Fungal strains and the development of tolerance against natamycin

Breaking Down the Barriers of Drug Resistance and Corneal Permeability with Chitosan-Poly(ethylene glycol)-LK13 Peptide Conjugate to Combat Fungal Keratitis

Fungal keratitis (FK) is a leading cause of preventable blindness and eye loss. The poor antifungal activity, increased drug resistance, limited corneal permeability, and unsatisfactory biosafety of conventional antifungal eye drops are among the majority of the challenges that need to be addressed for currently available antifungal drugs. Herein, this study proposes an effective strategy that employs chitosan-poly(ethylene glycol)-LK13 peptide conjugate (CPL) in the treatment of FK. Nanoassembly CPL can permeate the lipophilic corneal epithelium in the transcellular route, and its hydrophilicity surface is a feature to drive its permeability through hydrophilic stroma. When encountering fungal cell membrane, CPL dissembles and exposes the antimicrobial peptide (LK13) to destroy fungal cell membranes, the minimum inhibitory concentration values of CPL against Fusarium solani (F. solani) are always not to exceed 8 μg peptide/mL before and after drug resistance induction. In a rat model of Fusarium keratitis, CPL demonstrates superior therapeutic efficacy than commercially available natamycin ophthalmic suspension. This study provides more theoretical and experimental supports for the application of CPL in the treatment of FK.

Sensitivity of Mucor piriformis to Natamycin and Efficacy of Natamycin Alone and with Salt and Heat Treatments Against Mucor Rot of Stored Mandarin Fruit

Mucor rot caused by Mucor piriformis is an emerging postharvest disease of mandarin fruit in California. Natamycin is a newly registered biofungicide for postharvest use on citrus and some other fruits. In the study, baseline sensitivity to natamycin in 50 isolates of M. piriformis was determined in vitro. The mean EC50 (effective concentration to inhibit sporangiospore germination by 50%) and MIC (minimum inhibitory concentration to inhibit mycelial growth by 100%) values were 0.59 μg/ml and less than 1.0 μg/ml, respectively. Natamycin at the label rate of 920 μg/ml alone or in combination with 3% potassium sorbate (PS) or 3% sodium carbonate (SC) applied at 20 or 50°C was evaluated for control of Mucor rot on inoculated 'Tango' mandarin fruit. Natamycin alone reduced Mucor rot incidence on stored mandarin fruit from 100% among nontreated control fruit to approximately 30%, a reduction of more than 70% compared to the nontreated control, while 3% PS and 3% SC had no to little control. When applied at 50°C, natamycin and 3% PS reduced Mucor rot incidence by 65.0 and 31.2%, respectively; while natamycin in combination with 3% PS reduced disease incidence by 92.5% compared to the nontreated control after 2 weeks of storage at 5°C. This combined treatment remained effective even when the application of the treatment was delayed for 6 and 12 h after inoculation. However, the effectiveness of the treatments declined when storage was extended to 3 or 4 weeks. Natamycin can be an effective tool to control Mucor rot on mandarin fruit, and minimizing the period of extended storage could help maintain the control efficacy of natamycin.

A new cheese population in Penicillium roqueforti and adaptation of the five populations to their ecological niche

Domestication is an excellent case study for understanding adaptation and multiple fungal lineages have been domesticated for fermenting food products. Studying domestication in fungi has thus both fundamental and applied interest. Genomic studies have revealed the existence of four populations within the blue-cheese-making fungus Penicillium roqueforti. The two cheese populations show footprints of domestication, but the adaptation of the two non-cheese populations to their ecological niches (i.e., silage/spoiled food and lumber/spoiled food) has not been investigated yet. Here, we reveal the existence of a new P. roqueforti population, specific to French Termignon cheeses, produced using small-scale traditional practices, with spontaneous blue mould colonisation. This Termignon population is genetically differentiated from the four previously identified populations, providing a novel source of genetic diversity for cheese making. The Termignon population indeed displayed substantial genetic diversity, both mating types, horizontally transferred regions previously detected in the non-Roquefort population, and intermediate phenotypes between cheese and non-cheese populations. Phenotypically, the non-Roquefort cheese population was the most differentiated, with specific traits beneficial for cheese making, in particular higher tolerance to salt, to acidic pH and to lactic acid. Our results support the view that this clonal population, used for many cheese types in multiple countries, is a domesticated lineage on which humans exerted strong selection. The lumber/spoiled food and silage/spoiled food populations were not more tolerant to crop fungicides but showed faster growth in various carbon sources (e.g., dextrose, pectin, sucrose, xylose and/or lactose), which can be beneficial in their ecological niches. Such contrasted phenotypes between P. roqueforti populations, with beneficial traits for cheese-making in the cheese populations and enhanced ability to metabolise sugars in the lumber/spoiled food population, support the inference of domestication in cheese fungi and more generally of adaptation to anthropized environments.

Semisynthetic Amides of Polyene Antibiotic Natamycin

Natamycin is a macrolide polyene antibiotic, characterized by a potent broad spectrum antifungal activity and low toxicity. However, it is not used for the treatment of systemic mycoses due to its low bioavailability and low solubility in aqueous solutions. In order to create new semisynthetic antifungal agents for treatment of mycoses, a series of water-soluble amides of natamycin were synthesized. Antifungal activities of natamycin derivatives were investigated against Candida spp., including a panel of Candida auris clinical isolates and filamentous fungi. Toxicity for mammalian cells was assayed by monitoring antiproliferative activity against human postnatal fibroblasts (HPF) and human embryonic kidney cells (HEK293). By comparing leakage of contents from ergosterol versus cholesterol containing vesicles, a ratio that characterizes the efficacy and safety of natamycin and its derivatives was determined (EI, efficiency index). Ability of all tested semisynthetic natamycines to prevent proliferation of the yeast Candida spp. cells was comparable or even slightly higher to those of parent antibiotic. Interestingly, amide 8 was more potent than natamycin (1) against all tested C. auris strains (MIC values 2 μg/mL vs 8 μg/mL, respectively). Among 7 derivatives, amide 10 with long lipophilic side chains showed the highest EI and strong antifungal activity in vitro but was more toxic against HPF. In vivo experiments with amide 8 showed in vivo efficacy on a mouse candidemia model with a larger LD₅₀/ED₅₀ ratio in comparison to amphotericin B.

Therapeutic Approaches for Combating Aspergillus Associated Infection

Now-a-days fungal infection emerges as a significant problem to healthcare management systems due to high frequency of associated morbidity, mortality toxicity, drug-drug interactions, and resistance of the antifungal agents. Aspergillus is the most common mold that cause infection in immunocompromised hosts. It's a hyaline mold that is cosmopolitan and ubiquitous in nature. Aspergillus infects around 10 million population each year with a mortality rate of 30-90%. Clinically available antifungal formulations are restricted to four classes (i.e., polyene, triazole, echinocandin, and allylamine), and each of them have their own limitations associated with the activity spectrum, the emergence of resistance, and toxicity. Consequently, novel antifungal agents with modified and altered chemical structures are required to combat these invasive fungal infections. To overcome these limitations, there is an urgent need for new antifungal agents that can act as potent drugs in near future. Currently, some compounds have shown effective antifungal activity. In this review article, we have discussed all potential antifungal therapies that contain old antifungal drugs, combination therapies, and recent novel antifungal formulations, with a focus on the Aspergillus associated infections.

Patterns of Antifungal Resistance in Adult Patients With Fungal Keratitis in South India: A Post Hoc Analysis of 3 Randomized Clinical Trials

IMPORTANCE

Antifungal resistance has been shown to impact treatment success, but research analyzing antifungal resistance is scarce.

OBJECTIVE

To evaluate changes in antifungal resistance over time.

DESIGN, SETTING, AND PARTICIPANTS

Ad hoc analysis of 3 randomized clinical trials including consecutive patients 18 years and older presenting with smear-positive fungal ulcers to Aravind Eye Hospitals in Madurai, Coimbatore, Pondicherry, and Tirunelveli in South India who participated in 1 of 3 clinical trials: the Mycotic Ulcer Treatment Trials (MUTT) I (2010 to 2011) or II (2010 to 2015) or the Cross-Linking Assisted Infection Reduction (CLAIR) trial (2016 to 2018). This post hoc analysis was designed in March 2021 and data were analyzed in May and November 2021.

INTERVENTIONS

Minimum inhibitory concentration (MIC) of natamycin and voriconazole was determined from corneal cultures obtained using standardized methods outlined in the Clinical and Laboratory Standards Institute.

MAIN OUTCOMES AND MEASURES

The primary outcome of this post hoc analysis was MIC of natamycin and voriconazole.

RESULTS

A total of 890 fungal isolates were obtained from 651 patients (mean [SD] age, 49.6 [13.0]; 191 [43.3%] female) from 2010 to 2018. MICs were available for 522 samples in 446 patients. Fungal isolates overall demonstrated a 1.02-fold increase per year in voriconazole resistance as measured by MICs (95% CI, 1.00-1.04; P = .06). In subgroup analyses, Fusarium species demonstrated a 1.04-fold increase in voriconazole resistance per year (95% CI, 1.00-1.06; P = .01). Fungal isolates showed a 1.06-fold increase in natamycin resistance per year overall (95% CI, 1.03-1.09; P < .001). Fusarium species had a 1.06-fold increase in natamycin resistance (95% CI, 1.05-1.08; P < .001), Aspergillus had a 1.09-fold increase in resistance (95% CI, 1.05-1.15; P < .001), and other filamentous fungi had a 1.07-fold increase in resistance to natamycin per year (95% CI, 1.04-1.10; P < .001).

CONCLUSIONS AND RELEVANCE

This post hoc analysis suggests that susceptibility to both natamycin and voriconazole may be decreasing over the last decade in South India. While a trend of increasing resistance could impact treatment of mycoses in general and infectious fungal keratitis in particular, further study is needed to confirm these findings and determine their generalizability to other regions of the world.

TRIAL REGISTRATION

ClinicalTrials.gov Identifiers: NCT00996736 and NCT02570321.

Baseline Sensitivity of Alternaria alternata and A. arborescens to Natamycin and Control of Alternaria Rot on Stored Mandarin Fruit

Alternaria rot caused by Alternaria alternata and A. arborescens is one of the major postharvest diseases on mandarin fruit in California. In this study, natamycin, a newly registered biofungicide, was evaluated for its potential as a postharvest treatment to control Alternaria rot on mandarin fruit. The baseline sensitivities of A. alternata and A. arborescens to natamycin were determined. Effective concentration inhibiting 50% of fungal growth (EC₅₀) values of natamycin for 70 A. alternata isolates ranged from 0.694 to 1.275 µg/ml (mean = 0.921 µg/ml) in a conidial germination assay and from 2.001 to 3.788 µg/ml (mean = 2.797 µg/ml) for 40 A. alternata isolates in a mycelial growth assay. EC₅₀ values of natamycin for 30 A. arborescens isolates ranged from 0.698 to 1.203 µg/ml (mean = 0.923 µg/ml) in a conidial germination assay and from 2.035 to 3.368 µg/ml (mean = 2.658 µg/ml) for 20 A. arborescens isolates in a mycelial growth assay. Control tests on detached mandarin fruit showed that natamycin at both low (460 µg/ml) and high (920 µg/ml) recommended rates significantly reduced disease incidence and severity on mandarin fruit inoculated with Alternaria isolates, regardless of species. High rate of natamycin significantly reduced disease incidence and severity compared with the nontreated control even when natamycin treatment was delayed for 6, 12, and 18 h after inoculation. Our results suggested that natamycin can be an effective postharvest fungicide for control of Alternaria rot on mandarin fruit.

Baseline Sensitivities of Major Citrus, Pome, and Stone Fruits Postharvest Pathogens to Natamycin and Estimation of the Resistance Potential in Penicillium digitatum

Natamycin is a biofungicide that was registered in the United States in 2016 and approved in California in 2017 for postharvest use on citrus and stone fruits. It has been used as a food preservative for many decades, with no resistance ever observed to date. The objective of this study was to determine baseline sensitivities for mycelial growth of 43 to 72 isolates of seven postharvest pathogens to natamycin and the resistance potential of Penicillium digitatum. Mean effective concentrations to inhibit mycelial growth by 50% (EC₅₀ values), as determined by the spiral gradient method, were 0.90 μg/ml for Alternaria alternata, 0.76 μg/ml for Botrytis cinerea, 3.20 μg/ml for Geotrichum citri-aurantii, 0.17 μg/ml for Monilinia fructicola, 1.54 μg/ml for P. digitatum, 1.14 μg/ml for P. expansum, and 0.48 μg/ml for Rhizopus stolonifer. Distributions of EC₅₀ values for each pathogen were unimodal and mostly normal with no outliers detected. Natamycin was also inhibitory to spore germination with values for five of the species similar to those for mycelial growth. Microscopically, natamycin generally arrested spores at the pregermination swelling stage. Mass platings of a conidial mixture of 10 isolates of P. digitatum were inoculated on agar media with 2.5-log radial concentration gradients of natamycin or fludioxonil, and a conidial mixture of 10 isolates of G. citri-aurantii were plated on media amended with natamycin or propiconazole. No resistant isolates were observed for both species to natamycin or for G. citri-aurantii to propiconazole, whereas a resistance frequency of 4.5 × 10^-6 to 3.1 × 10^-6 was calculated for P. digitatum to fludioxonil. The wide spectrum of activity against different fungal pathogens and a low resistance potential support the registration of natamycin as a postharvest treatment and its integration into an integrated pest management program with other practices including sanitation and rotation of other fungicides with different modes of action.

Development of a natamycin-based non-migratory antimicrobial active packaging for extending shelf-life of yogurt drink (Doogh)

A natamycin-based non-migratory antimicrobial packaging for extending shelf-life of yogurt drink (Doogh) was developed. Firstly, the surface of low-density polyethylene film (LDPE) was modified with acrylic acid at different times of UV exposure (0-10 min) to produce carboxylic functional groups. Then, natamycin was applied to the UV-treated films to bind covalently with the pendent functional groups. The maximum grafting efficiency (81.96%) was obtained for the 6 min treated film. Moreover, surface properties of films were evaluated by Attenuated Total Reflectance/Fourier Transfer Infrared Spectroscopy (ATR-FTIR) and scanning electron microscopy (SEM). Antifungal activity of different treatments of natamycin grafted film was evaluated against two common spoilage yeasts of Doogh including Rhodotorula mucilaginosa and Candida parapsilosis. Results showed that 6 min treated film provides maximum anti-yeast activity and can be applied to control fungal growth in Doogh. Natamycin-grafted film postponed the yeast spoilage in Doogh and prolonged its shelf-life to 23 days.

Sensory analysis for stuffed cheese with Penicillium nalgiovense superficial growth

Sensory analysis for stuffed cheese with Penicillium nalgiovense superficial growth using a descriptive analysis was performed. Cheeses were manufactured in a pilot plant. Penicillium nalgiovense was superficially inoculated and the cheeses were ripened at 12 °C and 90% relative humidity until packaged using a microperforated polyethylene film on day 14. The ripening process continued at either 5 °C or 12 °C for 21 days. Results showed that P. nalgiovense not only confers the external desirable appearance but also has a protective effect against dehydration process. Inoculated cheeses showed descriptors of odour and flavour associated with moulds. Ammonia notes were perceived only for inoculated cheeses on day 35 being more pronounced at 12 °C than 5 °C. The high fat content of the cheeses and the transparent and microperforated packaging might affect the oxidative stability of cheeses at the end of the ripening.

Natamycin, a Biofungicide for Managing Major Postharvest Fruit Decays of Citrus

The antifungal polyene macrolide natamycin was evaluated as a postharvest biopesticide for citrus fruit. Aqueous spray applications with 1,000 µg/ml were moderately to highly effective against green mold incidence after inoculation but did not reduce sporulation of Penicillium digitatum on infected fruit. Treatments with natamycin were significantly more effective against green mold on grapefruit and lemon than on orange and mandarin, with 92.9, 88.5, 57.5, and 60.9% reductions in decay, respectively, as compared with the control. The biofungicide was compatible with a storage fruit coating but was less effective when applied in a packing coating. However, when either fruit coating was applied following an aqueous natamycin treatment (i.e., staged applications), the incidence of decay was reduced to ≤10.7% as compared with the untreated control (with 81.9%). The incidence of sour rot of lemon and mandarin was also significantly reduced from the untreated control by natamycin (1,000 µg/ml) but propiconazole (540 µg/ml) and propiconazole + natamycin (540 + 500 µg/ml) mixtures generally were significantly more effective than natamycin alone when using a severe inoculation procedure. Experimental and commercial packingline studies demonstrated that natamycin-fludioxonil or natamycin-propiconazole mixtures applied in a storage fruit coating or as an aqueous flooder treatment were highly effective and typically resulted in a >85.0% reduction of green mold and sour rot. Resistance to natamycin has never been documented in filamentous fungi. Thus, the use of natamycin, in contrast to other registered postharvest fungicides for citrus, can be an antiresistance strategy and an effective treatment in mixtures with other fungicides for the management of major postharvest decays of citrus.

Development of a Methodology for Estimating the Ergosterol in Meat Product-Borne Toxigenic Moulds to Evaluate Antifungal Agents

Antifungal agents are commonly used in the meat industry to prevent the growth of unwanted moulds, such as toxigenic ones, on dry-cured meat products. For enhancing the application of antifungals, their mode of action must be evaluated. Their effect on the mould ergosterol content is one of the most studied ones, since it is the target site of some commercialised antifungals or of those that are in development. The aim of this study was to develop a methodology for determining how the antifungal agents used in the meat industry work. A method for analysing ergosterol was firstly developed using high-performance liquid chromatography with fluorescence detection coupled to a diode array detector (HPLC-FLD/DAD). The chromatographically optimised conditions (gradient and mobile phases) allowed us to reduce the time per analysis with respect to previously published methods up to 22 min. Withing the six checked extraction methods, method 5, showing the best mean recovery values (99.51%), the shortest retention time (15.8 min), and the lowest standard deviation values (9.92) and working temperature (60 °C), was selected. The limit of detection and limit of quantification were 0.03 and 0.1 µg/mL, respectively. All the validation parameters corroborated the method's suitability. Finally, its feasibility for evaluating the effect of a commercial antifungal preparation (AP) and different herbs that are frequently added to meat products on the ergosterol content of several toxigenic moulds was studied. Differences at the strain level were obtained in the presence of AP. Moreover, the addition of herbs significantly reduced the ergosterol content in Penicillium nordicum up to 83.91%. The developed methodology is thus suitable for screening the antifungals' role in altering mould ergosterol biosynthesis before their application in real meat products.

Efficacy of Natamycin Against Gray Mold of Stored Mandarin Fruit Caused by Isolates of Botrytis cinerea With Multiple Fungicide Resistance

Gray mold caused by Botrytis cinerea is an emerging postharvest disease of mandarin fruit in California. Management of postharvest diseases of mandarins relies on postharvest fungicides; however, multiple resistance to fungicides of different modes of action is common in B. cinerea populations from mandarin, leading to their failure to control decay. Natamycin is commonly used in the food industry as an additive, and it has been registered as a biofungicide for postharvest use on citrus and some other fruits. Sensitivity to natamycin of 64 isolates of B. cinerea from decayed mandarin fruit with known resistance phenotypes to other citrus postharvest fungicides (azoxystrobin, fludioxonil, pyrimethanil, and thiabendazole) was tested. Effective concentrations of natamycin to cause a 50% reduction relative to the control for conidial germination were from 0.324 to 0.567 µg/ml (mean of 0.444 µg/ml), and those for mycelial growth were 1.021 to 2.007 µg/ml (mean of 1.578 µg/ml). Minimum inhibitory concentrations where no fungal growth was present were 0.7 to 1.0 µg/ml for conidial germination and 5.0 to 10.0 µg/ml for mycelial growth. No cross-resistance between natamycin and other citrus postharvest fungicides was detected. Decay control efficacy tests with natamycin were conducted on mandarin fruit inoculated with B. cinerea isolates exhibiting five different fungicide resistance phenotypes, and natamycin significantly reduced incidence and lesion size of gray mold on fruit, regardless of fungicide resistance phenotypes. Natamycin has the potential to be an effective tool for integration into postharvest fungicide programs to control gray mold and manage B. cinerea isolates resistant to fungicides with other modes of action.

Aspergillus fumigatus and Aspergillosis in 2019

Aspergillus fumigatus is a saprotrophic fungus; its primary habitat is the soil. In its ecological niche, the fungus has learned how to adapt and proliferate in hostile environments. This capacity has helped the fungus to resist and survive against human host defenses and, further, to be responsible for one of the most devastating lung infections in terms of morbidity and mortality. In this review, we will provide (i) a description of the biological cycle of A. fumigatus; (ii) a historical perspective of the spectrum of aspergillus disease and the current epidemiological status of these infections; (iii) an analysis of the modes of immune response against Aspergillus in immunocompetent and immunocompromised patients; (iv) an understanding of the pathways responsible for fungal virulence and their host molecular targets, with a specific focus on the cell wall; (v) the current status of the diagnosis of different clinical syndromes; and (vi) an overview of the available antifungal armamentarium and the therapeutic strategies in the clinical context. In addition, the emergence of new concepts, such as nutritional immunity and the integration and rewiring of multiple fungal metabolic activities occurring during lung invasion, has helped us to redefine the opportunistic pathogenesis of A. fumigatus.

Biosynthesis regulation of natamycin production from Streptomyces natalensis HDMNTE-01 enhanced by response surface methodology

Natamycin has been widely applied in medical treatments and food protection widely due to its effective inhibition to the growth of yeast and mold. As polyene macrolide antibiotic, the biosynthesis pathway of natamycin is relatively clear. To regulate the biosynthesis of natamycin, additions of precursors affecting cell growth and natamycin production were investigated. The results showed that 0.003% (w/v) potassium ferrocyanide and sodium propionate: n-butanol at a ratio of 4:1 was added into the broth at 0 and 24 hr, respectively, and they contributed to yield natamycin, reaching 1.62 g L^-1 (174.6% higher than control). Furthermore, response surface methodology was undertaken to enhance natamycin production by Streptomyces natalensis HDMNTE-01 (a wild strain). The optimum conditions determined were: glucose 3.97%; soya peptone 2%; yeast extract 0.5%; original pH 7.0; inoculum volume 6%; growth in a 250-mL flask containing 24.68 mL of medium; shaken (220 rpm) at 28°C for 4 days. Under the optimized conditions, the yield was 2.81 g L^-1 natamycin in 5-L fermentor when the fermentation was processed.

Diversity and Control of Spoilage Fungi in Dairy Products: An Update

Fungi are common contaminants of dairy products, which provide a favorable niche for their growth. They are responsible for visible or non-visible defects, such as off-odor and -flavor, and lead to significant food waste and losses as well as important economic losses. Control of fungal spoilage is a major concern for industrials and scientists that are looking for efficient solutions to prevent and/or limit fungal spoilage in dairy products. Several traditional methods also called traditional hurdle technologies are implemented and combined to prevent and control such contaminations. Prevention methods include good manufacturing and hygiene practices, air filtration, and decontamination systems, while control methods include inactivation treatments, temperature control, and modified atmosphere packaging. However, despite technology advances in existing preservation methods, fungal spoilage is still an issue for dairy manufacturers and in recent years, new (bio) preservation technologies are being developed such as the use of bioprotective cultures. This review summarizes our current knowledge on the diversity of spoilage fungi in dairy products and the traditional and (potentially) new hurdle technologies to control their occurrence in dairy foods.