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Gómez-Gaviria M, García-Carnero LC, Baruch-Martínez DA, Mora-Montes HM. The Emerging Pathogen Candida metapsilosis: Biological Aspects, Virulence Factors, Diagnosis, and Treatment. Infect Drug Resist 2024; 17:171-185. [PMID: 38268929 PMCID: PMC10807450 DOI: 10.2147/idr.s448213] [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: 11/04/2023] [Accepted: 01/16/2024] [Indexed: 01/26/2024] Open
Abstract
Fungal infections represent a constant and growing menace to public health. This concern is due to the emergence of new fungal species and the increase in antifungal drug resistance. Mycoses caused by Candida species are among the most common nosocomial infections and are associated with high mortality rates when the infection affects deep-seated organs. Candida metapsilosis is part of the Candida parapsilosis complex and has been described as part of the oral microbiota of healthy individuals. Within the complex, this species is considered the least virulent; however, the prevalence has been increasing in recent years, as well as an increment in the resistance to some antifungal drugs. One of the main concerns of candidiasis caused by this species is the wide range of clinical manifestations, ranging from tissue colonization to superficial infections, and in more severe cases it can spread, which makes diagnosis and treatment difficult. The study of virulence factors of this species is limited, however, proteomic comparisons between species indicate that virulence factors in this species could be similar to those already described for C. albicans. However, differences may exist, taking into account changes in the lifestyle of the species. Here, we provide a detailed review of the current literature about this organism, the caused disease, and some sharing aspects with other members of the complex, focusing on its biology, virulence factors, the host-fungus interaction, the identification, diagnosis, and treatment of infection.
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Affiliation(s)
- Manuela Gómez-Gaviria
- Departamento de Biología, División de Ciencias Naturales y Exactas, Universidad de Guanajuato, Guanajuato, Gto., México
| | - Laura C García-Carnero
- Departamento de Biología, División de Ciencias Naturales y Exactas, Universidad de Guanajuato, Guanajuato, Gto., México
| | - Dario A Baruch-Martínez
- Departamento de Biología, División de Ciencias Naturales y Exactas, Universidad de Guanajuato, Guanajuato, Gto., México
| | - Héctor M Mora-Montes
- Departamento de Biología, División de Ciencias Naturales y Exactas, Universidad de Guanajuato, Guanajuato, Gto., México
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Marzucco A, Gatti G, Montanari MS, Fantini M, Colosimo C, Tamburini MV, Arfilli V, Morotti M, Schiavone P, Congestrì F, Manera M, Denicolò A, Brandolini M, Taddei F, Grumiro L, Zannoli S, Dirani G, De Pascali AM, Sambri V, Cricca M. Evaluation of Biofilm Production and Antifungal Susceptibility to Fluconazole in Clinical Isolates of Candida spp. in Both Planktonic and Biofilm Form. Microorganisms 2024; 12:153. [PMID: 38257980 PMCID: PMC10820201 DOI: 10.3390/microorganisms12010153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 01/05/2024] [Accepted: 01/10/2024] [Indexed: 01/24/2024] Open
Abstract
Candida spp. are an important opportunistic pathogen that can represent a possible cause of severe infections, especially in immunocompromised individuals. The clinical impact of Candida spp. depends, in part, on the ability to form biofilms, communities of nestled cells into the extracellular matrix. In this study, we compared the biofilm formation ability of 83 strains of Candida spp. isolated from blood cultures and other materials, such as respiratory samples, urine, and exudate, and their sensitivity to fluconazole (FLZ). Strains were divided into tertiles to establish cut-offs to classify isolates as low, moderate, or high biofilm producers (<0.26, 0.266-0.839, >0.839) and biofilms with low, moderate, or high metabolic activity (<0.053, 0.053-0.183, >0.183). A non-linear relationship between biofilm production and metabolic activity was found in C. glabrata and C. tropicalis. In addition, the increase in minimum biofilm eradication concentrations (MBEC50) compared to the Minor Inhibitory Concentration (PMIC) of the planktonic form in Candida spp. confirms the role of biofilm in the induction of resistance to FLZ.
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Affiliation(s)
- Anna Marzucco
- Unit of Microbiology, The Great Romagna Hub Laboratory, 47522 Pievesestina, Italy; (M.S.M.); (M.V.T.); (V.A.); (M.M.); (P.S.); (F.C.); (M.M.); (A.D.); (F.T.); (L.G.); (S.Z.); (G.D.); (V.S.); (M.C.)
- Department of Medical and Surgical Sciences—DIMEC, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy; (C.C.); (M.B.); (A.M.D.P.)
| | - Giulia Gatti
- DIN—Department of Industrial Engineering, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy;
| | - Maria Sofia Montanari
- Unit of Microbiology, The Great Romagna Hub Laboratory, 47522 Pievesestina, Italy; (M.S.M.); (M.V.T.); (V.A.); (M.M.); (P.S.); (F.C.); (M.M.); (A.D.); (F.T.); (L.G.); (S.Z.); (G.D.); (V.S.); (M.C.)
| | - Michela Fantini
- Health Services Research, Evaluation and Policy Unit, AUSL Romagna, 42123 Rimini, Italy;
| | - Claudia Colosimo
- Department of Medical and Surgical Sciences—DIMEC, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy; (C.C.); (M.B.); (A.M.D.P.)
| | - Maria Vittoria Tamburini
- Unit of Microbiology, The Great Romagna Hub Laboratory, 47522 Pievesestina, Italy; (M.S.M.); (M.V.T.); (V.A.); (M.M.); (P.S.); (F.C.); (M.M.); (A.D.); (F.T.); (L.G.); (S.Z.); (G.D.); (V.S.); (M.C.)
| | - Valentina Arfilli
- Unit of Microbiology, The Great Romagna Hub Laboratory, 47522 Pievesestina, Italy; (M.S.M.); (M.V.T.); (V.A.); (M.M.); (P.S.); (F.C.); (M.M.); (A.D.); (F.T.); (L.G.); (S.Z.); (G.D.); (V.S.); (M.C.)
| | - Manuela Morotti
- Unit of Microbiology, The Great Romagna Hub Laboratory, 47522 Pievesestina, Italy; (M.S.M.); (M.V.T.); (V.A.); (M.M.); (P.S.); (F.C.); (M.M.); (A.D.); (F.T.); (L.G.); (S.Z.); (G.D.); (V.S.); (M.C.)
| | - Pasqualina Schiavone
- Unit of Microbiology, The Great Romagna Hub Laboratory, 47522 Pievesestina, Italy; (M.S.M.); (M.V.T.); (V.A.); (M.M.); (P.S.); (F.C.); (M.M.); (A.D.); (F.T.); (L.G.); (S.Z.); (G.D.); (V.S.); (M.C.)
| | - Francesco Congestrì
- Unit of Microbiology, The Great Romagna Hub Laboratory, 47522 Pievesestina, Italy; (M.S.M.); (M.V.T.); (V.A.); (M.M.); (P.S.); (F.C.); (M.M.); (A.D.); (F.T.); (L.G.); (S.Z.); (G.D.); (V.S.); (M.C.)
| | - Martina Manera
- Unit of Microbiology, The Great Romagna Hub Laboratory, 47522 Pievesestina, Italy; (M.S.M.); (M.V.T.); (V.A.); (M.M.); (P.S.); (F.C.); (M.M.); (A.D.); (F.T.); (L.G.); (S.Z.); (G.D.); (V.S.); (M.C.)
| | - Agnese Denicolò
- Unit of Microbiology, The Great Romagna Hub Laboratory, 47522 Pievesestina, Italy; (M.S.M.); (M.V.T.); (V.A.); (M.M.); (P.S.); (F.C.); (M.M.); (A.D.); (F.T.); (L.G.); (S.Z.); (G.D.); (V.S.); (M.C.)
| | - Martina Brandolini
- Department of Medical and Surgical Sciences—DIMEC, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy; (C.C.); (M.B.); (A.M.D.P.)
| | - Francesca Taddei
- Unit of Microbiology, The Great Romagna Hub Laboratory, 47522 Pievesestina, Italy; (M.S.M.); (M.V.T.); (V.A.); (M.M.); (P.S.); (F.C.); (M.M.); (A.D.); (F.T.); (L.G.); (S.Z.); (G.D.); (V.S.); (M.C.)
| | - Laura Grumiro
- Unit of Microbiology, The Great Romagna Hub Laboratory, 47522 Pievesestina, Italy; (M.S.M.); (M.V.T.); (V.A.); (M.M.); (P.S.); (F.C.); (M.M.); (A.D.); (F.T.); (L.G.); (S.Z.); (G.D.); (V.S.); (M.C.)
| | - Silvia Zannoli
- Unit of Microbiology, The Great Romagna Hub Laboratory, 47522 Pievesestina, Italy; (M.S.M.); (M.V.T.); (V.A.); (M.M.); (P.S.); (F.C.); (M.M.); (A.D.); (F.T.); (L.G.); (S.Z.); (G.D.); (V.S.); (M.C.)
| | - Giorgio Dirani
- Unit of Microbiology, The Great Romagna Hub Laboratory, 47522 Pievesestina, Italy; (M.S.M.); (M.V.T.); (V.A.); (M.M.); (P.S.); (F.C.); (M.M.); (A.D.); (F.T.); (L.G.); (S.Z.); (G.D.); (V.S.); (M.C.)
| | - Alessandra Mistral De Pascali
- Department of Medical and Surgical Sciences—DIMEC, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy; (C.C.); (M.B.); (A.M.D.P.)
| | - Vittorio Sambri
- Unit of Microbiology, The Great Romagna Hub Laboratory, 47522 Pievesestina, Italy; (M.S.M.); (M.V.T.); (V.A.); (M.M.); (P.S.); (F.C.); (M.M.); (A.D.); (F.T.); (L.G.); (S.Z.); (G.D.); (V.S.); (M.C.)
- Department of Medical and Surgical Sciences—DIMEC, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy; (C.C.); (M.B.); (A.M.D.P.)
| | - Monica Cricca
- Unit of Microbiology, The Great Romagna Hub Laboratory, 47522 Pievesestina, Italy; (M.S.M.); (M.V.T.); (V.A.); (M.M.); (P.S.); (F.C.); (M.M.); (A.D.); (F.T.); (L.G.); (S.Z.); (G.D.); (V.S.); (M.C.)
- Department of Medical and Surgical Sciences—DIMEC, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy; (C.C.); (M.B.); (A.M.D.P.)
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Douglas AP, Stewart AG, Halliday CL, Chen SCA. Outbreaks of Fungal Infections in Hospitals: Epidemiology, Detection, and Management. J Fungi (Basel) 2023; 9:1059. [PMID: 37998865 PMCID: PMC10672668 DOI: 10.3390/jof9111059] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 10/17/2023] [Accepted: 10/26/2023] [Indexed: 11/25/2023] Open
Abstract
Nosocomial clusters of fungal infections, whilst uncommon, cannot be predicted and are associated with significant morbidity and mortality. Here, we review reports of nosocomial outbreaks of invasive fungal disease to glean insight into their epidemiology, risks for infection, methods employed in outbreak detection including genomic testing to confirm the outbreak, and approaches to clinical and infection control management. Both yeasts and filamentous fungi cause outbreaks, with each having general and specific risks. The early detection and confirmation of the outbreak are essential for diagnosis, treatment of affected patients, and termination of the outbreak. Environmental sampling, including the air in mould outbreaks, for the pathogen may be indicated. The genetic analysis of epidemiologically linked isolates is strongly recommended through a sufficiently discriminatory approach such as whole genome sequencing or a method that is acceptably discriminatory for that pathogen. An analysis of both linked isolates and epidemiologically unrelated strains is required to enable genetic similarity comparisons. The management of the outbreak encompasses input from a multi-disciplinary team with epidemiological investigation and infection control measures, including screening for additional cases, patient cohorting, and strict hygiene and cleaning procedures. Automated methods for fungal infection surveillance would greatly aid earlier outbreak detection and should be a focus of research.
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Affiliation(s)
- Abby P. Douglas
- National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia
- Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC 3000, Australia
- Department of Infectious Diseases, Austin Health, Heidelberg, VIC 3084, Australia
| | - Adam G. Stewart
- Centre for Clinical Research, Faculty of Medicine, Royal Brisbane and Women’s Hospital Campus, The University of Queensland, Herston, QLD 4006, Australia;
| | - Catriona L. Halliday
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Sydney, NSW 2145, Australia; (C.L.H.); (S.C.-A.C.)
| | - Sharon C.-A. Chen
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Sydney, NSW 2145, Australia; (C.L.H.); (S.C.-A.C.)
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
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Benahmed A, Seghir A, Boucherit-Otmani Z, Tani ZZBAK, Aissaoui M, Kendil W, Merabet DH, Lakhal H, Boucherit K. In vitro evaluation of biofilm formation by Candida parapsilosis and Enterobacter cloacae. Scanning electron microscopy and efficacy of antimicrobial combinations study. Diagn Microbiol Infect Dis 2023; 107:116003. [PMID: 37423195 DOI: 10.1016/j.diagmicrobio.2023.116003] [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: 02/19/2023] [Revised: 05/08/2023] [Accepted: 06/04/2023] [Indexed: 07/11/2023]
Abstract
Fungal-bacterial infections are being increasingly recognized in clinical settings, and the interaction between these species in polymicrobial biofilms often lead to infections that are highly resistant to treatment. In this in vitro study, we analyzed the formation of mixed biofilms using clinically isolated Candida parapsilosis and Enterobacter cloacae. Additionally, we assessed the potential of conventional antimicrobials, both alone and in combination, for treating polymicrobial biofilms built by these human pathogens. Our results demonstrate that C. parapsilosis and E. cloacae are capable of forming mixed biofilms, as confirmed by scanning electron microscopy. Interestingly, we found that colistin alone or in combination with antifungal drugs was highly effective reducing up to 80% of the total biomass of polymicrobial biofilms.
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Affiliation(s)
- Abdeselem Benahmed
- Tlemcen University, Algeria; Laboratory Antibiotics Antifungals, Physico-Chemical, Synthesis and Biological Activities, Tlemcen University, Algeria.
| | - Abdelfettah Seghir
- Tlemcen University, Algeria; Laboratory Antibiotics Antifungals, Physico-Chemical, Synthesis and Biological Activities, Tlemcen University, Algeria
| | - Zahia Boucherit-Otmani
- Tlemcen University, Algeria; Laboratory Antibiotics Antifungals, Physico-Chemical, Synthesis and Biological Activities, Tlemcen University, Algeria
| | - Zahira Zakia Baba Ahmed-Kazi Tani
- Tlemcen University, Algeria; Laboratory Antibiotics Antifungals, Physico-Chemical, Synthesis and Biological Activities, Tlemcen University, Algeria
| | - Mohammed Aissaoui
- Department of Biology, Faculty of Sciences and Technology, University of Tamanghasset, Tamanghasset, Algeria
| | - Wafaa Kendil
- Tlemcen University, Algeria; Laboratory Antibiotics Antifungals, Physico-Chemical, Synthesis and Biological Activities, Tlemcen University, Algeria
| | | | - Hafsa Lakhal
- Tlemcen University, Algeria; Laboratory Antibiotics Antifungals, Physico-Chemical, Synthesis and Biological Activities, Tlemcen University, Algeria
| | - Kebir Boucherit
- Tlemcen University, Algeria; Laboratory Antibiotics Antifungals, Physico-Chemical, Synthesis and Biological Activities, Tlemcen University, Algeria
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Salvador A, Veiga FF, Svidzinski TIE, Negri M. Case of Mixed Infection of Toenail Caused by Candida parapsilosis and Exophiala dermatitidis and In Vitro Effectiveness of Propolis Extract on Mixed Biofilm. J Fungi (Basel) 2023; 9:jof9050581. [PMID: 37233292 DOI: 10.3390/jof9050581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 04/12/2023] [Accepted: 05/15/2023] [Indexed: 05/27/2023] Open
Abstract
Onychomycosis is a chronic fungal nail infection caused by several filamentous and yeast-like fungi, such as the genus Candida spp., of great clinical importance. Black yeasts, such as Exophiala dermatitidis, a closely related Candida spp. species, also act as opportunistic pathogens. Fungi infectious diseases are affected by organisms organized in biofilm in onychomycosis, making treatment even more difficult. This study aimed to evaluate the in vitro susceptibility profile to propolis extract and the ability to form a simple and mixed biofilm of two yeasts isolated from the same onychomycosis infection. The yeasts isolated from a patient with onychomycosis were identified as Candida parapsilosis sensu stricto and Exophiala dermatitidis. Both yeasts were able to form simple and mixed (in combination) biofilms. Notably, C. parapsilosis prevailed when presented in combination. The susceptibility profile of propolis extract showed action against E. dermatitidis and C. parapsilosis in planktonic form, but when the yeasts were in mixed biofilm, we only observed action against E. dermatitidis, until total eradication.
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Affiliation(s)
- Alana Salvador
- Departamento de Análises Clínicas e Biomedicina, Universidade Estadual de Maringá (UEM), Avenida Colombo, 5790, Maringá CEP 87020-900, PR, Brazil
| | - Flávia Franco Veiga
- Departamento de Análises Clínicas e Biomedicina, Universidade Estadual de Maringá (UEM), Avenida Colombo, 5790, Maringá CEP 87020-900, PR, Brazil
| | - Terezinha Inez Estivalet Svidzinski
- Departamento de Análises Clínicas e Biomedicina, Universidade Estadual de Maringá (UEM), Avenida Colombo, 5790, Maringá CEP 87020-900, PR, Brazil
| | - Melyssa Negri
- Departamento de Análises Clínicas e Biomedicina, Universidade Estadual de Maringá (UEM), Avenida Colombo, 5790, Maringá CEP 87020-900, PR, Brazil
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Orive Bañuelos A, Santamaría Carro A, Feijóo Lera R, Sacristán Egüén C, Andollo Victoriano N, Etxebarria Ecenarro J. Candida Colonization on the Surface of Contact Lenses in Long-Term Wearers and Boston Type 1 Keratoprosthesis Patients Presenting as White Mulberry-Shaped Deposits. Eye Contact Lens 2023; 49:188-192. [PMID: 37088944 DOI: 10.1097/icl.0000000000000984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2023] [Indexed: 04/25/2023]
Abstract
PURPOSE To report Candida colonies on the surface of the contact lens in long-term contact lens wearers and patients with Boston type 1 keratoprosthesis (KPro I). METHODS A retrospective study was performed based on analyzing cultures from bandage contact lenses with small whitish mulberry-shaped deposits on their surface. RESULTS Eight samples (from seven patients) were positive for Candida. Seven of the eight were positive for Candida parapsilosis. CONCLUSIONS The whitish deposits on contact lenses are often Candida colonies that colonize the surface but do not cause an active infection in the eye. C. parapsilosis is well-known for colonizing prosthetic devices. We underline the importance of including Candida species in the differential diagnosis of lens deposits, especially in susceptible patients such as keratoprosthesis carriers.
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Affiliation(s)
- Ana Orive Bañuelos
- Department of Ophthalmology (A.O.B., A.S.C., R.F.L., C.S.E., J.E.E.), BioCruces Bizkaia Health Research Institute, University Hospital of Cruces, Barakaldo, Spain; and Department of Cell Biology and Histology (N.A.V., J.E.E.), School of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain
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Characteristics of Biofilms Formed by C. parapsilosis Causing an Outbreak in a Neonatal Intensive Care Unit. J Fungi (Basel) 2022; 8:jof8070700. [PMID: 35887456 PMCID: PMC9322970 DOI: 10.3390/jof8070700] [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: 05/18/2022] [Revised: 06/15/2022] [Accepted: 06/29/2022] [Indexed: 01/21/2023] Open
Abstract
Background: We dealt with the occurrence of an outbreak of Candida parapsilosis in a neonatal intensive care unit (NICU) in September 2020. There have been several reports of C. parapsilosis outbreaks in NICUs. In this study we describe our investigation into both the transmission route and the biofilm of C. parapsilosis. Methods: C. parapsilosis strains were detected in three inpatients and in two environmental cultures in our NICU. One environmental culture was isolated from the incubator used by a fungemia patient, and another was isolated from the humidifier of an incubator that had been used by a nonfungemia patient. To prove their identities, we tested them by micro satellite analysis. We used two methods, dry weight measurements and observation by electron microscopy, to confirm biofilm. Results: Microsatellite analysis showed the five C. parapsilosis cultures were of the same strain. Dry weight measurements and electron microscopy showed C. parapsilosis formed biofilms that amounted to clumps of fungal cells. Conclusions: We concluded that the outbreak happened due to horizontal transfer through the humidifier of the incubator and that the C. parapsilosis had produced biofilm, which promoted an invasive and infectious outbreak. Additionally, biofilm is closely associated with pathogenicity.
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Shafiei M, Toreyhi H, Firoozpour L, Akbarzadeh T, Amini M, Hosseinzadeh E, Hashemzadeh M, Peyton L, Lotfali E, Foroumadi A. Design, Synthesis, and In Vitro and In Vivo Evaluation of Novel Fluconazole-Based Compounds with Promising Antifungal Activities. ACS OMEGA 2021; 6:24981-25001. [PMID: 34604679 PMCID: PMC8482776 DOI: 10.1021/acsomega.1c04016] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Indexed: 05/30/2023]
Abstract
Demand has arisen for developing new azole antifungal agents with the growth of the resistant rate of infective fungal species to current azole antifungals in recent years. Accordingly, the present study reports the synthesis of novel fluconazole (FLC) analogues bearing urea functionality that led to discovering new azole agents with promising antifungal activities. In particular, compounds 8b and 8c displayed broad-spectrum activity and superior in vitro antifungal capabilities compared to the standard drug FLC against sensitive and resistant Candida albicans (C. albicans). The highly active compounds 8b and 8c had potent antibiofilm properties against FLC-resistant C. albicans species. Additionally, these compounds exhibited very low toxicity for three mammalian cell lines and human red blood cells. Time-kill studies revealed that our synthesized compounds displayed a fungicidal mechanism toward fungal growth. Furthermore, a density functional theory (DFT) calculation, additional docking, and independent gradient model (IGM) studies were performed to analyze their structure-activity relationship (SAR) and to assess the molecular interactions in the related target protein. Finally, in vivo results represented a significant reduction in the tissue fungal burden and improvements in the survival rate in a mice model of systemic candidiasis along with in vitro and in silico studies, demonstrating the therapeutic efficiency of compounds 8b and 8c as novel leads for candidiasis drug discovery.
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Affiliation(s)
- Mohammad Shafiei
- Department
of Medicinal Chemistry, Faculty of Pharmacy, and Drug Design &
Development Research Center, The Institute of Pharmaceutical Sciences
(TIPS), Tehran University of Medical Sciences, Tehran 1417614411, Iran
| | - Hossein Toreyhi
- Student
Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran 19839-63113, Iran
| | - Loghman Firoozpour
- Department
of Medicinal Chemistry, Faculty of Pharmacy, and Drug Design &
Development Research Center, The Institute of Pharmaceutical Sciences
(TIPS), Tehran University of Medical Sciences, Tehran 1417614411, Iran
| | - Tahmineh Akbarzadeh
- Department
of Medicinal Chemistry, Faculty of Pharmacy, and Drug Design &
Development Research Center, The Institute of Pharmaceutical Sciences
(TIPS), Tehran University of Medical Sciences, Tehran 1417614411, Iran
| | - Mohsen Amini
- Department
of Medicinal Chemistry, Faculty of Pharmacy, and Drug Design &
Development Research Center, The Institute of Pharmaceutical Sciences
(TIPS), Tehran University of Medical Sciences, Tehran 1417614411, Iran
| | - Elaheh Hosseinzadeh
- Department
of Chemistry, Tarbiat Modares University, Tehran 1411713116, Iran
| | - Mehrnoosh Hashemzadeh
- University
of Arizona College of Medicine Phoenix and Pima college, Tucson, Arizona 85750, United States
| | - Lee Peyton
- Department
of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic College of Medicine and Science, Rochester, Minnesota 55905-0001, United States
| | - Ensieh Lotfali
- Department
of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran 19839-63113, Iran
| | - Alireza Foroumadi
- Department
of Medicinal Chemistry, Faculty of Pharmacy, and Drug Design &
Development Research Center, The Institute of Pharmaceutical Sciences
(TIPS), Tehran University of Medical Sciences, Tehran 1417614411, Iran
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Sasani E, Khodavaisy S, Rezaie S, Salehi M, Yadegari MH. The relationship between biofilm formation and mortality in patients with Candida tropicalis candidemia. Microb Pathog 2021; 155:104889. [PMID: 33878395 DOI: 10.1016/j.micpath.2021.104889] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Biofilm formation by Candida species is an influential virulence factor in candidemia pathogenesis. We investigated the relationship between biofilm formation of Candida tropicalis isolates with the clinical characteristics and mortality outcomes in patients with candidemia. MATERIALS AND METHODS Thirty-nine C. tropicalis isolates were recovered from patients with candidemia admitted to two university hospitals in Tehran, Iran. Biofilm mass and metabolic activity of C. tropicalis biofilms were assessed in vitro with two colorimetric methods. The sessile minimum inhibitory concentrations (SMICs) were evaluated in vitro by treating preformed biofilms with diluted concentrations of azoles according to CLSI-M27 A3/S4 protocol, followed by metabolic activity quantification. The expressions of ERG11, UPC2, MDR1, and CDR1 genes were also evaluated. RESULTS All C. tropicalis isolates produced biofilm. Respectively, higher <7-day and ≥7-day mortality rates were found among cases with high metabolic activity (46.7% vs. 13%, P = 0.03) and high biofilm mass (31.8% vs. 0, P = 0.029). Sessile cells had high resistance to fluconazole, voriconazole, and itraconazole. The azole minimum inhibitory concentrations (MICs) of C. tropicalis sessile were significantly greater than the planktonic minimum inhibitory concentrations (PMICs). In fluconazole-treated biofilms, the expression of ERG11 and UPC2 genes was increased. CONCLUSION Our findings highlight the importance of C. tropicalis biofilm formation as an important factor in candidemia pathogenesis and the clinical outcome of patients with candidemia.
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Affiliation(s)
- Elahe Sasani
- Department of Medical Mycology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Sadegh Khodavaisy
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Sassan Rezaie
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Salehi
- Department of Infectious Diseases and Tropical Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hossein Yadegari
- Department of Medical Mycology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
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Prusty JS, Kumar A. Innovative screening and drug susceptibility analysis on Candida albicans using Foldscope microscopy. RENDICONTI LINCEI. SCIENZE FISICHE E NATURALI 2021. [DOI: 10.1007/s12210-021-00974-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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11
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Lotfali E, Fattahi M, Ghasemi R, Zakermashhadi F, Shafiei M, Borzouie M, Rabiei MM. Enhancement of the Anti-biofilm Activity of Gold Nanoparticles- Itraconazole Conjugates in Resistant Candida glabrata. RECENT ADVANCES IN ANTI-INFECTIVE DRUG DISCOVERY 2021; 16:137-147. [PMID: 34961432 DOI: 10.2174/2772434416666210607144543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/26/2021] [Accepted: 04/15/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Onychomycosis, also called tinea unguium, is a common fungal infection affecting the nails. After dermatophytes, Candida species are recognized as second-line pathogens responsible for this infection. The treatment of onychomycosis requires a long time and is associated with high rates of recurrence. Antifungal medicines conjugated with gold (Au-NP) nanoparticle are the possible platforms for the reduction of drug resistance. METHODS In the present study, we reported the in-vitro antifungal activity of itraconazole (ITZ) - Au conjugates, time-kill studies, and biofilm-producing ability of six ITZ-resistant C. glabrata. RESULTS 3-(4,5-Dimethylthiazol-2-yl)-2,5-Diphenyltetrazolium bromide (MTT) quantitative results revealed that four out of six resistant isolates studied able to form biofilms in vitro. ITZ-Au conjugates were more effective than ITZ or Au nanoparticle alone, and the time-kill tests pointed to the suitable effect of ITZ-Au conjugate. CONCLUSION The present study concluded that ITZ-Au conjugates have an inhibitory effect on the biofilm of resistant C. glabrata isolates. Further studies are needed to compare the ex-vivo onychomycosis model.
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Affiliation(s)
- Ensieh Lotfali
- Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahsa Fattahi
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Ghasemi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzan Zakermashhadi
- Student Research Committee, Gifted and Talented Dental Students Division, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Shafiei
- Department of Medicinal Chemistry, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojgan Borzouie
- Medical Laboratory Scientist, Hospital RomGerMed, Bucharest, Romania
| | - Mohammad Mahdi Rabiei
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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12
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Khodavaisy S, Badali H, Meis JF, Modiri M, Mahmoudi S, Abtahi H, Salehi M, Dehghan Manshadi SA, Aala F, Agha Kuchak Afshari S, Lotfali E, Ahangarkani F, Rezaie S. Comparative in vitro activities of seven antifungal drugs against clinical isolates of Candida parapsilosis complex. J Mycol Med 2020; 30:100968. [PMID: 32386800 DOI: 10.1016/j.mycmed.2020.100968] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 03/15/2020] [Accepted: 03/31/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Candida parapsilosis species complex, an important set of non-albicans Candida species, is known to cause candidaemia particularly in neonates and infants. However, the incidence has increased in recent years, owing to higher numbers of at individuals at risk for these infections. Our objective was to evaluate the in vitro susceptibility of clinical isolates of C. parapsilosis complex isolates from Iran to seven antifungal drugs. MATERIAL AND METHODS One hundred-one clinical isolates of C. parapsilosis species complex cultured from humans were included. Species identification had been previously confirmed by combined phenotypic characteristics, matrix-assisted laser desorption ionization-time of flight mass spectrometry-based assay and reconfirmed by DNA sequence analysis of the ITS rDNA region and D1/D2 gene. Minimum inhibitory concentrations (MICs) for amphotericin B, fluconazole, itraconazole, voriconazole, posaconazole, micafungin and anidulafungin were determined against well-characterized isolates by broth microdilution susceptibility testing according to the CLSI M27-A3 guideline. RESULTS Species identifications were performed on 101 isolates, of which 88 (87.2%) C. parapsilosis sensu stricto and 13 (12.8%) C. orthopsilosis. Amphotericin B and posaconazole were the most active drugs with 100% of isolates being wild-type (WT). Voriconazole and micafungin, 99% of isolates were WT. The low activity was recorded for fluconazole and itraconazole with 93.1% and 89.1% of isolates being WT, respectively. At the species level, all Candida parapsilosis sensu stricto isolates were WT to amphotericin B and posaconazole and all Candida orthopsilosis isolates were WT to amphotericin B, voriconazole, posaconazole, anidulafungin and micafungin. In contrast, the highest rate of non-WT was observed in C. orthopsilosis to itraconazole (4 of 13, 30.8%). CONCLUSIONS Although almost all of the tested drugs demonstrated potent activity against C. parapsilosis species complex, it seems that more especially C. orthopsilosis isolates had decreased susceptibility to itraconazole. Further studies are needed to determine how these findings may switch into in vivo efficacy.
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Affiliation(s)
- S Khodavaisy
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - H Badali
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran; Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - J F Meis
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital (CWZ), Nijmegen, The Netherlands; Centre of Expertise in Mycology Radboudumc/CWZ, Nijmegen, The Netherlands
| | - M Modiri
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - S Mahmoudi
- Department of Medical Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - H Abtahi
- Department of Pulmonary and Critical Care, Advanced Thoracic Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - M Salehi
- Department of Infectious Diseases and tropical medicines, School of Medicine, Imam Khomeini Hospital complex, Tehran University of Medical Sciences, Tehran, Iran
| | - S A Dehghan Manshadi
- Department of Infectious Diseases and tropical medicines, School of Medicine, Imam Khomeini Hospital complex, Tehran University of Medical Sciences, Tehran, Iran
| | - F Aala
- Department of Parasitology and Mycology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - S Agha Kuchak Afshari
- Department of Medical Parasitology and Mycology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - E Lotfali
- Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - F Ahangarkani
- Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences, Sari, Iran; Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - S Rezaie
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
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Modiri M, Hashemi SJ, GhazvinI RD, Khodavaisy S, Ahmadi A, Ghaffari M, Rezaie S. Antifungal susceptibility pattern and biofilm-related genes expression in planktonic and biofilm cells of Candida parapsilosis species complex. Curr Med Mycol 2020; 5:35-42. [PMID: 32104742 PMCID: PMC7034785 DOI: 10.18502/cmm.5.4.1950] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Background and Purpose: Candida parapsilosis complex isolates are mainly responsible for nosocomial catheter-related infection in immunocompromised patients. Biofilm formation is regarded as one of the most pertinent key virulence factors in the development of these emerging infections. The present study aimed to compare in vitro antifungal susceptibility patterns and biofilm-related genes expression ratio in planktonic and biofilm’s cells of clinically C. parapsilosis complex isolates. Materials and Methods: The current study was conducted on a number of 17 clinical C. parapsilosis complex (10 C. parapsilosis sensu stricto, 5 C. orthopsilosis, and 2 C. metapsilosis). The antifungal susceptibility patterns of amphotericin B, fluconazole, itraconazole, voriconazole, posaconazole, and caspofungin in planktonic and biofilm forms were closely examined using CLSI M27-A3 broth microdilution method. The expression levels of biofilm-related genes (BCR1, EFG1, and FKS1) were evaluated in planktonic and biofilm’s cells using Real-time polymerase chain reaction (PCR) technique. Results: The obtained results indicated that all C. parapsilosis complex isolates were able to produce high and moderate amounts of biofilm forms. In addition, the sessile minimum inhibitory concentrations were reported to be high for fluconazole (≥ 64 µg/ml), itraconazole, voriconazole, and posaconazole (≥ 16 µg/ml), as compared to planktonic minimum inhibitory concentrations. Moreover, a significant difference was observed between antifungal susceptibility patterns for all azole antifungal agents (P<0.05). Furthermore, the BCR1 overexpression was considered significant in biofilms with regard to planktonic cells in C. parapsilosis species complex (P=0.002). Conclusion: C. parapsilosis complex isolates were found susceptible to most of the tested antifungal drugs, while biofilms demonstrated a noticeable resistant to azoles. The marked discrepancy noted in antifungal susceptibility patterns among these species should be highlighted to achieve effective therapeutic treatment.
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Affiliation(s)
- Mona Modiri
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Jamal Hashemi
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Roshanak Daie GhazvinI
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Sadegh Khodavaisy
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ahmadi
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mansoureh Ghaffari
- Department of Microbiology, Faculty of Science, Islamic Azad University, Varamin-Pishva, Iran
| | - Sassan Rezaie
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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