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Fernandes LDS, Ogasawara LS, Medina-Alarcón KP, dos Santos KS, de Matos Silva S, de Assis LR, Regasini LO, de Oliveira AG, Mendes Giannini MJS, Scarpa MV, Fusco Almeida AM. Bioprospecting, Synergistic Antifungal and Toxicological Aspects of the Hydroxychalcones and Their Association with Azole Derivates against Candida spp. for Treating Vulvovaginal Candidiasis. Pharmaceutics 2024; 16:843. [PMID: 39065540 PMCID: PMC11279727 DOI: 10.3390/pharmaceutics16070843] [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: 03/11/2024] [Revised: 06/10/2024] [Accepted: 06/17/2024] [Indexed: 07/28/2024] Open
Abstract
Vulvovaginal candidiasis (VVC) remains a prevalent fungal disease, characterized by challenges, such as increased fungal resistance, side effects of current treatments, and the rising prevalence of non-albicans Candida spp. naturally more resistant. This study aimed to propose a novel therapeutic approach by investigating the antifungal properties and toxicity of 2-hydroxychalcone (2-HC) and 3'-hydroxychalcone (3'-HC), both alone and in combination with fluconazole (FCZ) and clotrimazole (CTZ). A lipid carrier (LC) was also developed to deliver these molecules. The study evaluated in vitro anti-Candida activity against five Candida species and assessed cytotoxicity in the C33-A cell line. The safety and therapeutic efficacy of in vivo were tested using an alternative animal model, Galleria mellonella. The results showed antifungal activity of 2-HC and 3'-HC, ranging from 7.8 to 31.2 as fungistatic and 15.6 to 125.0 mg/L as fungicide effect, with cell viability above 80% from a concentration of 9.3 mg/L (2-HC). Synergistic and partially synergistic interactions of these chalcones with FCZ and CTZ demonstrated significant improvement in antifungal activity, with MIC values ranging from 0.06 to 62.5 mg/L. Some combinations reduced cytotoxicity, achieving 100% cell viability in many interactions. Additionally, two LCs with suitable properties for intravaginal application were developed. These formulations demonstrated promising therapeutic efficacy and low toxicity in Galleria mellonella assays. These results suggest the potential of this approach in developing new therapies for VVC.
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Affiliation(s)
- Lígia de Souza Fernandes
- Laboratory of Clinical Mycology, Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Road Araraquara Jaú, Km 01, S/N, Araraquara 14800-903, SP, Brazil; (L.d.S.F.); (L.S.O.); (K.P.M.-A.); (K.S.d.S.); (S.d.M.S.); (M.J.S.M.G.)
- Department of Drugs and Medicines, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Road Araraquara Jaú, Km 01, S/N, Araraquara 14800-903, SP, Brazil; (A.G.d.O.); (M.V.S.)
| | - Letícia Sayuri Ogasawara
- Laboratory of Clinical Mycology, Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Road Araraquara Jaú, Km 01, S/N, Araraquara 14800-903, SP, Brazil; (L.d.S.F.); (L.S.O.); (K.P.M.-A.); (K.S.d.S.); (S.d.M.S.); (M.J.S.M.G.)
| | - Kaila Petronila Medina-Alarcón
- Laboratory of Clinical Mycology, Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Road Araraquara Jaú, Km 01, S/N, Araraquara 14800-903, SP, Brazil; (L.d.S.F.); (L.S.O.); (K.P.M.-A.); (K.S.d.S.); (S.d.M.S.); (M.J.S.M.G.)
| | - Kelvin Sousa dos Santos
- Laboratory of Clinical Mycology, Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Road Araraquara Jaú, Km 01, S/N, Araraquara 14800-903, SP, Brazil; (L.d.S.F.); (L.S.O.); (K.P.M.-A.); (K.S.d.S.); (S.d.M.S.); (M.J.S.M.G.)
| | - Samanta de Matos Silva
- Laboratory of Clinical Mycology, Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Road Araraquara Jaú, Km 01, S/N, Araraquara 14800-903, SP, Brazil; (L.d.S.F.); (L.S.O.); (K.P.M.-A.); (K.S.d.S.); (S.d.M.S.); (M.J.S.M.G.)
| | - Letícia Ribeiro de Assis
- Department of Chemistry and Environmental Sciences, Institute of Biosciences, Humanities and Exact Sciences, São Paulo State University (UNESP), St. Quirino de Andrade, 215, São José do Rio Preto 01049-010, SP, Brazil; (L.R.d.A.); (L.O.R.)
| | - Luís Octavio Regasini
- Department of Chemistry and Environmental Sciences, Institute of Biosciences, Humanities and Exact Sciences, São Paulo State University (UNESP), St. Quirino de Andrade, 215, São José do Rio Preto 01049-010, SP, Brazil; (L.R.d.A.); (L.O.R.)
| | - Anselmo Gomes de Oliveira
- Department of Drugs and Medicines, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Road Araraquara Jaú, Km 01, S/N, Araraquara 14800-903, SP, Brazil; (A.G.d.O.); (M.V.S.)
| | - Maria José Soares Mendes Giannini
- Laboratory of Clinical Mycology, Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Road Araraquara Jaú, Km 01, S/N, Araraquara 14800-903, SP, Brazil; (L.d.S.F.); (L.S.O.); (K.P.M.-A.); (K.S.d.S.); (S.d.M.S.); (M.J.S.M.G.)
| | - Maria Virginia Scarpa
- Department of Drugs and Medicines, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Road Araraquara Jaú, Km 01, S/N, Araraquara 14800-903, SP, Brazil; (A.G.d.O.); (M.V.S.)
| | - Ana Marisa Fusco Almeida
- Laboratory of Clinical Mycology, Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Road Araraquara Jaú, Km 01, S/N, Araraquara 14800-903, SP, Brazil; (L.d.S.F.); (L.S.O.); (K.P.M.-A.); (K.S.d.S.); (S.d.M.S.); (M.J.S.M.G.)
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Al Dhaheri F, Thomsen J, Everett D, Denning DW. Mapping the Burden of Fungal Diseases in the United Arab Emirates. J Fungi (Basel) 2024; 10:353. [PMID: 38786708 PMCID: PMC11121979 DOI: 10.3390/jof10050353] [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: 02/26/2024] [Revised: 04/09/2024] [Accepted: 04/23/2024] [Indexed: 05/25/2024] Open
Abstract
The United Arab Emirates has very little data on the incidence or prevalence of fungal diseases. Using total and underlying disease risk populations and likely affected proportions, we have modelled the burden of fungal disease for the first time. The most prevalent serious fungal conditions are recurrent vulvovaginitis (~190,000 affected) and fungal asthma (~34,000 affected). Given the UAE's low prevalence of HIV, we estimate an at-risk population of 204 with respect to serious fungal infections with cryptococcal meningitis estimated at 2 cases annually, 15 cases of Pneumocystis pneumonia (PCP) annually, and 20 cases of esophageal candidiasis in the HIV population. PCP incidence in non-HIV patients is estimated at 150 cases annually. Likewise, with the same low prevalence of tuberculosis in the country, we estimate a total chronic pulmonary aspergillosis prevalence of 1002 cases. The estimated annual incidence of invasive aspergillosis is 505 patients, based on local data on rates of malignancy, solid organ transplantation, and chronic obstructive pulmonary disease (5.9 per 100,000). Based on the 2022 annual report of the UAE's national surveillance database, candidaemia annual incidence is 1090 (11.8/100,000), of which 49.2% occurs in intensive care. Fungal diseases affect ~228,695 (2.46%) of the population in the UAE.
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Affiliation(s)
- Fatima Al Dhaheri
- Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Jens Thomsen
- Department of Public Health and Epidemiology, Khalifa University, Abu Dhabi P.O. Box 127788, United Arab Emirates; (J.T.); (D.E.)
| | - Dean Everett
- Department of Public Health and Epidemiology, Khalifa University, Abu Dhabi P.O. Box 127788, United Arab Emirates; (J.T.); (D.E.)
- Infection Research Unit, Khalifa University, Abu Dhabi P.O. Box 127788, United Arab Emirates
| | - David W. Denning
- Manchester Fungal Infection Group, The University of Manchester, Manchester Academic Health Science Centre, Grafton Street, Manchester M13 9NT, UK
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Song J, Dong X, Lan Y, Lu Y, Liu X, Kang X, Huang Z, Yue B, Liu Y, Ma W, Zhang L, Yan H, He M, Fan Z, Guo T. Interpretation of vaginal metagenomic characteristics in different types of vaginitis. mSystems 2024; 9:e0137723. [PMID: 38364107 PMCID: PMC10949516 DOI: 10.1128/msystems.01377-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 01/22/2024] [Indexed: 02/18/2024] Open
Abstract
Although vaginitis is closely related to vaginal microecology in females, the precise composition and functional potential of different types of vaginitis remain unclear. Here, metagenomic sequencing was applied to analyze the vaginal flora in patients with various forms of vaginitis, including cases with a clue cell proportion ranging from 1% to 20% (Clue1_20), bacterial vaginitis (BV), vulvovaginal candidiasis (VVC), and BV combined with VVC (VVC_BV). Our results identified Prevotella as an important biomarker between BV and Clue1_20. Moreover, a gradual decrease was observed in the relative abundance of shikimic acid metabolism associated with bacteria producing indole as well as a decline in the abundance of Gardnerella vaginalis in patients with BV, Clue1_20, and healthy women. Interestingly, the vaginal flora of patients in the VVC_BV group exhibited structural similarities to that of the VVC group, and its potentially functional characteristics resembled those of the BV and VVC groups. Finally, Lactobacillus crispatus was found in high abundance in healthy samples, greatly contributing to the stability of the vaginal environment. For the further study of L. crispatus, we isolated five strains of L. crispatus from healthy samples and evaluated their capacity to inhibit G. vaginalis biofilms and produce lactic acid in vitro to select the potential probiotic candidate for improving vaginitis in future clinical studies. Overall, we successfully identified bacterial biomarkers of different vaginitis and characterized the dynamic shifts in vaginal flora between patients with BV and healthy females. This research advances our understanding and holds great promise in enhancing clinical approaches for the treatment of vaginitis. IMPORTANCE Vaginitis is one of the most common gynecological diseases, mostly caused by infections of pathogens such as Candida albicans and Gardnerella vaginalis. In recent years, it has been found that the stability of the vaginal flora plays an important role in vaginitis. Furthermore, the abundant Lactobacillus-producing rich lactic acid in the vagina provides a healthy acidic environment such as Lactobacillus crispatus. The metabolites of Lactobacillus can inhibit the colonization of pathogens. Here, we collected the vaginal samples of patients with bacterial vaginitis (BV), vulvovaginal candidiasis (VVC), and BV combined with VVC to discover the differences and relationships among the different kinds of vaginitis by metagenomic sequencing. Furthermore, because of the importance of L. crispatus in promoting vaginal health, we isolated multiple strains from vaginal samples of healthy females and chose the most promising strain with potential probiotic benefits to provide clinical implications for treatment strategies.
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Affiliation(s)
- Jiarong Song
- Key Laboratory of Bioresources and Ecoenvironment (Ministry of Education), College of Life Sciences, Sichuan University, Chengdu, China
| | - Xue Dong
- Department of Gynecology and Obstetrics, West China Second Hospital, Sichuan University, Chengdu, China
| | - Yue Lan
- Key Laboratory of Bioresources and Ecoenvironment (Ministry of Education), College of Life Sciences, Sichuan University, Chengdu, China
| | - Yunwei Lu
- Key Laboratory of Bioresources and Ecoenvironment (Ministry of Education), College of Life Sciences, Sichuan University, Chengdu, China
| | - Xu Liu
- Key Laboratory of Bioresources and Ecoenvironment (Ministry of Education), College of Life Sciences, Sichuan University, Chengdu, China
| | - Xuena Kang
- Key Laboratory of Bioresources and Ecoenvironment (Ministry of Education), College of Life Sciences, Sichuan University, Chengdu, China
| | - Zhonglu Huang
- Meishan Women and Children’s Hospital, Meishan, Sichuan, China
| | - Bisong Yue
- Key Laboratory of Bioresources and Ecoenvironment (Ministry of Education), College of Life Sciences, Sichuan University, Chengdu, China
| | - Yu Liu
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China
| | - Wenjin Ma
- Chenghua District Maternal and Child Health Hospital, Chengdu, Sichuan, China
| | - Libo Zhang
- Renshou County People’s Hospital, Renshou, Sichuan, China
| | - Haijun Yan
- Meishan Traditional Chinese Medicine Hospital, Meishan, Sichuan, China
| | - Miao He
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China
| | - Zhenxin Fan
- Key Laboratory of Bioresources and Ecoenvironment (Ministry of Education), College of Life Sciences, Sichuan University, Chengdu, China
| | - Tao Guo
- Department of Gynecology and Obstetrics, West China Second Hospital, Sichuan University, Chengdu, China
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Maftei NM, Arbune M, Georgescu CV, Elisei AM, Iancu AV, Tatu AL. Vulvovaginal Candidiasis in Pregnancy-Between Sensitivity and Resistance to Antimycotics. J Xenobiot 2023; 13:312-322. [PMID: 37489336 PMCID: PMC10366840 DOI: 10.3390/jox13030023] [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: 03/17/2023] [Revised: 06/06/2023] [Accepted: 07/01/2023] [Indexed: 07/26/2023] Open
Abstract
Vulvovaginitis with Candida spp. is the most common infection in women and the rate is increased during pregnancy. Antifungal prescription in pregnant women continues to present challenges and the decision must balance the risk of fetal toxicity with the benefits to the fetus and mother. Starting from the idea that clotrimazole is the most recommended antifungal in candidal vaginitis in pregnancy, we tested the sensitivity of different species of Candida spp. to other azoles, polyenes, and antimetabolites. This retrospective study (January to June 2019) assessed 663 pregnant women hospitalized for various pregnancy-related symptoms in which samples of phage secretion were taken. The laboratory results confirmed 21% of cases, indicating 140 positive mycologic samples. In this study, vaginal candidiasis was mostly related to the first trimester of pregnancy (53.57%,) and less related in the last trimester (17.14%). Candida albicans was the most frequent isolated strain in this study, accounting for 118 cases, followed by 16 strains of Candida glabrata and 6 cases of Candida krusei. The highest sensitivity for C. albicans was found in azoles, mostly in miconazole (93.2%), while C. krusei was completely resistant to polyene with low sensitivity in antimetabolites and even in some azoles, such as fluconazole. In our study, higher resistance rates to flucytosine were found, with C. glabrata and C. krusei exhibiting greater resistance than C. albicans.
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Affiliation(s)
- Nicoleta-Maricica Maftei
- Faculty of Medicine and Pharmacy, Research Centre in the Medical-Pharmaceutical Field, University "Dunărea de Jos", 800010 Galati, Romania
- Medical Laboratory Department, "Sfântul Ioan" Children's Emergency Hospital, 800487 Galați, Romania
| | - Manuela Arbune
- Clinical Medical Department, Faculty of Medicine and Pharmacy, University "Dunărea de Jos", 800010 Galati, Romania
- Infectious Diseases Department, Clinical Hospital of Infectious Diseases "Sf. Cuvioasa Parascheva", 800179 Galati, Romania
| | - Costinela Valerica Georgescu
- Faculty of Medicine and Pharmacy, Research Centre in the Medical-Pharmaceutical Field, University "Dunărea de Jos", 800010 Galati, Romania
- Department of Public Health, Clinical Hospital of Obstetrics and Gynecology "Buna Vestire", 800151 Galati, Romania
| | - Alina Mihaela Elisei
- Faculty of Medicine and Pharmacy, Research Centre in the Medical-Pharmaceutical Field, University "Dunărea de Jos", 800010 Galati, Romania
| | - Alina Viorica Iancu
- Medical Laboratory Department, Clinical Hospital of Infectious Diseases "Sf. Cuvioasa Parascheva", 800179 Galati, Romania
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, University "Dunărea de Jos", 800010 Galati, Romania
| | - Alin Laurentiu Tatu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, University "Dunărea de Jos", 800010 Galati, Romania
- Research Center in the Field of Medical and Pharmaceutical Sciences, ReFORM-UDJ, 800010 Galati, Romania
- Dermatology Department, Clinical Hospital of Infectious Diseases "Sf. Cuvioasa Parascheva", 800179 Galati, Romania
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Zhang J, Peng J, Li D, Mei H, Yu Y, Li X, She X, Liu W. Divergent EGFR/MAPK-Mediated Immune Responses to Clinical Candida Pathogens in Vulvovaginal Candidiasis. Front Immunol 2022; 13:894069. [PMID: 35720274 PMCID: PMC9204526 DOI: 10.3389/fimmu.2022.894069] [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: 03/11/2022] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
Vulvovaginal candidiasis (VVC) is characterized by symptomatic inflammatory responses in the vagina caused by Candida albicans and non-albicans Candida (NAC) species. The epidermal growth factor receptor (EGFR) -mitogen-activated protein kinase (MAPK) signaling pathway has been linked to immune responses of oral mucosa after C. albicans exposure, but whether this pathway plays a similar response in vaginal epithelial cells is not known. Here, we observed that phosphorylation of EGFR and p38 was continuously activated in vaginal epithelial cells by C. albicans strain SC5314. This differs markedly from oral epithelial cells, which respond in a biphasic manner in order to properly discriminate the morphology of C. albicans. When compared with SC5314, a highly azole-resistant C. albicans isolate 1052 can induce a stronger phosphorylated signal of EGFR and p38, while clinically-isolated NAC strains including C. tropicalis, C. glabrata, C. parapsilosis and C. auris trigger higher levels of phosphorylated ERK1/2 and c-Fos than C. albicans. Inhibition of EGFR significantly reduces inflammatory response and epithelial damage induced by C. albicans both in vitro and in vivo, while inhibition of p38 leads to significant repair of epithelial damage triggered by both C. albicans and NAC species. These results confirm the importance of the EGFR-MAPK signaling in VVC pathogenesis and highlight the remarkable immunogenic differences between C. albicans and NAC species in host-microbe interactions.
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Affiliation(s)
- Jingyun Zhang
- Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College (PUMC), Nanjing, China.,Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, China
| | - Jingwen Peng
- Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College (PUMC), Nanjing, China.,Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, China
| | - Dongmei Li
- Department of Microbiology & Immunology, Georgetown University Medical Center, Washington, DC, United States
| | - Huan Mei
- Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College (PUMC), Nanjing, China.,Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, China
| | - Yu Yu
- Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College (PUMC), Nanjing, China.,Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, China
| | - Xiaofang Li
- Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College (PUMC), Nanjing, China.,Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, China
| | - Xiaodong She
- Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College (PUMC), Nanjing, China.,Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, China
| | - Weida Liu
- Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College (PUMC), Nanjing, China.,Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, China.,Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
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Prevalence and species distribution of microorganisms isolated among non-pregnant women affected by vulvovaginal candidiasis: a retrospective study over a 20 year-period. J Mycol Med 2022; 32:101278. [DOI: 10.1016/j.mycmed.2022.101278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 04/09/2022] [Accepted: 04/14/2022] [Indexed: 11/19/2022]
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Anh DN, Hung DN, Tien TV, Dinh VN, Son VT, Luong NV, Van NT, Quynh NTN, Van Tuan N, Tuan LQ, Bac ND, Luc NK, Anh LT, Trung DM. Prevalence, species distribution and antifungal susceptibility of Candida albicans causing vaginal discharge among symptomatic non-pregnant women of reproductive age at a tertiary care hospital, Vietnam. BMC Infect Dis 2021; 21:523. [PMID: 34082699 PMCID: PMC8176683 DOI: 10.1186/s12879-021-06192-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/13/2021] [Indexed: 12/13/2022] Open
Abstract
Background Vaginal candidiasis is frequent in women of reproductive age. Accurate identification Candida provides helpful information for successful therapy and epidemiology study; however, there are very limited data from the Vietnam have been reported. This study was performed to determine the prevalence, species distribution of yeast causing vaginal discharge and antifungal susceptibility patterns of Candida albicans among symptomatic non-pregnant women of reproductive age. Methods Vaginal discharge samples were collected from 462 women of reproductive age in Hanoi, Vietnam between Sep 2019 and Oct 2020. Vaginal swabs from these patients were examined by direct microscopic examination (10% KOH). CHROMagar™ Candida medium and Sabouraud dextrose agar supplemented with chloramphenicol (0.5 g/l) were used to isolate yeast, and species identification was performed using morphological tests and molecular tools (PCR and sequencing). Antifungal susceptibility testing was determined according to the Clinical and Laboratory Standards Institute guidelines (M27-A3 and M27-S4). Results The prevalence of vaginal yeast colonization in non-pregnant women was 51.3% of 462 participants. Nine different yeast species were identified. Among these isolates, C. albicans (51.37%) was the most frequent, followed by C. parapsilosis (25.88%), C. glabrata (11.37%), C. tropicalis (4.31%), C. krusei (3.92%), C. africana (1.57%), Saccharomyces cerevisiae (0.78%), C. nivariensis (1 isolates, 0.39%), and C. lusitaniae (1 isolates, 0.39%), respectively. Among C. albicans, all 46 isolates were 100% susceptible to micafungin, caspofungin, and miconazole. The susceptibility rates to amphotericine B, 5-flucytosine, fluconazole, itraconazole and voriconazole were 95.65, 91.30, 91.30, 82.61 and 86.95%, respectively. Conclusions The prevalence of VVC among symptomatic non-pregnant women of reproductive age in Vietnam was higher than many parts of the world. The high frequency of non-albicans Candida species, which were often more resistant to antifungal agents, was a notable feature. Resistance rates of vaginal C. albicans isolates to antifungal agents was low. Our findings suggest that continued surveillance of changes in species distribution and susceptibility to antifungals should be routinely screened and treated. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06192-7.
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Affiliation(s)
- Do Ngoc Anh
- Department of Medical Parasitology, Vietnam Military Medical University, Hanoi, Vietnam. .,Laboratory of Parasitology and Medical Mycology, 103 Military Hospital, Hanoi, Vietnam.
| | - Dao Nguyen Hung
- 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Tran Viet Tien
- 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Vu Nhat Dinh
- 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Vu Tung Son
- Department of Epidemiology, Vietnam Military Medical University, Hanoi, Vietnam
| | | | - Nguyen Thi Van
- Laboratory of Parasitology and Medical Mycology, 103 Military Hospital, Hanoi, Vietnam
| | - Nguyen Thi Nhu Quynh
- Department of Medical Parasitology, Vietnam Military Medical University, Hanoi, Vietnam
| | - Nguyen Van Tuan
- Department of Medical Parasitology, Vietnam Military Medical University, Hanoi, Vietnam
| | - Le Quoc Tuan
- Department of Medical Parasitology, Vietnam Military Medical University, Hanoi, Vietnam.,Laboratory of Parasitology and Medical Mycology, 103 Military Hospital, Hanoi, Vietnam
| | - Nguyen Duy Bac
- Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, Hanoi, Vietnam
| | - Nguyen Khac Luc
- Department of Medical Parasitology, Vietnam Military Medical University, Hanoi, Vietnam.,Laboratory of Parasitology and Medical Mycology, 103 Military Hospital, Hanoi, Vietnam
| | - Le Tran Anh
- Department of Medical Parasitology, Vietnam Military Medical University, Hanoi, Vietnam.,Laboratory of Parasitology and Medical Mycology, 103 Military Hospital, Hanoi, Vietnam
| | - Do Minh Trung
- Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, Hanoi, Vietnam.
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Ganeshkumar A, Nagarajan P, Mahalingam P, Balasubramanian S, Archunan PA, Govindaraju A, Rajaram R. Antifungal susceptibility and virulence profile of candida isolates from abnormal vaginal discharge of women from southern India. Eur J Obstet Gynecol Reprod Biol 2020; 254:153-158. [PMID: 32971434 DOI: 10.1016/j.ejogrb.2020.09.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 09/10/2020] [Accepted: 09/11/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Vaginal candidiasis is the most common opportunistic fungal infection, largely associated with a woman's psychological and economic status. Recently, the rate of disease progression has increased extensively; however, region-specific studies are very limited. This study aimed to understand variation in hydrolytic activities and antifungal susceptibility of Candida isolates from vaginal discharge. STUDY DESIGN The present study was aimed to understand the variation of hydrolytic activities and antifungal susceptibility of Candida isolates from vaginal discharge. RESULTS In total, 34 different Candida isolates were collected: C. albicans (n = 17; 50 %), C. glabrata (n = 6; 17.64 %), C. tropicalis (n = 4; 11.76 %) and C. parapsilosis (n = 7; 20.58 %). All isolates were primarily identified and confirmed by basic microbiological methods followed by the VITEK-2 system. Antifungal susceptibility of the isolates were evaluated using yeast antifungal susceptibility testing cards. The isolates of C. albicans, C. glabrata, C. tropicalis and C. parapsilosis were 100 % susceptible to amphotericin B. The non-albicans isolates presented 100 % of proteolytic and lipolytic activity compared with C. albicans. Eight (47.06 %) C. albicans isolates showed positive esterase activity (Pz<1), whereas nine (52.94 %) were negative to esterase (Pz = 1). Of the 34 Candida isolates, 28 (82.35 %) were found to be moderate-to-strong biofilm producers: 14 C. albicans, three C. glabrata, six C. parapsilosis and five C. tropicalis. CONCLUSION This study clarified the antifungal susceptibility and virulence behaviour of Candida isolates; this will be of use in the selection of antifungal agents for Candida prophylaxis.
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Affiliation(s)
- Arumugam Ganeshkumar
- DNA Barcoding and Marine Genomics Laboratory, Department of Marine Sciences, Bharathidasan University, Tiruchirapalli, India; Department of Microbiology, Trichy SRM Medical College Hospital and Research Centre, Tiruchirapalli, India
| | - Prabhusaran Nagarajan
- Department of Microbiology, Trichy SRM Medical College Hospital and Research Centre, Tiruchirapalli, India
| | - Pramila Mahalingam
- Department of Microbiology, Trichy SRM Medical College Hospital and Research Centre, Tiruchirapalli, India; Department of Biotechnology, Nehru Memorial College, Tiruchirapalli, India
| | - Saranya Balasubramanian
- Department of Obstetrics and Gynaecology, Trichy SRM Medical College Hospital and Research Centre, Tiruchirapalli, India
| | | | - Archunan Govindaraju
- Centre for Pheromone Technology, Department of Animal Sciences, Bharathidasan University, Tiruchirapalli, India
| | - Rajendran Rajaram
- DNA Barcoding and Marine Genomics Laboratory, Department of Marine Sciences, Bharathidasan University, Tiruchirapalli, India.
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Willems HME, Ahmed SS, Liu J, Xu Z, Peters BM. Vulvovaginal Candidiasis: A Current Understanding and Burning Questions. J Fungi (Basel) 2020; 6:jof6010027. [PMID: 32106438 PMCID: PMC7151053 DOI: 10.3390/jof6010027] [Citation(s) in RCA: 132] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 02/17/2020] [Accepted: 02/19/2020] [Indexed: 12/22/2022] Open
Abstract
Candida albicans, along with other closely related Candida species, are the primary causative agents of vulvovaginal candidiasis (VVC)-a multifactorial infectious disease of the lower female reproductive tract resulting in pathologic inflammation. Unlike other forms of candidiasis, VVC is a disease of immunocompetent and otherwise healthy women, most predominant during their child-bearing years. While VVC is non-lethal, its high global incidence and profound negative impact on quality-of-life necessitates further understanding of the host and fungal factors that drive disease pathogenesis. In this review, we cover the current state of our understanding of the epidemiology, host response, fungal pathogenicity mechanisms, impact of the microbiome, and novel approaches to treatment of this most prevalent human candidal infection. We also offer insight into the latest advancements in the VVC field and identify important questions that still remain.
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Affiliation(s)
- Hubertine M. E. Willems
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (H.M.E.W.); (J.L.); (Z.X.)
| | - Salman S. Ahmed
- School of Food Science and Engineering, South China University of Technology, Guangzhou 510641, China;
| | - Junyan Liu
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (H.M.E.W.); (J.L.); (Z.X.)
| | - Zhenbo Xu
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (H.M.E.W.); (J.L.); (Z.X.)
- School of Food Science and Engineering, South China University of Technology, Guangzhou 510641, China;
| | - Brian M. Peters
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (H.M.E.W.); (J.L.); (Z.X.)
- Correspondence:
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10
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Bignoumba M, Onanga R, Bivigou Mboumba B, Gafou A, Mouanga Ndzime Y, Lendamba RW, Mbombe Moghoa K, Kassa Kassa RF. Vulvovaginal candidiasis among symptomatic women of childbearing age attended at a Medical Analysis Laboratory in Franceville, Gabon. J Mycol Med 2019; 29:317-319. [PMID: 31481349 DOI: 10.1016/j.mycmed.2019.100895] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 08/20/2019] [Accepted: 08/22/2019] [Indexed: 11/15/2022]
Abstract
BACKGROUND Vulvovaginal candidiasis (VVC) is one of the most common lower genital tract infections in women; this unpleasant and extremely embarrassing pathology is one of the main reasons for gynaecological consultation. In Gabon, the prevalence of VVC remains poorly described even though VVC is known to be the leading gynaecological condition in several countries. This retrospective cross-sectional study sought to assess the prevalence of VVC among symptomatic women in southeastern Gabon. METHODS Clinical samples were collected from patients suspected to have VVC during a 2-year period (from January 2016 to December 2017). Gram staining of vaginal smears provided indications of vaginal flora and confirmed the presence of yeast. Sabouraud-chloramphenicol and chromID Candida media were used to isolate yeast, and species identification was performed using morphological tests and the Vitek 2 Compact automated system. RESULTS For the 873 patients included in this study, the prevalence of VVC was 28.52%. Eleven Candida species were identified, with greater representation of Candidaalbicans (82.73%) than of Non C. albicanscandida (NCAC) (17.27%), which were distributed as follows: Candidafamata (4.02%), Candida spp. (3.61%), Candidarugosa (3.21%), Candidalipolytica (1.61%), Candidaparapsilosis (1.61%), Candidaglabrata (1.21%), Candidatropicalis (0.80%), Candidakrusei (0.40%), Candidadubliniensis (0.40%), and Candidasphaerica (0.40%). CONCLUSION This study offers the first estimation of VVC among Gabonese women in childbearing age with the symptoms. It showed that VVC is very common in Gabon. C. albicans as the most commonly represented species.
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Affiliation(s)
- M Bignoumba
- Centre International de Recherches Médicales de Franceville, BP 769, Franceville, Gabon.
| | - R Onanga
- Centre International de Recherches Médicales de Franceville, BP 769, Franceville, Gabon
| | - B Bivigou Mboumba
- Centre International de Recherches Médicales de Franceville, BP 769, Franceville, Gabon
| | - A Gafou
- Centre International de Recherches Médicales de Franceville, BP 769, Franceville, Gabon
| | - Y Mouanga Ndzime
- Centre International de Recherches Médicales de Franceville, BP 769, Franceville, Gabon
| | - R W Lendamba
- Centre International de Recherches Médicales de Franceville, BP 769, Franceville, Gabon
| | - K Mbombe Moghoa
- Université des sciences et techniques et Masuku, BP 943,Franceville, Gabon
| | - R F Kassa Kassa
- Centre International de Recherches Médicales de Franceville, BP 769, Franceville, Gabon
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11
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Emergence of Vulvovaginal Candidiasis among Lebanese Pregnant Women: Prevalence, Risk Factors, and Species Distribution. Infect Dis Obstet Gynecol 2019; 2019:5016810. [PMID: 31467477 PMCID: PMC6699268 DOI: 10.1155/2019/5016810] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 07/18/2019] [Indexed: 01/09/2023] Open
Abstract
Objective Candida species colonize the vagina in at least 20% of women, with rates rising to 30% during pregnancy. This study aimed at determining the prevalence and risk factors of vulvovaginal candidiasis (VVC) in pregnant women at 35-37 weeks of gestation. It also aims at finding possible correlations between VVC and vaginal colonization by other agents, such as Group B Streptococcus (GBS) and bacterial vaginosis. Methodology Over a one-year period, high vaginal swabs were collected from pregnant women during their regular antenatal checkup in different polyclinics in Beirut and South Lebanon. Swabs were examined microscopically, cultured on Sabouraud Dextrose Agar, and Candida isolates were identified using Chromatic Candida medium and Germ Tube Test. Results VVC was detected in 44.8% of samples, with C. glabrata (44.4%) and C. albicans (43.4%) being the most isolated species. Approximately, half of pregnant women (57.7%) were coinfected with Candida and bacterial vaginosis, while 26% of them carried simultaneously Candida spp. and GBS. No significant correlation was found between the occurrence of VVC and demographic, clinical, medical, and reproductive health characteristics of pregnant women. In contrast, participants with previous miscarriages and those being hospitalized during the past 12 months were more susceptible to develop vaginal C. krusei infection in comparison to other Candida species (p=0.0316 and p=0.0042, respectively). Conclusion The prevalence of VVC in pregnant women is an increasing trend in our community. Therefore, routine medical examination and regular screening for candidiasis in the antenatal care program is highly recommended to manage the disease and its complications.
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12
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Comparative Analysis of the Capacity of the Candida Species To Elicit Vaginal Immunopathology. Infect Immun 2018; 86:IAI.00527-18. [PMID: 30249743 DOI: 10.1128/iai.00527-18] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 09/12/2018] [Indexed: 01/01/2023] Open
Abstract
The human fungal pathogen Candida albicans is the major etiological agent of vulvovaginal candidiasis (VVC). Despite this fact, other non-albicans Candida (NAC) species have frequently been reported, as well. Despite their presence in the vaginal environment, little is known about their capacities to elicit immune responses classically associated with C. albicans-mediated immunopathology, including neutrophil recruitment and proinflammatory cytokine signaling. Therefore, using a combination of in vitro and in vivo approaches, we undertook a comparative analysis to determine whether a representative panel of NAC species could colonize, induce immunopathological markers, or cause damage at the vaginal mucosa. Using a murine model of VVC, C. albicans was found to induce robust immunopathology (neutrophils and interleukin 1β [IL-1β]) and elicit mucosal damage. However, all the NAC species tested (including C. dubliniensis, C. tropicalis, C. parapsilosis, C. krusei, C. glabrata, and C. auris) induced significantly less damage and neutrophil recruitment than C. albicans, despite achieving similar early colonization levels. These results largely correlated with a notable lack of ability by the NAC species (including C. dubliniensis and C. tropicalis) to form hyphae both in vitro and in vivo Furthermore, both C. dubliniensis and C. tropicalis induced significantly less expression of the ECE1 gene encoding candidalysin, a key fungal virulence determinant driving VVC immunopathology. In order to determine the relative capacities of these species to elicit inflammasome-dependent IL-1β release, both wild-type and NLRP3-/- THP-1 cells were challenged in vitro While most species tested elicited only modest amounts of IL-1β, challenge with C. albicans led to significantly elevated levels that were largely NLRP3 dependent. Collectively, our findings demonstrate that although NAC species are increasingly reported as causative agents of VVC, C. albicans appears to be exceedingly vaginopathogenic, exhibiting robust immunopathology, hypha formation, and candidalysin expression. Thus, this study provides mechanistic insight into why C. albicans is overwhelmingly the major pathogen reported during VVC.
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13
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Risk Factors of Vulvovaginal Candidiasis among Women of Reproductive Age in Xi'an: A Cross-Sectional Study. BIOMED RESEARCH INTERNATIONAL 2018; 2018:9703754. [PMID: 29977925 PMCID: PMC6011108 DOI: 10.1155/2018/9703754] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Accepted: 05/09/2018] [Indexed: 11/18/2022]
Abstract
Purpose. To explore risk factors of vulvovaginal candidiasis (VVC) among women of reproductive age in Xi'an district and then to offer reference for clinical prevention and treatment of VVC. Methods. Patients from the outpatient department of gynecology and obstetrics in the First Affiliated Hospital of Xi'an Jiaotong University from June 2016 to May 2017 were recruited strictly according to the inclusion and exclusion criteria. Participants diagnosed as simple VVC were assigned to the case group, while women who underwent routine gynecological examination and had normal vaginal microflora were assigned to the control group. Then we conducted a questionnaire survey of the two groups and used the logistic regression model to explore the related risk factors of VVC. Results. In the present study, ninety-seven cases were sample VVC patients and eighty-seven cases were healthy women. This cross-sectional study showed that occasionally or never drinking sweet drinks (odds ratio [OR] =0.161, 95% confidence interval [CI] =0.056-0.462, P=0.001), occasionally or never eating sweet foods (OR=0.158, 95%CI=0.054-0.460, P=0.001), and the use of condom (OR=0.265, 95%CI=0.243-0.526, P=0.001) were regarded as protective factors for VVC. In addition, sedentary life style (OR=7.876, 95%CI=1.818-34.109, P=0.006), frequently wearing tights (OR=6.613, 95%CI=1.369-27.751, P=0.018), frequent intravaginal douching (OR=3.493, 95%CI=1.379-8.847, P=0.008), having the first sexual encounter when under 20 years old (OR=2.364, 95%CI=1.181-7.758, P=0.006), the number of sexual partners being over two (OR=3.222, 95%CI=1.042-9.960, P=0.042), history of curettage (OR=3.471, 95%CI=1.317-9.148, P=0.012), history of vaginitis (OR=8.999, 95%CI=2.816-28.760, P<0.001), and not cleaning the vulva before or after sexual encounters (OR=13.684, 95%CI=2.843-65.874, P=0.001) were considered to be risk factors of VVC. Conclusion. In conclusion, risk factors of VVC are various, involving ages, hygienic habits, disease history, and other aspects.
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Abstract
Vulvovaginal conditions are common in mature women. This reflects age-related changes in immunity and skin barrier function of vulvovaginal tissues. Vaginal atrophy is commonly complicated by dryness and inflammation, which makes postmenopausal atrophic vaginitis a virtually ubiquitous condition. The differential of vaginitis includes inflammatory, infectious, and malignant diseases, plus drug hypersensitivity. Atrophic vaginitis is treated with estrogen replacement therapy. Vulvovaginal malignant melanoma occurs predominantly in postmenopausal women and carries a poor prognosis. Similarly, the incidence of vulvovaginal malignancies, such as squamous cell carcinoma and extramammary Paget disease, rises exponentially after 65 years of age. Early diagnosis of these malignancies is of utmost importance. Lichen sclerosus et atrophicus and vulvovaginal candidosis are among the most common postmenopausal vulvovaginal conditions. Lichen sclerosus et atrophicus is associated with significant morbidity, and its management can be challenging. The incidence of vulvovaginal candidosis increases in patients on estrogen replacement therapy.
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Affiliation(s)
- Natalie Matthews
- Department of Dermatology, Alpert Medical School of Brown University, Providence, RI
| | - Vivian Wong
- Department of Dermatology, Alpert Medical School of Brown University, Providence, RI
| | | | - George Kroumpouzos
- Department of Dermatology, Alpert Medical School of Brown University, Providence, RI; Department of Dermatology, Medical School of Jundiaí, São Paulo, Brazil.
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15
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Zanni PCMD, Bonfim-Mendonça PDS, Negri M, Nakamura SS, Donatti L, Svidzinski TIE, Consolaro MEL. Virulence factors and genetic variability of vaginal Candida albicans isolates from HIV-infected women in the post-highly active antiretroviral era. Rev Inst Med Trop Sao Paulo 2017; 59:e44. [PMID: 28793015 PMCID: PMC5626220 DOI: 10.1590/s1678-9946201759044] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 02/22/2017] [Indexed: 01/23/2023] Open
Abstract
Vulvovaginal candidiasis (VVC) in HIV-infected (HIV+) women is a serious public
health problem. However, little is known about the virulence mechanisms of vaginal
Candida albicans from HIV+ women in the post-highly active
antiretroviral therapy (HAART) era. Here, we report a comparative analysis of the
expression of key virulence factors and genetic variability of 26 vaginal C.
albicans strains isolated from HIV+ women undergoing HAART and 18 from
HIV-uninfected (HIV-) women. In general, we observed that C.
albicans from HIV+ women receiving HAART showed lower expression of
virulence factors compared with C. albicans from HIV- women, except
for the proteinase activity which is highly expressed. The results in HIV-women
further suggest that virulence factors appear to be expressed in response to the
yeast stress, in the presence of an adequate immune response. Furthermore, the RAPD
results showed a high heterogeneity among isolates from both groups of women. These
findings in HIV+ women using HAART will help to improve the monitoring of vaginal
yeast infections and the quality of life of patients.
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Affiliation(s)
- Pâmela Cristina Mastellaro Delvas Zanni
- Universidade Estadual de Maringá, Departamento de Análises Clínicas e Biomedicina, Laboratório de Micologia Médica, Maringá, Paraná, Brazil.,Universidade Estadual de Maringá, Departamento de Análises Clínicas e Biomedicina, Laboratório de Citologia Clínica, Maringá, Paraná, Brazil
| | - Patrícia de Souza Bonfim-Mendonça
- Universidade Estadual de Maringá, Departamento de Análises Clínicas e Biomedicina, Laboratório de Micologia Médica, Maringá, Paraná, Brazil
| | - Melyssa Negri
- Universidade Estadual de Maringá, Departamento de Análises Clínicas e Biomedicina, Laboratório de Micologia Médica, Maringá, Paraná, Brazil
| | - Sandra Sayuri Nakamura
- Universidade Estadual de Maringá, Departamento de Análises Clínicas e Biomedicina, Laboratório de Micologia Médica, Maringá, Paraná, Brazil
| | - Lucélia Donatti
- Universidade Federal do Paraná, Departamento de Biologia Celular, Curitiba, Paraná, Brazil
| | | | - Márcia Edilaine Lopes Consolaro
- Universidade Estadual de Maringá, Departamento de Análises Clínicas e Biomedicina, Laboratório de Citologia Clínica, Maringá, Paraná, Brazil
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16
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Emergence of Candida glabrata in vulvovaginal candidiasis should be attributed to selective pressure or virulence ability? Arch Gynecol Obstet 2017; 296:519-526. [DOI: 10.1007/s00404-017-4465-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 07/12/2017] [Indexed: 01/10/2023]
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17
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Soliman S, Alnajdy D, El-Keblawy AA, Mosa KA, Khoder G, Noreddin AM. Plants' Natural Products as Alternative Promising Anti- Candida Drugs. Pharmacogn Rev 2017; 11:104-122. [PMID: 28989245 PMCID: PMC5628516 DOI: 10.4103/phrev.phrev_8_17] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Candida is a serious life-threatening pathogen, particularly with immunocompromised patients. Candida infections are considered as a major cause of morbidity and mortality in a broad range of immunocompromised patients. Candida infections are common in hospitalized patients and elderly people. The difficulty to eradicate Candida infections is owing to its unique switch between yeast and hyphae forms and more likely to biofilm formations that render resistance to antifungal therapy. Plants are known sources of natural medicines. Several plants show significant anti-Candida activities and some of them have lower minimum inhibitory concentration, making them promising candidates for anti-Candida therapy. However, none of these plant products is marketed for anti-Candida therapy because of lack of sufficient information about their efficacy, toxicity, and kinetics. This review revises major plants that have been tested for anti-Candida activities with recommendations for further use of some of these plants for more investigation and in vivo testing including the use of nanostructure lipid system.
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Affiliation(s)
- Sameh Soliman
- Department of Medicinal Chemistry, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
- Department of Pharmacognosy, Faculty of Pharmacy, Zagazig University, Zagazig, Egypt
| | - Dina Alnajdy
- Department of Medicinal Chemistry, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | - Ali A. El-Keblawy
- Department of Applied Biology, University of Sharjah, Sharjah, United Arab Emirates
| | - Kareem A. Mosa
- Department of Applied Biology, University of Sharjah, Sharjah, United Arab Emirates
- Department of Biotechnology, Faculty of Agriculture, Al-Azhar University, Cairo, Egypt
| | - Ghalia Khoder
- Department of Pharmaceutics and Pharmaceutical Technology, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | - Ayman M. Noreddin
- Department of Pharmacy Practice and Pharmacotherapy, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
- Department of Pharmacy Practice, School of Pharmacy, Chapman University, Irvine, California, USA
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18
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Wang FJ, Zhang D, Liu ZH, Wu WX, Bai HH, Dong HY. Species Distribution and In Vitro Antifungal Susceptibility of Vulvovaginal Candida Isolates in China. Chin Med J (Engl) 2017; 129:1161-5. [PMID: 27174323 PMCID: PMC4878160 DOI: 10.4103/0366-6999.181964] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Vulvovaginal candidiasis (VVC) was a common infection associated with lifelong harassment of woman's social and sexual life. The purpose of this study was to describe the species distribution and in vitroCandidaCandida spp.) isolated from patients with VVC over 8 years. METHODS Species which isolated from patients with VVC in Peking University First Hospital were identified using chromogenic culture media. Susceptibility to common antifungal agents was determined using agar diffusion method based on CLSI M44-A2 document. SPSS software (version 14.0, Inc., Chicago, IL, USA) was used for statistical analysis, involving statistical description and Chi-square test. RESULTS The most common strains were Candida (C.) albicans, 80.5% (n = 1775) followed by C. glabrata, 18.1% (n = 400). Nystatin exhibited excellent activity against all species (<4% resistant [R]). Resistance to azole drugs varied among different species. C. albicans: clotrimazole (3.1% R) < fluconazole (16.6% R) < itraconazole (51.5% R) < miconazole (54.0% R); C. glabrata: miconazole (25.6% R) < clotrimazole (50.5% R) < itraconazole (61.9% R) < fluconazole (73.3% R); Candida krusei: clotrimazole (0 R) < fluconazole (57.7% R) < miconazole (73.1% R) < itraconazole (83.3% R). The susceptibility of fluconazole was noticeably decreasing among all species in the study period. CONCLUSIONS Nystatin was the optimal choice for the treatment of VVC at present. The species distribution and in vitroCandida spp. isolated from patients with VVC had changed over time.
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Affiliation(s)
- Feng-Juan Wang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China
| | - Dai Zhang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China
| | - Zhao-Hui Liu
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China
| | - Wen-Xiang Wu
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China
| | - Hui-Hui Bai
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China
| | - Han-Yu Dong
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China
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Rocha RM, Zanni PCMD, de Souza Bonfim-Mendonça P, Gimenes F, Alczuk SSD, Svidzinski TIE, Consolaro MEL. Effect of norfloxacin therapy for acute, uncomplicated lower urinary tract infection on vaginal Candida prevalence. Int Urogynecol J 2015; 27:773-80. [PMID: 26564224 DOI: 10.1007/s00192-015-2884-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Accepted: 10/26/2015] [Indexed: 11/25/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Acute uncomplicated lower urinary tract infections (UTI) and vulvovaginal candidiasis (VVC) both occur frequently in women. Although VVC is believed to commonly occur after antibiotic therapy, few studies have demonstrated this association. Thus, the aim of the study was to estimate the prevalence of colonization by Candida spp. and VVC after norfloxacin (NOR) use for UTI and the effects on the vaginal microbiota and inflammatory process. METHODS This was a prospective cohort study of women with culture-proven UTI who were treated with NOR (antibiotic group). The control group consisted of women with noninfectious diseases or in preventive care. Candida vaginal infections were monitored both clinically and mycologically at baseline and at the follow-up evaluation. RESULTS All women showed UTI remission after NOR treatment, and no woman in either group, antibiotic and control, showed symptoms of VVC. Both groups showed similar ratios of a positive Candida culture at baseline (6.7 % and 12.8 %, respectively) and at follow-up (3.3 % and 8.5 %, respectively) (p = 0.2768 and p = 0.5035, respectively). The antibiotic group showed no increased risk of Candida colonization or VVC after NOR treatment compared with the control group [odds ratio (OR) 0.556, 95 % confidence interval (CI) 0.2407-10.05]. CONCLUSIONS NOR was effective for UTI treatment, did not increase the risk of vaginal colonization by Candida or VVC, and did not lead to major disturbances of the vaginal microbiota.
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Affiliation(s)
- Rodrigo M Rocha
- Clinical Cytology Laboratory, Department of Clinical Analysis and Biomedicine, State University of Maringá, Paraná, Brazil
| | - Pâmela C M Delvas Zanni
- Clinical Cytology Laboratory, Department of Clinical Analysis and Biomedicine, State University of Maringá, Paraná, Brazil.,Medical Mycology Laboratory, Department of Clinical Analysis and Biomedicine, State University of Maringá, Paraná, Brazil
| | - Patrícia de Souza Bonfim-Mendonça
- Clinical Cytology Laboratory, Department of Clinical Analysis and Biomedicine, State University of Maringá, Paraná, Brazil.,Medical Mycology Laboratory, Department of Clinical Analysis and Biomedicine, State University of Maringá, Paraná, Brazil
| | - Fabrícia Gimenes
- Clinical Cytology Laboratory, Department of Clinical Analysis and Biomedicine, State University of Maringá, Paraná, Brazil
| | - Silvia S Dantas Alczuk
- Clinical Cytology Laboratory, Department of Clinical Analysis and Biomedicine, State University of Maringá, Paraná, Brazil.,Medical Mycology Laboratory, Department of Clinical Analysis and Biomedicine, State University of Maringá, Paraná, Brazil
| | | | - Márcia E Lopes Consolaro
- Clinical Cytology Laboratory, Department of Clinical Analysis and Biomedicine, State University of Maringá, Paraná, Brazil. .,Departamento de Análises Clínicas e Biomedicina, Universidade Estadual de Maringá, Av. Colombro, 5790, Maringá, Paraná, 87020-900, Brazil.
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Paulovičová E, Bujdáková H, Chupáčová J, Paulovičová L, Kertys P, Hrubiško M. Humoral immune responses to Candida albicans complement receptor 3-related protein in the atopic subjects with vulvovaginal candidiasis. Novel sensitive marker for Candida infection. FEMS Yeast Res 2015; 15:fou001. [DOI: 10.1093/femsyr/fou001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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21
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Criseo G, Scordino F, Romeo O. Current methods for identifying clinically important cryptic Candida species. J Microbiol Methods 2015; 111:50-6. [PMID: 25659326 DOI: 10.1016/j.mimet.2015.02.004] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 02/03/2015] [Accepted: 02/03/2015] [Indexed: 01/12/2023]
Abstract
In recent years, the taxonomy of the most important pathogenic Candida species (Candida albicans, Candida parapsilosis and Candida glabrata) has undergone profound changes due to the description of new closely-related species. This has resulted in the establishment of cryptic species complexes difficult to recognize in clinical diagnostic laboratories. The identification of these novel Candida species seems to be clinically relevant because it is likely that they differ in virulence and drug resistance. Nevertheless, current phenotypic methods are not suitable to accurately distinguish all the species belonging to a specific cryptic complex and therefore their recognition still requires molecular methods. Since traditional mycological techniques have not been useful, a number of molecular based methods have recently been developed. These range from simple PCR-based methods to more sophisticated real-time PCR and/or MALDI-TOF methods. In this article, we review the current methods designed for discriminating among closely related Candida species by highlighting, in particular, the limits of the existing phenotypic tests and the development of rapid and specific molecular tools for their proper identification.
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Affiliation(s)
- Giuseppe Criseo
- Department of Environmental and Biological Sciences, University of Messina, Viale Ferdinando Stagno d'Alcontres 31, 98166 Messina, Italy
| | - Fabio Scordino
- Department of Environmental and Biological Sciences, University of Messina, Viale Ferdinando Stagno d'Alcontres 31, 98166 Messina, Italy
| | - Orazio Romeo
- Department of Environmental and Biological Sciences, University of Messina, Viale Ferdinando Stagno d'Alcontres 31, 98166 Messina, Italy.
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