular identification using species-specific PCR assay. The current study obtained 636 Candida samples from several tertiary care institutions in Lahore. Fluconazole resistance was found in 248 (38.9%) of 636 Candida samples. No isolate was identified as Candida auris by VITEK 2 Compact ID and real-time PCR-based molecular identification. Thus with limited resources, these two methods may serve as useful screens for Candida auris. However, it should be screened all over the country to limit its spread to break the chain of nosocomial infections.
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Affiliation(s)
- Zill-e- Huma
- Department of Microbiology, University of Health Sciences, Lahore, Pakistan
| | - Sidrah Saleem
- Department of Microbiology, University of Health Sciences, Lahore, Pakistan
| | - Muhammad Imran
- Department of Microbiology, University of Health Sciences, Lahore, Pakistan
| | - Kokab Jabeen
- Department of Microbiology, University of Health Sciences, Lahore, Pakistan
| | - Faiqa Arshad
- Department of Microbiology, University of Health Sciences, Lahore, Pakistan
| | - Ali Amar
- Department of Human Genetics and Molecular Biology, University of Health Sciences, Lahore, Pakistan
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4
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Piksa M, Lian C, Samuel IC, Pawlik KJ, Samuel IDW, Matczyszyn K. The role of the light source in antimicrobial photodynamic therapy. Chem Soc Rev 2023; 52:1697-1722. [PMID: 36779328 DOI: 10.1039/d0cs01051k] [Citation(s) in RCA: 49] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Antimicrobial photodynamic therapy (APDT) is a promising approach to fight the growing problem of antimicrobial resistance that threatens health care, food security and agriculture. APDT uses light to excite a light-activated chemical (photosensitiser), leading to the generation of reactive oxygen species (ROS). Many APDT studies confirm its efficacy in vitro and in vivo against bacteria, fungi, viruses and parasites. However, the development of the field is focused on exploring potential targets and developing new photosensitisers. The role of light, a crucial element for ROS production, has been neglected. What are the main parameters essential for effective photosensitiser activation? Does an optimal light radiant exposure exist? And finally, which light source is best? Many reports have described the promising antibacterial effects of APDT in vitro, however, its application in vivo, especially in clinical settings remains very limited. The restricted availability may partially be due to a lack of standard conditions or protocols, arising from the diversity of selected photosensitising agents (PS), variable testing conditions including light sources used for PS activation and methods of measuring anti-bacterial activity and their effectiveness in treating bacterial infections. We thus sought to systematically review and examine the evidence from existing studies on APDT associated with the light source used. We show how the reduction of pathogens depends on the light source applied, radiant exposure and irradiance of light used, and type of pathogen, and so critically appraise the current state of development of APDT and areas to be addressed in future studies. We anticipate that further standardisation of the experimental conditions will help the field advance, and suggest key optical and biological parameters that should be reported in all APDT studies. More in vivo and clinical studies are needed and are expected to be facilitated by advances in light sources, leading to APDT becoming a sustainable, alternative therapeutic option for bacterial and other microbial infections in the future.
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Affiliation(s)
- Marta Piksa
- Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Science, Weigla 12, 53-114, Wroclaw, Poland
| | - Cheng Lian
- Organic Semiconductor Centre, SUPA, School of Physics and Astronomy, University of St Andrews, Fife, KY16 9SS, UK.
| | - Imogen C Samuel
- School of Medicine, University of Manchester, Manchester, M13 9PL, UK
| | - Krzysztof J Pawlik
- Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Science, Weigla 12, 53-114, Wroclaw, Poland
| | - Ifor D W Samuel
- Organic Semiconductor Centre, SUPA, School of Physics and Astronomy, University of St Andrews, Fife, KY16 9SS, UK.
| | - Katarzyna Matczyszyn
- Institute of Advanced Materials, Faculty of Chemistry, Wroclaw University of Science and Technology, Wyb. Wyspianskiego 27, 50-370 Wroclaw, Poland.
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de Carvalho BMDF, Garcia BA, Gomes AKP, Alcantara DD, de Freitas Pontes KM. Antimicrobial Photodynamic Therapy as a Technique for Decontamination of Acrylic Resin Devices Provided by Different Dental Laboratories. J Lasers Med Sci 2023; 14:e8. [PMID: 37089770 PMCID: PMC10114022 DOI: 10.34172/jlms.2023.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 09/17/2022] [Indexed: 04/25/2023]
Abstract
Introduction: Dentures, occlusal splints, surgical guides and orthodontic appliances are examples of acrylic resin devices made in dental laboratories, which must be disinfected and even sterilized before insertion into the oral cavity. This study evaluated the antimicrobial effect of photodynamic therapy (PDT) applied to acrylic resin specimens received from different laboratories. Methods: Three hundred standardized specimens were ordered from six randomly selected laboratories registered in the Council of Dentistry of Ceará (n=50). The PDT consisted in the association of 22 µM erythrosine, as a photosensitizer (P), and a 520-nm LED at 38 J/cm2 (L). The specimens of each laboratory were randomly distributed into five groups: positive control, sterilized with ethylene oxide; negative control, untreated (P-L-); erythrosine control, only stained (P+L-); LED control, only irradiated (P-L+); PDT (P+L+). Then, the specimens were individually sonicated in saline solution; the suspension was diluted, plated on culture mediums (blood agar, sabouraud dextrose agar and a non-selective chromogenic agar), and incubated for 48 hours at 37°C. Colony-forming-unit (CFU) counts were done and statistical tests of Kruskal-Wallis/Dunn were carried out. Results: The specimens from all laboratories were contaminated with bacteria and yeasts. Staphylococcus aureus, Staphylococcus saprophyticus, Escherichia coli, Enterococcus spp., Klebsiella and Pseudomonas spp. were identified. The PDT significantly reduced CFU counts (P<0.0001), compared to P-L-. Conclusion: PDT was able to effectively decontaminate the acrylic resin specimens provided from dental laboratories.
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Affiliation(s)
| | - Bruna Albuquerque Garcia
- Department of Oral Biology, University of Florida (College of Dentistry), 1395 Center Drive, POBOX 100424 - 62610, Gainesville, FL, United States
| | - Aghata Kelma Palacio Gomes
- Department of Restorative Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Ceará Federal University (UFC), Monsenhor Furtado Street – Rodolfo Teófilo, 60430-350, Fortaleza, CE, Brazil
| | - Danielle Dourado Alcantara
- Dentistry and Nursing, Ceará Federal University (UFC), Monsenhor Furtado Street - Rodolfo Teófilo, 60430-350, Fortaleza, CE, Brazil
| | - Karina Matthes de Freitas Pontes
- Department of Restorative Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Ceará Federal University (UFC), Monsenhor Furtado Street – Rodolfo Teófilo, 60430-350, Fortaleza, CE, Brazil
- Correspondence to Karina Matthes de Freitas Pontes,
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Štefánek M, Černáková L, Dekkerová J, Bujdáková H. Photodynamic Inactivation Effectively Eradicates Candida auris Biofilm despite Its Interference with the Upregulation of CDR1 and MDR1 Efflux Genes. J Fungi (Basel) 2022; 8:1137. [PMID: 36354904 PMCID: PMC9697027 DOI: 10.3390/jof8111137] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/12/2022] [Accepted: 10/24/2022] [Indexed: 07/29/2023] Open
Abstract
Candida auris, in recent years, has emerged as a dangerous nosocomial pathogen. It represents a challenge for effective treatment because of its multiresistance. Photodynamic inactivation (PDI) is a promising way to solve problems with a wide range of resistant microorganisms. This study aimed to use PDI for the eradication of C. auris biofilms. Moreover, the regulation of the CDR1, CDR2, and MDR1 resistance genes was studied. Experiments were performed on 24 h biofilms formed by three clinical isolates of C. auris in vitro. PDI was performed in the presence of the photosensitizer methylene blue (0.25 mM) and samples were irradiated with a red laser (λ = 660 nm, 190 mW/cm2) for 79, 120, and 300 s. To confirm the PDI effect, confocal laser scanning microscopy was performed after treatment. Effective PDI was achieved in all strains. The highest inhibition was observed after 300 s irradiation, with over 90% inhibition compared with the non-irradiated control sample. PDI was observed to upregulate the expression of the CDR1 gene, but mainly the MDR1 gene. Despite this observation, PDI significantly decreased the survival of C. auris biofilm cells and proved to have great potential for the eradication of problematic resistant yeasts.
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Zinc(II), Palladium(II), and Metal-Free Phthalocyanines Bearing Nipagin-Functionalized Substituents against Candida auris and Selected Multidrug-Resistant Microbes. Pharmaceutics 2022; 14:pharmaceutics14081686. [PMID: 36015312 PMCID: PMC9416722 DOI: 10.3390/pharmaceutics14081686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/08/2022] [Accepted: 08/11/2022] [Indexed: 12/03/2022] Open
Abstract
Due to the rapidly increasing problem of antibiotic resistance in recent years, the use of phthalocyanines as photosensitizers with their superior properties in photodynamic antimicrobial therapy (PACT) applications has become important. In this study, magnesium(II) 1,4,8,11,15,18,22,25-octakis(4-[4-butoxycarbonylphenoxy]butyloxy)phthalocyanine was used in the demetalation reaction in trifluoroacetic acid, and subsequently subjected to metalation reaction in dimethylformamide with zinc(II) acetate and bis(benzonitrile)palladium(II) chloride towards zinc(II) and palladium(II) derivatives. Three phthalocyanines, including a demetalated one as well as two metalated, in the core with zinc(II) and palladium(II) were characterized using 1D and 2D NMR spectroscopy and mass spectrometry. In addition, all macrocycles were subjected to absorption and emission studies as well as photostability tests. In a photochemical study, zinc(II) and palladium(II) phthalocyanine complexes appeared to be efficient singlet oxygen generators. There were noted quantum yields of singlet oxygen generation for zinc(II) phthalocyanine derivative in DMF and DMSO at 0.55 and 0.72, whereas for palladium(II) complex at 0.73 and 0.77, respectively. Liposomal formulations of phthalocyanine derivatives were prepared, and their activity was evaluated against a broad spectrum of antibiotic-resistant microorganisms, such as methicillin-resistant Staphylococcus aureus (MRSA), Escherichia coli (ESBL+), Candida albicans resistant to fluconazole, C. auris, and against dermatophytes. Phthalocyanine palladium(II) complex showed the highest bactericidal activity against all antibiotic-resistant microorganisms, including reducing C. auris growth at 3.54 log.
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Grizante Barião PH, Tonani L, Brancini GTP, Nascimento E, Braga GÚL, Wainwright M, von Zeska Kress MR. In vitro and in vivo photodynamic efficacies of novel and conventional phenothiazinium photosensitizers against multidrug-resistant Candida auris. Photochem Photobiol Sci 2022; 21:1807-1818. [PMID: 35816272 DOI: 10.1007/s43630-022-00258-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 06/10/2022] [Indexed: 10/17/2022]
Abstract
The fast-emerging and multidrug-resistant Candida auris is the first fungal pathogen to be considered a threat to global public health. Thus, there is a high unmet medical need to develop new therapeutic strategies to control this species. Antimicrobial photodynamic therapy (APDT) is a promising alternative that simultaneously targets and damages numerous microbial biomolecules. Here, we investigated the in vitro and in vivo effects of APDT with four phenothiazinium photosensitizers: (i) methylene blue (MB), (ii) toluidine blue (TBO), and two MB derivatives, (iii) new methylene blue (NMBN) and (iv) the pentacyclic derivative S137, against C. auris. To measure the in vitro efficacy of each PS, minimal inhibitory concentrations (MICs) and survival fraction were determined. Also, the efficiency of APDT was evaluated in vivo with the Galleria mellonella insect model for infection and treatment. Although the C. auris strain used in our study was shown to be resistant to the most-commonly used clinical antifungals, it could not withstand the damages imposed by APDT with any of the four photosensitizers. However, for the in vivo model, only APDT performed with S137 allowed survival of infected G. mellonella larvae. Our results show that structural and chemical properties of the photosensitizers play a major role on the outcomes of in vivo APDT and underscore the need to synthesize and develop novel photosensitizing molecules against multidrug-resistant microorganisms.
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Affiliation(s)
- Patrícia Helena Grizante Barião
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, 14040-903, Brazil
| | - Ludmilla Tonani
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, 14040-903, Brazil
| | - Guilherme Thomaz Pereira Brancini
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, 14040-903, Brazil
| | - Erika Nascimento
- Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, 14048-900, Brazil
| | - Gilberto Úbida Leite Braga
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, 14040-903, Brazil
| | - Mark Wainwright
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | - Marcia Regina von Zeska Kress
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, 14040-903, Brazil.
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Gupta H, Gupta P, Kairamkonda M, Poluri KM. Molecular investigations on Candida glabrata clinical isolates for pharmacological targeting. RSC Adv 2022; 12:17570-17584. [PMID: 35765448 PMCID: PMC9194923 DOI: 10.1039/d2ra02092k] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/03/2022] [Indexed: 12/12/2022] Open
Abstract
Prevalence of drug resistant C. glabrata strains in hospitalized immune-compromised patients with invasive fungal infections has increased at an unexpected pace. This has greatly pushed researchers in identification of mutations/variations in clinical isolates for better assessment of the prevailing drug resistance trends and also for updating of antifungal therapy regime. In the present investigation, the clinical isolates of C. glabrata were comprehensively characterized at a molecular level using metabolic profiling and transcriptional expression analysis approaches in combination with biochemical, morphological and chemical profiling methods. Biochemically, significant variations in azole susceptibility, surface hydrophobicity, and oxidative stress generation were observed among the isolates as compared to wild-type. The 1H NMR profiling identified 18 differential metabolites in clinical strains compared to wild-type and were classified into five categories, that include: sugars (7), amino acids and their derivatives (7), nitrogen bases (3) and coenzymes (1). Transcriptional analysis of selective metabolic and regulatory enzymes established that the major differences were found in cell membrane stress, carbohydrate metabolism, amino acid biosynthesis, ergosterol pathway and turnover of nitrogen bases. This detailed molecular level/metabolic fingerprint study is a useful approach for differentiating pathogenic/clinical isolates to that of wild-type. This study comprehensively delineated the differential cellular pathways at a molecular level that have been re-wired by the pathogenic clinical isolates for enhanced pathogenicity and virulence traits. The clinical isolates of Candida glabrata were characterized and found to be different in terms of metabolic pathways that could be targeted for drug development.![]()
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Affiliation(s)
- Hrishikesh Gupta
- Department of Biosciences and Bioengineering, Indian Institute of Technology Roorkee (IIT-Roorkee) Roorkee-247667 Uttarakhand India
| | - Payal Gupta
- Department of Biosciences and Bioengineering, Indian Institute of Technology Roorkee (IIT-Roorkee) Roorkee-247667 Uttarakhand India
| | - Manikyaprabhu Kairamkonda
- Department of Biosciences and Bioengineering, Indian Institute of Technology Roorkee (IIT-Roorkee) Roorkee-247667 Uttarakhand India
| | - Krishna Mohan Poluri
- Department of Biosciences and Bioengineering, Indian Institute of Technology Roorkee (IIT-Roorkee) Roorkee-247667 Uttarakhand India .,Centre for Nanotechnology, Indian Institute of Technology Roorkee Roorkee-247667 Uttarakhand India
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Bandara HMHN, Samaranayake LP. Emerging strategies for environmental decontamination of the nosocomial fungal pathogen Candida auris. J Med Microbiol 2022; 71. [PMID: 35687657 DOI: 10.1099/jmm.0.001548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Candida auris is a recently emerged multidrug-resistant fungal pathogen that causes life-threatening infections to the human population worldwide. Recent rampant outbreaks of C. auris in coronavirus disease 2019 (COVID-19) patients, together with outbreaks in over 45 countries, highlight its threat to patients and healthcare economies. Unlike other pathogenic Candida species, C. auris is capable of surviving in abiotic surfaces of healthcare facilities for prolonged periods, leading to increased risk of transmission within nosocomial settings. C. auris is resistant to multiple classes of antifungal agents, forms dry biofilms and transmits independently to regional epicentres, making its eradication from nosocomial environment arduous. The lack of strategies for environmental decontamination of C. auris from nosocomial settings is evident from the generic guidance and recommendations provided by leading global healthcare bodies. Therefore, this minireview discusses the current guidelines for environmental decontamination of C. auris and compounds and strategies currently under investigation for potential future use. While established guidelines recommend the use of products mainly consisting of sodium hypochlorite and hydrogen peroxide, initial works have been reported on the promising anti-C. auris properties of various other compounds and some biocompatible alternatives. Further validation of these approaches, coupled up with environmentally friendly decontamination protocols, are warranted to achieve superior elimination of C. auris from healthcare settings.
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Aroso RT, Schaberle FA, Arnaut LG, Pereira MM. Photodynamic disinfection and its role in controlling infectious diseases. Photochem Photobiol Sci 2021; 20:1497-1545. [PMID: 34705261 PMCID: PMC8548867 DOI: 10.1007/s43630-021-00102-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 09/03/2021] [Indexed: 12/23/2022]
Abstract
Photodynamic therapy is witnessing a revival of its origins as a response to the rise of multi-drug resistant infections and the shortage of new classes of antibiotics. Photodynamic disinfection (PDDI) of microorganisms is making progresses in preclinical models and in clinical cases, and the perception of its role in the clinical armamentarium for the management of infectious diseases is changing. We review the positioning of PDDI from the perspective of its ability to respond to clinical needs. Emphasis is placed on the pipeline of photosensitizers that proved effective to inactivate biofilms, showed efficacy in animal models of infectious diseases or reached clinical trials. Novel opportunities resulting from the COVID-19 pandemic are briefly discussed. The molecular features of promising photosensitizers are emphasized and contrasted with those of photosensitizers used in the treatment of solid tumors. The development of photosensitizers has been accompanied by the fabrication of a variety of affordable and customizable light sources. We critically discuss the combination between photosensitizer and light source properties that may leverage PDDI and expand its applications to wider markets. The success of PDDI in the management of infectious diseases will ultimately depend on the efficacy of photosensitizers, affordability of the light sources, simplicity of the procedures, and availability of fast and efficient treatments.
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Affiliation(s)
- Rafael T Aroso
- Chemistry Department, University of Coimbra, 3004-535, Coimbra, Portugal
| | - Fábio A Schaberle
- Chemistry Department, University of Coimbra, 3004-535, Coimbra, Portugal
| | - Luís G Arnaut
- Chemistry Department, University of Coimbra, 3004-535, Coimbra, Portugal.
| | - Mariette M Pereira
- Chemistry Department, University of Coimbra, 3004-535, Coimbra, Portugal.
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Ziental D, Mlynarczyk DT, Czarczynska-Goslinska B, Lewandowski K, Sobotta L. Photosensitizers Mediated Photodynamic Inactivation against Fungi. NANOMATERIALS 2021; 11:nano11112883. [PMID: 34835655 PMCID: PMC8621466 DOI: 10.3390/nano11112883] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/13/2021] [Accepted: 10/19/2021] [Indexed: 01/12/2023]
Abstract
Superficial and systemic fungal infections are essential problems for the modern health care system. One of the challenges is the growing resistance of fungi to classic antifungals and the constantly increasing cost of therapy. These factors force the scientific world to intensify the search for alternative and more effective methods of treatment. This paper presents an overview of new fungal inactivation methods using Photodynamic Antimicrobial Chemotherapy (PACT). The results of research on compounds from the groups of phenothiazines, xanthanes, porphyrins, chlorins, porphyrazines, and phthalocyanines are presented. An intensive search for a photosensitizer with excellent properties is currently underway. The formulation based on the existing ones is also developed by combining them with nanoparticles and common antifungal therapy. Numerous studies indicate that fungi do not form any specific defense mechanism against PACT, which deems it a promising therapeutic alternative.
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Affiliation(s)
- Daniel Ziental
- Chair and Department of Inorganic and Analytical Chemistry, Poznan University of Medical Sciences, Grunwaldzka 6, 60-780 Poznan, Poland; (D.Z.); (K.L.)
| | - Dariusz T. Mlynarczyk
- Chair and Department of Chemical Technology of Drugs, Poznan University of Medical Sciences, Grunwaldzka 6, 60-780 Poznan, Poland;
| | - Beata Czarczynska-Goslinska
- Chair and Department of Pharmaceutical Technology, Poznan University of Medical Sciences, Grunwaldzka 6, 60-780 Poznan, Poland;
| | - Konrad Lewandowski
- Chair and Department of Inorganic and Analytical Chemistry, Poznan University of Medical Sciences, Grunwaldzka 6, 60-780 Poznan, Poland; (D.Z.); (K.L.)
| | - Lukasz Sobotta
- Chair and Department of Inorganic and Analytical Chemistry, Poznan University of Medical Sciences, Grunwaldzka 6, 60-780 Poznan, Poland; (D.Z.); (K.L.)
- Correspondence:
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Bapat PS, Nobile CJ. Photodynamic Therapy Is Effective Against Candida auris Biofilms. Front Cell Infect Microbiol 2021; 11:713092. [PMID: 34540717 PMCID: PMC8446617 DOI: 10.3389/fcimb.2021.713092] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 08/13/2021] [Indexed: 12/23/2022] Open
Abstract
Fungal infections are increasing in prevalence worldwide. The paucity of available antifungal drug classes, combined with the increased occurrence of multidrug resistance in fungi, has led to new clinical challenges in the treatment of fungal infections. Candida auris is a recently emerged multidrug resistant human fungal pathogen that has become a worldwide public health threat. C. auris clinical isolates are often resistant to one or more antifungal drug classes, and thus, there is a high unmet medical need for the development of new therapeutic strategies effective against C. auris. Additionally, C. auris possesses several virulence traits, including the ability to form biofilms, further contributing to its drug resistance, and complicating the treatment of C. auris infections. Here we assessed red, green, and blue visible lights alone and in combination with photosensitizing compounds for their efficacies against C. auris biofilms. We found that (1) blue light inhibited and disrupted C. auris biofilms on its own and that the addition of photosensitizing compounds improved its antibiofilm potential; (2) red light inhibited and disrupted C. auris biofilms, but only in combination with photosensitizing compounds; and (3) green light inhibited C. auris biofilms in combination with photosensitizing compounds, but had no effects on disrupting C. auris biofilms. Taken together, our findings suggest that photodynamic therapy could be an effective non-drug therapeutic strategy against multidrug resistant C. auris biofilm infections.
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Affiliation(s)
- Priyanka S Bapat
- Department of Molecular and Cell Biology, School of Natural Sciences, University of California Merced, Merced, CA, United States.,Quantitative and Systems Biology Graduate Program, University of California Merced, Merced, CA, United States
| | - Clarissa J Nobile
- Department of Molecular and Cell Biology, School of Natural Sciences, University of California Merced, Merced, CA, United States.,Health Sciences Research Institute, University of California Merced, Merced, CA, United States
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Giacobbe DR, Magnasco L, Sepulcri C, Mikulska M, Koehler P, Cornely OA, Bassetti M. Recent advances and future perspectives in the pharmacological treatment of Candida auris infections. Expert Rev Clin Pharmacol 2021; 14:1205-1220. [PMID: 34176393 DOI: 10.1080/17512433.2021.1949285] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Candida auris is responsible for hospital outbreaks worldwide. Some C. auris isolates may show concomitant resistance to azoles, echinocandins, and polyenes, thereby possibly leaving clinicians with few therapeutic options. AREAS COVERED Antifungal agents both in early and in late phases of clinical development showing anti-C. auris activity. EXPERT OPINION The research on antifungal agents active against C. auris has made important steps forward in recent years: (i) the development of drugs with novel mechanisms of action, such as ibrexafungerp and fosmanogepix, could provide a valid option against C. auris strains resistant to one or more older antifungals, including pan-resistant strains; (ii) rezafungin could allow once weekly administration of an active drug in the case of echinocandin-susceptible isolates, providing an effective outpatient treatment, while at the same time relieving selective pressure on novel classes; (iii) the development of oral formulations could allow step-down therapy and/or early discharge, or even to avoid hospitalization in mild or noninvasive diseases; (iv) according to available data, these novel agents show a good safety profile and a low potential for drug-drug interactions.
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Affiliation(s)
- Daniele R Giacobbe
- Department of Health Sciences, University of Genoa, Genoa, Italy.,Clinica Malattie Infettive, San Martino Policlinico Hospital - IRCCS, Genoa, Italy
| | - Laura Magnasco
- Clinica Malattie Infettive, San Martino Policlinico Hospital - IRCCS, Genoa, Italy
| | - Chiara Sepulcri
- Department of Health Sciences, University of Genoa, Genoa, Italy.,Clinica Malattie Infettive, San Martino Policlinico Hospital - IRCCS, Genoa, Italy
| | - Malgorzata Mikulska
- Department of Health Sciences, University of Genoa, Genoa, Italy.,Clinica Malattie Infettive, San Martino Policlinico Hospital - IRCCS, Genoa, Italy
| | - Philipp Koehler
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
| | - Oliver A Cornely
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany.,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Matteo Bassetti
- Department of Health Sciences, University of Genoa, Genoa, Italy.,Clinica Malattie Infettive, San Martino Policlinico Hospital - IRCCS, Genoa, Italy
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Hu S, Zhu F, Jiang W, Wang Y, Quan Y, Zhang G, Gu F, Yang Y. Retrospective Analysis of the Clinical Characteristics of Candida auris Infection Worldwide From 2009 to 2020. Front Microbiol 2021; 12:658329. [PMID: 34093471 PMCID: PMC8173142 DOI: 10.3389/fmicb.2021.658329] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/28/2021] [Indexed: 12/21/2022] Open
Abstract
Introduction Candida auris is an emerging multidrug-resistant fungus that may cause infections with a high mortality rate. The first case of C. auris infection was reported in 2009 and infections have been reported in 44 countries. The fungus now represents a major global public health threat. We analyzed cases from the emergence of C. auris infections up until the end of 2020. It is hoped that the results of this analysis will raise awareness in scientists to promote protection and control research pertaining to this pathogen. Methods PubMed and Web of Science databases were searched for all papers related to C. auris infections up until December 31, 2020. We sorted and organized these data into the following categories: date of publication, patient age and sex, underlying diseases, risk factors for infection, patient mortality information, drug sensitivity information of C. auris isolates, and genetic classification. The χ2 test was used to screen for factors that may affect patient mortality. Results A total of 912 patients were included in the analysis. There’s a higher proportion of men and a high proportion of patients were premature babies and elderly people. The proportions of patients with underlying diseases such as diabetes, kidney disease, trauma, and ear disease were also high. More than half of patients had a history of central venous catheter use and a history of broad-spectrum antibiotic use. The χ2 test revealed that only kidney disease (P < 0.05) was an important risk factor for mortality in C. auris-infected patients. Conclusions A comprehensive understanding of C. auris was achieved following this retrospective analysis, including the characteristics of C. auris-infected patients. In recent years, increasing numbers of multidrug-resistant C. auris isolates have been identified, and the high mortality rates associated with infection merit greater attention from the medical world.
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Affiliation(s)
- Shan Hu
- Department of Biotechnology, Beijing Institute of Radiation Medicine, Beijing Key Laboratory of New Molecular Diagnosis Technologies for Infectious Diseases, Beijing, China.,Department of Laboratory Medicine, Xuzhou Tumor Hospital, Xuzhou, China
| | - Feilong Zhu
- The Affiliated Xuzhou Rehabilitation Hospital of Xuzhou Medical University, Xuzhou Rehabilitation Hospital, Xuzhou, China
| | - Weiwei Jiang
- Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Yuehua Wang
- Department of Life Science, Hebei University, Baoding, China
| | - Yongqiang Quan
- Department of Nephrology, Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, China
| | - Guoming Zhang
- Department of Laboratory Medicine, Shuyang People's Hospital, The Affiliated Shuyang Hospital of Xuzhou Medical University, Shuyang, China
| | - Feng Gu
- Department of Laboratory Medicine, Xuzhou Tumor Hospital, Xuzhou, China
| | - Ying Yang
- Department of Biotechnology, Beijing Institute of Radiation Medicine, Beijing Key Laboratory of New Molecular Diagnosis Technologies for Infectious Diseases, Beijing, China
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Rodrigues CH, Araújo EAG, Almeida RP, Nascimento TP, Silva MM, Abbas G, Nunes FD, Lins E, Lira-Nogueira MCB, Falcão JSA, Fontes A, Porto ALF, Pereira G, Santos BS. Silver nanoprisms as plasmonic enhancers applied in the photodynamic inactivation of Staphylococcus aureus isolated from bubaline mastitis. Photodiagnosis Photodyn Ther 2021; 34:102315. [PMID: 33932564 DOI: 10.1016/j.pdpdt.2021.102315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/04/2021] [Accepted: 04/23/2021] [Indexed: 10/21/2022]
Abstract
Mastitis is a bacterial infection that affects all lactating mammals, and in dairy cattle, it leads to a reduction in their milk production and, in worse cases, it may lead to animal death. One viable therapeutic modality for overcoming bacterial resistance can be photodynamic inactivation (PDI), a therapeutic modality for bacterial infection treatment. One of the main factors that can lead to an efficient PDI process is the association of metallic nanoparticles in the close vicinity of photosensitizers, which has shown promising results due to localized surface plasmon resonance phenomena. In this work, methylene blue (MB) molecules were associated with Ag prismatic nanoplatelets (AgNPrs) to use as PDI photosensitizer against Staphylococcus aureus isolated from bubaline mastitis. The optical plasmonic activity of AgNPrs was tuned to the MB absorption region (600-700 nm) by inducing their growth into prismatic shapes by a seed-mediated procedure, using poly (sodium 4-styrene sulfonate) as the surfactant. A simulation on the plasmonic properties of the nanoprisms, applying particle size within the dimensions determined by TEM image analysis (d = 32 ± 6 nm), showed a 30 % increase of the incident field on the prismatic tips. Photodynamic results showed that the electrostatic AgNPr-MB conjugates promoted enhancement (ca. 15 %) of the reactive oxygen species production. Besides, PDI mediated by AgNPrs-MB led to the complete inactivation of the mastitis S. aureus strain after 6 min inactivation, in contrast to PDI mediated by MB, which reduced less than a 0.5 bacterial log. Thus, the results show this plasmonic enhanced photodynamic tool's potential to be applied in the inactivation of multi-resistant bacterial strains.
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Affiliation(s)
- Cláudio H Rodrigues
- Pharmaceutical Sciences Department, Federal University of Pernambuco, Recife, PE, Brazil
| | - Evanísia A G Araújo
- Pharmaceutical Sciences Department, Federal University of Pernambuco, Recife, PE, Brazil
| | - Rômulo P Almeida
- Pharmaceutical Sciences Department, Federal University of Pernambuco, Recife, PE, Brazil
| | - Thiago P Nascimento
- Morphology and Animal Physiology Department, Federal Rural University of Pernambuco, Recife, PE, Brazil
| | - Marllyn M Silva
- Academic Center of Vitória, Federal University of Pernambuco, Vitória, PE, Brazil
| | - Ghulam Abbas
- Department of Physics, Riphah International University Faisalabad Campus, Pakistan
| | - Frederico D Nunes
- Nuclear Engineering Department, Federal University of Pernambuco, Recife, PE, Brazil
| | - Emery Lins
- Electronic and Systems Department, Federal University of Pernambuco, Recife, PE, Brazil
| | | | - Juliana S A Falcão
- Education and Health Center, Federal University of Campina Grande, Cuité, PB, Brazil
| | - Adriana Fontes
- Biophysics and Radiobiology Department, Federal University of Pernambuco, Recife, PE, Brazil
| | - Ana L F Porto
- Morphology and Animal Physiology Department, Federal Rural University of Pernambuco, Recife, PE, Brazil
| | - Goreti Pereira
- Fundamental Chemistry Department, Federal University of Pernambuco, Recife, PE, Brazil
| | - Beate S Santos
- Pharmaceutical Sciences Department, Federal University of Pernambuco, Recife, PE, Brazil.
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Černáková L, Roudbary M, Brás S, Tafaj S, Rodrigues CF. Candida auris: A Quick Review on Identification, Current Treatments, and Challenges. Int J Mol Sci 2021; 22:4470. [PMID: 33922907 PMCID: PMC8123192 DOI: 10.3390/ijms22094470] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/21/2021] [Accepted: 04/21/2021] [Indexed: 02/07/2023] Open
Abstract
Candida auris is a novel and major fungal pathogen that has triggered several outbreaks in the last decade. The few drugs available to treat fungal diseases, the fact that this yeast has a high rate of multidrug resistance and the occurrence of misleading identifications, and the ability of forming biofilms (naturally more resistant to drugs) has made treatments of C. auris infections highly difficult. This review intends to quickly illustrate the main issues in C. auris identification, available treatments and the associated mechanisms of resistance, and the novel and alternative treatment and drugs (natural and synthetic) that have been recently reported.
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Affiliation(s)
- Lucia Černáková
- Department of Microbiology and Virology, Faculty of Natural Sciences, Comenius University in Bratislava, Ilkovičova 6, 842 15 Bratislava, Slovakia;
| | - Maryam Roudbary
- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran 1449614535, Iran;
| | - Susana Brás
- Centre of Biological Engineering, LIBRO—‘Laboratório de Investigação em Biofilmes Rosário Oliveira’, University of Minho, 4710-057 Braga, Portugal;
| | - Silva Tafaj
- Microbiology Department, University Hospital “Shefqet Ndroqi”, 1044 Tirana, Albania;
| | - Célia F. Rodrigues
- LEPABE—Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal
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Openda YI, Nyokong T. Enhanced photo-ablation effect of positively charged phthalocyanines-detonation nanodiamonds nanoplatforms for the suppression of Staphylococcus aureus and Escherichia coli planktonic cells and biofilms. J Photochem Photobiol A Chem 2021. [DOI: 10.1016/j.jphotochem.2021.113200] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Openda YI, Matshitse R, Nyokong T. A search for enhanced photodynamic activity against Staphylococcus aureus planktonic cells and biofilms: the evaluation of phthalocyanine-detonation nanodiamond-Ag nanoconjugates. Photochem Photobiol Sci 2020; 19:1442-1454. [PMID: 33000851 DOI: 10.1039/d0pp00075b] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The present work reports on the synthesis and characterization of novel zinc (2) and indium (3) 2-amino-4-bromophenoxy substituted phthalocyanines (Pcs) along with the self-assembled nanoconjugates formed viaπ-π stacking interaction onto detonation nanodiamonds (DNDs) to form 2@DNDs and 3@DNDs. 2@DNDs and 3@DNDs were covalently linked to chitosan-silver mediated nanoparticles (CSAg) to form 2@DNDs-CSAg and 3@DNDs-CSAg nanoconjugates. High singlet oxygen quantum yields in DMSO of 0.69 and 0.72 for Pcs alone and 0.90 and 0.92 for 2@DNDs-CSAg and 3@DNDs-CSAg, respectively, were obtained. The photodynamic antimicrobial chemotherapy (PACT) activity of both phthalocyanines and nanoconjugates was tested against planktonic cells and biofilms of S. aureus. 2@DNDs-CSAg and 3@DNDs-CSAg caused effective killing with a log reduction of 9.74. In addition, PACT studies on single-species S. aureus biofilms were carried out with log reduction values of 5.12 and 5.27 at 200 μg mL-1 for 2@DNDs-CSAg and 3@DNDs-CSAg, respectively.
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Affiliation(s)
- Yolande Ikala Openda
- Institute for Nanotechnology Innovation, Department of Chemistry, Rhodes University, Makhanda, 6140, South Africa.
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Avoiding ventilator-associated pneumonia: Curcumin-functionalized endotracheal tube and photodynamic action. Proc Natl Acad Sci U S A 2020; 117:22967-22973. [PMID: 32868444 DOI: 10.1073/pnas.2006759117] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Hospital-acquired infections are a global health problem that threatens patients' treatment in intensive care units, causing thousands of deaths and a considerable increase in hospitalization costs. The endotracheal tube (ETT) is a medical device placed in the patient's trachea to assist breathing and delivering oxygen into the lungs. However, bacterial biofilms forming at the surface of the ETT and the development of multidrug-resistant bacteria are considered the primary causes of ventilator-associated pneumonia (VAP), a severe hospital-acquired infection for significant mortality. Under these circumstances, there has been a need to administrate antibiotics together. Although necessary, it has led to a rapid increase in bacterial resistance to antibiotics. Therefore, it becomes necessary to develop alternatives to prevent and combat these bacterial infections. One possibility is to turn the ETT itself into a bactericide. Some examples reported in the literature present drawbacks. To overcome those issues, we have designed a photosensitizer-containing ETT to be used in photodynamic inactivation (PDI) to avoid bacteria biofilm formation and prevent VAP occurrence during tracheal intubation. This work describes ETT's functionalization with curcumin photosensitizer, as well as its evaluation in PDI against Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli A significant photoinactivation (up to 95%) against Gram-negative and Gram-positive bacteria was observed when curcumin-functionalized endotracheal (ETT-curc) was used. These remarkable results demonstrate this strategy's potential to combat hospital-acquired infections and contribute to fighting antimicrobial resistance.
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