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Ono J, Kuzmin A, Miller L, Otto SP. The limit to evolutionary rescue depends on ploidy in yeast exposed to nystatin. Can J Microbiol 2024; 70:394-404. [PMID: 38875715 DOI: 10.1139/cjm-2023-0235] [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] [Indexed: 06/16/2024]
Abstract
The number of copies of each chromosome, or ploidy, of an organism is a major genomic factor affecting adaptation. We set out to determine how ploidy can impact the outcome of evolution, as well as the likelihood of evolutionary rescue, using short-term experiments with yeast (Saccharomyces cerevisiae) in a high concentration of the fungicide nystatin. In similar experiments using haploid yeast, the genetic changes underlying evolutionary rescue were highly repeatable, with all rescued lines containing a single mutation in the ergosterol biosynthetic pathway. All of these beneficial mutations were recessive, which led to the expectation that diploids would find alternative genetic routes to adaptation. To test this, we repeated the experiment using both haploid and diploid strains and found that diploid populations did not evolve resistance. Although diploids are able to adapt at the same rate as haploids to a lower, not fully inhibitory, concentration of nystatin, the present study suggests that diploids are limited in their ability to adapt to an inhibitory concentration of nystatin, while haploids may undergo evolutionary rescue. These results demonstrate that ploidy can tip the balance between adaptation and extinction when organisms face an extreme environmental change.
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Affiliation(s)
- Jasmine Ono
- Department of Zoology & Biodiversity Research Centre, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Centre for Ecology and Evolution & Environment and Sustainability Institute, University of Exeter, Penryn, Cornwall TR10 9FE, United Kingdom
- School of Life Sciences, University of Nottingham, University Park, Nottingham NG7 2RD, United Kingdom
| | - Anastasia Kuzmin
- Department of Zoology & Biodiversity Research Centre, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Lesley Miller
- Department of Zoology & Biodiversity Research Centre, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Sarah P Otto
- Department of Zoology & Biodiversity Research Centre, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
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Ahmady L, Gothwal M, Mukkoli MM, Bari VK. Antifungal drug resistance in Candida: a special emphasis on amphotericin B. APMIS 2024; 132:291-316. [PMID: 38465406 DOI: 10.1111/apm.13389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 02/12/2024] [Indexed: 03/12/2024]
Abstract
Invasive fungal infections in humans caused by several Candida species, increased considerably in immunocompromised or critically ill patients, resulting in substantial morbidity and mortality. Candida albicans is the most prevalent species, although the frequency of these organisms varies greatly according to geographic region. Infections with C. albicans and non-albicans Candida species have become more common, especially in the past 20 years, as a result of aging, immunosuppressive medication use, endocrine disorders, malnourishment, extended use of medical equipment, and an increase in immunogenic diseases. Despite C. albicans being the species most frequently associated with human infections, C. glabrata, C. parapsilosis, C. tropicalis, and C. krusei also have been identified. Several antifungal drugs with different modes of action are approved for use in clinical settings to treat fungal infections. However, due to the common eukaryotic structure of humans and fungi, only a limited number of antifungal drugs are available for therapeutic use. Furthermore, drug resistance in Candida species has emerged as a result of the growing use of currently available antifungal drugs against fungal infections. Amphotericin B (AmB), a polyene class of antifungal drugs, is mainly used for the treatment of serious systemic fungal infections. AmB interacts with fungal plasma membrane ergosterol, triggering cellular ion leakage via pore formation, or extracting the ergosterol from the plasma membrane inducing cellular death. AmB resistance is primarily caused by changes in the content or structure of ergosterol. This review summarizes the antifungal drug resistance exhibited by Candida species, with a special focus on AmB.
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Affiliation(s)
- Lailema Ahmady
- Department of Biochemistry, School of Basic Sciences, Central University of Punjab, Bathinda, India
| | - Manisha Gothwal
- Department of Biochemistry, School of Basic Sciences, Central University of Punjab, Bathinda, India
| | | | - Vinay Kumar Bari
- Department of Biochemistry, School of Basic Sciences, Central University of Punjab, Bathinda, India
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Dominguez JAJ, Luque-Vilca OM, Mallma NES, FLores DDC, Zea CYH, Huayhua LLA, Lizárraga-Gamarra FB, Cáceres CGM, Yauricasa-Tornero SV, Paricanaza-Ticona DC, Cajavilca HLV. Antifungal chemicals promising function in disease prevention, method of action and mechanism. BRAZ J BIOL 2024; 83:e275055. [PMID: 38422253 DOI: 10.1590/1519-6984.275055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 09/28/2023] [Indexed: 03/02/2024] Open
Abstract
The increasing use of antimicrobial drugs has been linked to the rise of drug-resistant fungus in recent years. Antimicrobial resistance is being studied from a variety of perspectives due to the important clinical implication of resistance. The processes underlying this resistance, enhanced methods for identifying resistance when it emerges, alternate treatment options for infections caused by resistant organisms, and so on are reviewed, along with strategies to prevent and regulate the formation and spread of resistance. This overview will focus on the action mechanism of antifungals and the resistance mechanisms against them. The link between antibacterial and antifungal resistance is also briefly discussed. Based on their mechanism action, antifungals are divided into three distinct categories: azoles, which target the ergosterol synthesis; 5-fluorocytosine, which targets macromolecular synthesis and polyenes, which interact physiochemically with fungal membrane sterols. Antifungal resistance can arise through a wide variety of ways. Overexpression of the target of the antifungal drug, changes to the drug target, changes to sterol biosynthesis, decreased intercellular concentration of the target enzyme, and other processes. A correlation exists between the mechanisms of resistance to antibacterial and antifungals, despite the fact that the comparison between the two is inevitably constrained by various parameters mentioned in the review. Drug extrusion via membrane pumps has been thoroughly documented in both prokaryotic and eukaryotic cells, and development of new antifungal compounds and strategies has also been well characterized.
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Affiliation(s)
| | | | - N E S Mallma
- Universidad Nacional del Centro del Perú, Huancayo, Perú
| | - D D C FLores
- Universidad Nacional de Huancavelica, Huancavelica, Perú
| | - C Y H Zea
- Universidad Nacional de Juliaca, Juliaca, Perú
| | - L L A Huayhua
- Universidad Nacional de Huancavelica, Huancavelica, Perú
| | | | - C G M Cáceres
- Universidad Nacional de Huancavelica, Huancavelica, Perú
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Umarje SC, Banerjee SK. Non-traditional approaches for control of antibiotic resistance. Expert Opin Biol Ther 2023; 23:1113-1135. [PMID: 38007617 DOI: 10.1080/14712598.2023.2279644] [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: 08/28/2023] [Accepted: 11/01/2023] [Indexed: 11/27/2023]
Abstract
INTRODUCTION The drying up of antibiotic pipeline has necessitated the development of alternative therapeutic strategies to control the problem of antimicrobial resistance (AMR) that is expected to kill 10-million people annually by 2050. Newer therapeutic approaches address the shortcomings of traditional small-molecule antibiotics - the lack of specificity, evolvability, and susceptibility to mutation-based resistance. These 'non-traditional' molecules are biologicals having a complex structure and mode(s) of action that makes them resilient to resistance. AREAS COVERED This review aims to provide information about the non-traditional drug development approaches to tackle the problem of antimicrobial resistance, from the pre-antibiotic era to the latest developments. We have covered the molecules under development in the clinic with literature sourced from reviewed scholarly articles, official company websites involved in innovation of concerned therapeutics, press releases from the regulatory bodies, and clinical trial databases. EXPERT OPINION Formal introduction of non-traditional therapies in general practice can be quick and feasible only if supported with companion diagnostics and used in conjunction with established therapies. Owing to relatively higher development costs, non-traditional therapeutics require more funding as well as well as clarity in regulatory and clinical path. We are hopeful these issues are adequately addressed before AMR develops into a pandemic.
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Affiliation(s)
- Siddharth C Umarje
- Department of Proteomics, AbGenics Life Sciences Pvt. Ltd., Pune, India
- AbGenics Life Sciences Pvt. Ltd., Pune, India
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Raj N, Vanathi M, Ahmed NH, Gupta N, Lomi N, Tandon R. Recent Perspectives in the Management of Fungal Keratitis. J Fungi (Basel) 2021; 7:jof7110907. [PMID: 34829196 PMCID: PMC8621027 DOI: 10.3390/jof7110907] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/22/2021] [Accepted: 10/23/2021] [Indexed: 12/28/2022] Open
Abstract
Mycotic keratitis is common in warm, humid regions with a varying profile of pathogenic fungi according to geographical origin, socioeconomic status, and climatic condition. Clinical diagnosis can be challenging in difficult cases and those refractory to treatment. Fungal hyphae on microscopic examination and culture isolation have been the gold standard in the laboratory diagnosis of fungal keratitis. A culture isolate of the aetiological fungus is essential to perform antifungal susceptibility testing. As the culture isolation of fungi is time-consuming, causing delays in the initiation of treatment, newer investigative modalities such as in vivo confocal microscopy and molecular diagnostic methods have recently gained popularity. Molecular diagnostic techniques now help to obtain a rapid diagnosis of fungal keratitis. Genomic approaches are based on detecting amplicons of ribosomal RNA genes, with internal transcribed spacers being increasingly adopted. Metagenomic deep sequencing allows for rapid and accurate diagnosis without the need to wait for the fungus to grow. This is also helpful in identifying new emerging strains of fungi causing mycotic keratitis. A custom-tear proteomic approach will probably play an important diagnostic role in future in the management of mycotic keratitis. Positive repeat cultures are being suggested as an important gauge indicative of a poor prognosis. Positive repeat fungal cultures help to modify a treatment regimen by increasing its frequency, providing the addition of another topical and oral antifungal agent along with close follow-up for perforation and identifying need for early therapeutic keratoplasty. The role of collagen crosslinking in the treatment of fungal keratitis is not convincingly established. Rapid detection by multiplex PCR and antifungal susceptibility testing of the pathogenic fungi, adopted into a routine management protocol of fungal keratitis, will help to improve treatment outcome. Early therapy is essential in minimizing damage to the corneal tissue, thereby providing a better outcome. The role of conventional therapy with polyenes, systemic and targeted therapy of antifungal agents, newer azoles and echinocandins in fungal keratitis has been widely studied in recent times. Combination therapy can be more efficacious in comparison to monotherapy. Given the diversity of fungal aetiology, the emergence of new corneal pathogenic fungi with varying drug susceptibilities, increasing the drug resistance to antifungal agents in some genera and species, it is perhaps time to adopt recent molecular methods for precise identification and incorporate antifungal susceptibility testing as a routine.
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Affiliation(s)
- Nimmy Raj
- Cornea, Lens & Refractive Surgery Services—Dr R P Centre for Ophthalmic Sciences, All India Institute for Medical Sciences, New Delhi 110029, India; (N.R.); (N.G.); (N.L.); (R.T.)
| | - Murugesan Vanathi
- Cornea, Lens & Refractive Surgery Services—Dr R P Centre for Ophthalmic Sciences, All India Institute for Medical Sciences, New Delhi 110029, India; (N.R.); (N.G.); (N.L.); (R.T.)
- Correspondence: ; Tel.: +91-11-26593010; Fax: +91-11-26588919
| | - Nishat Hussain Ahmed
- Ocular Microbiology Services—Dr R P Centre for Ophthalmic Sciences, All India Institute for Medical Sciences, New Delhi 110029, India;
| | - Noopur Gupta
- Cornea, Lens & Refractive Surgery Services—Dr R P Centre for Ophthalmic Sciences, All India Institute for Medical Sciences, New Delhi 110029, India; (N.R.); (N.G.); (N.L.); (R.T.)
| | - Neiwete Lomi
- Cornea, Lens & Refractive Surgery Services—Dr R P Centre for Ophthalmic Sciences, All India Institute for Medical Sciences, New Delhi 110029, India; (N.R.); (N.G.); (N.L.); (R.T.)
| | - Radhika Tandon
- Cornea, Lens & Refractive Surgery Services—Dr R P Centre for Ophthalmic Sciences, All India Institute for Medical Sciences, New Delhi 110029, India; (N.R.); (N.G.); (N.L.); (R.T.)
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Garcia-Effron G. Molecular Markers of Antifungal Resistance: Potential Uses in Routine Practice and Future Perspectives. J Fungi (Basel) 2021; 7:197. [PMID: 33803304 PMCID: PMC7998127 DOI: 10.3390/jof7030197] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/01/2021] [Accepted: 03/04/2021] [Indexed: 12/16/2022] Open
Abstract
Antifungal susceptibility testing (AST) has come to establish itself as a mandatory routine in clinical practice. At the same time, the mycological diagnosis seems to have headed in the direction of non-culture-based methodologies. The downside of these developments is that the strains that cause these infections are not able to be studied for their sensitivity to antifungals. Therefore, at present, the mycological diagnosis is correctly based on laboratory evidence, but the antifungal treatment is undergoing a growing tendency to revert back to being empirical, as it was in the last century. One of the explored options to circumvent these problems is to couple non-cultured based diagnostics with molecular-based detection of intrinsically resistant organisms and the identification of molecular mechanisms of resistance (secondary resistance). The aim of this work is to review the available molecular tools for antifungal resistance detection, their limitations, and their advantages. A comprehensive description of commercially available and in-house methods is included. In addition, gaps in the development of these molecular technologies are discussed.
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Affiliation(s)
- Guillermo Garcia-Effron
- Laboratorio de Micología y Diagnóstico Molecular, Cátedra de Parasitología y Micología, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe CP3000, Argentina; ; Tel.: +54-9342-4575209 (ext. 135)
- Consejo Nacional de Investigaciones Científicas y Tecnológicas, Santa Fe CP3000, Argentina
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Sixty years of Amphotericin B: An Overview of the Main Antifungal Agent Used to Treat Invasive Fungal Infections. Infect Dis Ther 2021; 10:115-147. [PMID: 33523419 PMCID: PMC7954977 DOI: 10.1007/s40121-020-00382-7] [Citation(s) in RCA: 128] [Impact Index Per Article: 42.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 12/04/2020] [Indexed: 12/29/2022] Open
Abstract
Introduced in the late 1950s, polyenes represent the oldest family of antifungal drugs. The discovery of amphotericin B and its therapeutic uses is considered one of the most important scientific milestones of the twentieth century . Despite its toxic potential, it remains useful in the treatment of invasive fungal diseases owing to its broad spectrum of activity, low resistance rate, and excellent clinical and pharmacological action. The well-reported and defined toxicity of the conventional drug has meant that much attention has been paid to the development of new products that could minimize this effect. As a result, lipid-based formulations of amphotericin B have emerged and, even keeping the active principle in common, present distinct characteristics that may influence therapeutic results. This study presents an overview of the pharmacological properties of the different formulations for systemic use of amphotericin B available for the treatment of invasive fungal infections, highlighting the characteristics related to their chemical, pharmacokinetic structures, drug–target interactions, stability, and others, and points out the most relevant aspects for clinical practice.
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8
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Waikhom SD, Afeke I, Kwawu GS, Mbroh HK, Osei GY, Louis B, Deku JG, Kasu ES, Mensah P, Agede CY, Dodoo C, Asiamah EA, Tampuori J, Korbuvi J, Opintan JA. Prevalence of vulvovaginal candidiasis among pregnant women in the Ho municipality, Ghana: species identification and antifungal susceptibility of Candida isolates. BMC Pregnancy Childbirth 2020; 20:266. [PMID: 32375724 PMCID: PMC7201979 DOI: 10.1186/s12884-020-02963-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 04/21/2020] [Indexed: 12/19/2022] Open
Abstract
Background Candida is the leading cause of vaginitis, and 75% of women have at least one episode of infection in their lives, with pregnancy being a predisposing factor. If left untreated, vulvovaginal candidiasis (VVC) can lead to chorioamnionitis with subsequent abortion, prematurity and congenital infection of the neonate. We aimed to determine the prevalence of VVC, identify the recent and most frequently occurring species of Candida in pregnant women, and determine the most effective antifungal drug of choice for treatment. Method A prospective cross-sectional study in which 176 high vaginal swab samples of consented pregnant women visiting the antenatal clinic from February 2018 to April 2018 were subjected to direct gram smear and culture for Candida isolation. Candida isolates were identified using a germ tube test and HiCrome Candida differential agar. Candida isolates were then subjected to a disk diffusion method using fluconazole (25 μg), nystatin (100 units), and voriconazole (1 μg) on Mueller-Hinton agar supplemented with 2% (w/v) glucose and 0.5 μg/ml methylene blue dye to determine the susceptibility pattern as per the guidelines of the Clinical Laboratory Standard Institute (CLSI). Chi-square analysis was used to ascertain the significant association of participants’ sociodemographics and clinical presentations to VVC. A univariate logistic regression model was used to identify potential risk factors of VVC. Results The prevalence of VVC among our study participants was 30.7%. Non-albicans Candida (NAC) and Candida albicans had a prevalence of 74.1 and 25.9%, respectively. Candida glabrata was the most common species, followed by Candida albicans, Candida krusei, and Candida parapsilosis. 50.0, 18.5 and 3.7% of Candida species were susceptible to voriconazole, fluconazole and nystatin, respectively, whereas 37.0, 48.1 and 9.3% of Candida species were resistant to voriconazole, fluconazole and nystatin, respectively. The majority of isolates were susceptible dose dependent to all three antifungal agents, with voriconazole being the most efficacious antifungal agent. There was no significant association between participants’ socio-demographic information and clinical presentations to VVC. Conclusion The prevalence of VVC was high in the study area. C. glabrata was found to be the most common cause of VVC among the pregnant women attending antenatal clinics, in the Ho Municipality region of Ghana. The majority of the Candida isolates were susceptible and resistant to voriconazole and fluconazole, respectively.
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Affiliation(s)
- Sayanika Devi Waikhom
- Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, PMB 31, Ho, Ghana.
| | - Innocent Afeke
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Grace Sefakor Kwawu
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | | | - George Yiadom Osei
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Bengyella Louis
- Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, PMB 31, Ho, Ghana
| | - John Gameli Deku
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Emmanuel Senyo Kasu
- Public Health Department, Ho Teaching Hospital, Ho, Ghana.,Department of Biostatistics and Epidemiology, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Prosper Mensah
- Medical Laboratory Department, Ho Teaching Hospital, Ho, Ghana
| | | | - Cornelius Dodoo
- Department of Pharmaceutical Microbiology, School of Pharmacy, University of Health and Allied Sciences, Ho, Ghana
| | - Emmanuel Akomanin Asiamah
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | | | - John Korbuvi
- Pharmacy Department, Ho Teaching Hospital, Ho, Ghana
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Cheeseman S, Christofferson AJ, Kariuki R, Cozzolino D, Daeneke T, Crawford RJ, Truong VK, Chapman J, Elbourne A. Antimicrobial Metal Nanomaterials: From Passive to Stimuli-Activated Applications. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2020; 7:1902913. [PMID: 32440470 PMCID: PMC7237851 DOI: 10.1002/advs.201902913] [Citation(s) in RCA: 124] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 01/23/2020] [Accepted: 02/22/2020] [Indexed: 05/20/2023]
Abstract
The development of antimicrobial drug resistance among pathogenic bacteria and fungi is one of the most significant health issues of the 21st century. Recently, advances in nanotechnology have led to the development of nanomaterials, particularly metals that exhibit antimicrobial properties. These metal nanomaterials have emerged as promising alternatives to traditional antimicrobial therapies. In this review, a broad overview of metal nanomaterials, their synthesis, properties, and interactions with pathogenic micro-organisms is first provided. Secondly, the range of nanomaterials that demonstrate passive antimicrobial properties are outlined and in-depth analysis and comparison of stimuli-responsive antimicrobial nanomaterials are provided, which represent the next generation of microbiocidal nanomaterials. The stimulus applied to activate such nanomaterials includes light (including photocatalytic and photothermal) and magnetic fields, which can induce magnetic hyperthermia and kinetically driven magnetic activation. Broadly, this review aims to summarize the currently available research and provide future scope for the development of metal nanomaterial-based antimicrobial technologies, particularly those that can be activated through externally applied stimuli.
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Affiliation(s)
- Samuel Cheeseman
- School of ScienceCollege of ScienceEngineering and HealthRMIT UniversityMelbourneVIC3001Australia
- Nanobiotechnology LaboratorySchool of ScienceCollege of ScienceEngineering and HealthRMIT UniversityMelbourneVIC3001Australia
| | - Andrew J. Christofferson
- School of EngineeringRMIT UniversityMelbourneVIC3001Australia
- Food Science and TechnologyBundoora CampusSchool of ScienceCollege of ScienceEngineering and HealthRMIT UniversityMelbourneVIC3086Australia
| | - Rashad Kariuki
- School of ScienceCollege of ScienceEngineering and HealthRMIT UniversityMelbourneVIC3001Australia
- Nanobiotechnology LaboratorySchool of ScienceCollege of ScienceEngineering and HealthRMIT UniversityMelbourneVIC3001Australia
| | - Daniel Cozzolino
- School of ScienceCollege of ScienceEngineering and HealthRMIT UniversityMelbourneVIC3001Australia
- Food Science and TechnologyBundoora CampusSchool of ScienceCollege of ScienceEngineering and HealthRMIT UniversityMelbourneVIC3086Australia
| | - Torben Daeneke
- School of EngineeringRMIT UniversityMelbourneVIC3001Australia
| | - Russell J. Crawford
- School of ScienceCollege of ScienceEngineering and HealthRMIT UniversityMelbourneVIC3001Australia
- Nanobiotechnology LaboratorySchool of ScienceCollege of ScienceEngineering and HealthRMIT UniversityMelbourneVIC3001Australia
| | - Vi Khanh Truong
- School of ScienceCollege of ScienceEngineering and HealthRMIT UniversityMelbourneVIC3001Australia
- Nanobiotechnology LaboratorySchool of ScienceCollege of ScienceEngineering and HealthRMIT UniversityMelbourneVIC3001Australia
| | - James Chapman
- School of ScienceCollege of ScienceEngineering and HealthRMIT UniversityMelbourneVIC3001Australia
- Nanobiotechnology LaboratorySchool of ScienceCollege of ScienceEngineering and HealthRMIT UniversityMelbourneVIC3001Australia
| | - Aaron Elbourne
- School of ScienceCollege of ScienceEngineering and HealthRMIT UniversityMelbourneVIC3001Australia
- Nanobiotechnology LaboratorySchool of ScienceCollege of ScienceEngineering and HealthRMIT UniversityMelbourneVIC3001Australia
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Gowda DV, Afrasim M, Meenakshi SI, Manohar M, Hemalatha S, Siddaramaiah H, Sathishbabu P, Rizvi SMD, Hussain T, Kamal MA. A Paradigm Shift in the Development of Anti-Candida Drugs. Curr Top Med Chem 2019; 19:2610-2628. [PMID: 31663480 DOI: 10.2174/1568026619666191029145209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 04/27/2019] [Accepted: 09/26/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND The considerable increase in the incidence of Candida infection in recent times has prompted the use of numerous antifungal agents, which has resulted in the development of resistance towards various antifungal agents. With rising Candida infections, the need for design and development of novel antifungal agents is in great demand. However, new therapeutic approaches are very essential in preventing the mortality rate and improving the patient outcome in those suffering from Candida infections. OBJECTIVE The present review objective is to describe the burden, types of Candidiasis, mechanism of action of antifungal agents and its resistance and the current novel approaches used to combat candidiasis. METHODS We have collected and analyzed 135 different peer-reviewed literature studies pertinent to candidiasis. In this review, we have compiled the major findings from these studies. RESULTS AND CONCLUSION The review describes the concerns related to candidiasis, its current treatment strategy, resistance mechanisms and imminent ways to tackle the problem. The review explored that natural plant extracts and essential oils could act as sources of newer therapeutic agents, however, the focus was on novel strategies, such as combinational therapy, new antibodies, utilization of photodynamic therapy and adaptive transfer primed immune cells with emphasis on the development of effective vaccination.
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Affiliation(s)
- D V Gowda
- Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru- 570015, India
| | - M Afrasim
- Department of Pharmaceutics, Hail University, Hail, Saudi Arabia
| | - S I Meenakshi
- Department of Prosthodontics and Crown & Bridge, JSS Dental College and Hospital, JSS Academy of Higher Education and Research, Mysuru-570015, India
| | - M Manohar
- Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru- 570015, India
| | - S Hemalatha
- Department of Anaesthesia, JSS Medical College & Hospital, JSS Academy of Higher Education and Research, Mysuru - 570004, India
| | - H Siddaramaiah
- Department of Polymer Science and Technology, Sri Jayachamarajendra College of Engineering, JSS Science and Technology University, Mysuru - 570006, India
| | - P Sathishbabu
- Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru- 570015, India
| | - S M Danish Rizvi
- Department of Pharmaceutics, Hail University, Hail, Saudi Arabia
| | - T Hussain
- Department of Pharmacology and Toxicology, University of Hail, Hail, Saudi Arabia
| | - M A Kamal
- King Fahd Medical Research Center, King Abdulaziz University, P.O. Box 80216, Jeddah 21589, Saudi Arabia.,Enzymoics, 7 Peterlee Place, Hebersham, NSW 2770, Australia.,Novel Global Community Educational Foundation, Australia
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11
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Kumar A, Khan F, Saikia D. Exploration of Medicinal Plants as Sources of Novel Anticandidal Drugs. Curr Top Med Chem 2019; 19:2579-2592. [PMID: 31654513 DOI: 10.2174/1568026619666191025155856] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 03/25/2019] [Accepted: 04/25/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Human infections associated with skin and mucosal surfaces, mainly in tropical and sub-tropical parts of the world. During the last decade, there have been an increasing numbers of cases of fungal infections in immunocompromised patients, coupled with an increase in the number of incidences of drug resistance and toxicity to anti fungal agents. Hence, there is a dire need for safe, potent and affordable new antifungal drugs for the efficient management of candidal infections with minimum or no side effects. INTRODUCTION Candidiasis represents a critical problem to human health and a serious concern worldwide. Due to the development of drug resistance, there is a need for new antifungal agents. Therefore, we reviewed the different medicinal plants as sources of novel anticandidal drugs. METHODS The comprehensive and detailed literature on medicinal plants was carried out using different databases, such as Google Scholar, PubMed, and Science Direct and all the relevant information from the articles were analyzed and included. RESULTS Relevant Publications up to the end of November 2018, reporting anticandidal activity of medicinal plants has been included in the present review. In the present study, we have reviewed in the light of SAR and mechanisms of action of those plants whose extracts or phytomolecules are active against candida strains. CONCLUSION This article reviewed natural anticandidal drugs of plant origin and also summarized the potent antifungal bioactivity against fungal strains. Besides, mechanism of action of these potent active plant molecules was also explored for a comparative study. We concluded that the studied active plant molecules exhibit potential antifungal activity against resistant fungal strains.
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Affiliation(s)
- Ajay Kumar
- Molecular Bioprospection Department, CSIR-Central Institute of Medicinal & Aromatic Plants, P.O.- CIMAP, Kukrail Picnic Spot Road, Lucknow -226015 (U.P.), India
| | - Feroz Khan
- Metabolic & Structural Biology Department, CSIR-Central Institute of Medicinal & Aromatic Plants, P.O.- CIMAP, Kukrail Picnic Spot Road, Lucknow -226015 (U.P.), India
| | - Dharmendra Saikia
- Molecular Bioprospection Department, CSIR-Central Institute of Medicinal & Aromatic Plants, P.O.- CIMAP, Kukrail Picnic Spot Road, Lucknow -226015 (U.P.), India
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12
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Esfahani AN, Golestannejad Z, Khozeimeh F, Dehghan P, Maheronnaghsh M, Zarei Z. Antifungal effect of Atorvastatin against Candida species in comparison to Fluconazole and Nystatin. Med Pharm Rep 2019; 92:368-373. [PMID: 31750437 PMCID: PMC6853048 DOI: 10.15386/mpr-1209] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 02/13/2019] [Accepted: 03/13/2019] [Indexed: 01/29/2023] Open
Abstract
Background and aims Atorvastatin is a plasma cholesterol-lowering drug which applies antifungal effects by inhibiting the production of yeast cell wall ergostrol. The aim of present study was to investigate in-vitro susceptibility of candida species to atorvastatin, in comparison to nystatin and fluconazole. Methods Minimum inhibitory concentrations (MIC) and minimum fungicidal concentrations (MFC) were determined using serial dilution. Candida strains isolated from 35 patients receiving cancer chemotherapy in Isfahan, Seyyed-al-Shohada Hospital and analyzed by Kruskal-Wallis and Mann Whitney statistical methods. Results Candida isolates included 5 strains, C. albicans, C. glabrata, C. kefyr, C. stellatoidea and C. krusei. All five strains appeared to be resistant to nystatin and fluconazole but sensitive to atorvastatin with no statistically significant difference. The MFC of atorvastatin was significantly lower in comparison to both nystatin and fluconazole for all five strains (p value<0.05). There was no significant difference between the MFCs of 5 strains for fluconazole and atorvastatin. However, MFC of nystatin differed significantly for C. albicans and C. kefyr (p=0.007). Conclusion The results showed that all strains were sensitive to atorvastatin and resistant to nystatin and fluconazole. Atorvastatin MIC for C. albicans, C. krusei and C. stellatoidea was equivalent to its serum level used to treat hyperlipidemia and was above such level for both C. glabrata and C. kefyr.
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Affiliation(s)
- Ava Nasr Esfahani
- Dental Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Islamic Republic of Iran
| | - Zahra Golestannejad
- Department of Oral Medicine, Dental Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Islamic Republic of Iran
| | - Faezeh Khozeimeh
- Department of Oral Medicine, Dental Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Islamic Republic of Iran
| | - Parvin Dehghan
- Department of Mycology and Parasitology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Islamic Republic of Iran
| | - Mehrnoosh Maheronnaghsh
- Department of Mycology and Parasitology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Islamic Republic of Iran
| | - Zahra Zarei
- Department of Orthodontics, Dental Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Islamic Republic of Iran
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Vahedi Shahandashti R, Lass-Flörl C. Antifungal resistance in Aspergillus terreus: A current scenario. Fungal Genet Biol 2019; 131:103247. [PMID: 31247322 DOI: 10.1016/j.fgb.2019.103247] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 06/20/2019] [Indexed: 12/31/2022]
Abstract
Invasive aspergillosis caused by intrinsically resistant non-fumigatus Aspergillus species displays a poor outcome in immunocompromised patients. The polyene antifungal amphotericin B (AmB) remains to be "gold standard" in the treatment of invasive fungal infections. Aspergillus terreus is innately resistant to AmB, in vivo and in vitro. Till now, the exact mode of action in polyene resistance is not well understood. This review highlights the underlying molecular basis of AmB resistance in A. terreus, displaying data obtained from AmB susceptible A. terreus and AmB resistant A. terreus strains. The effect of AmB on main cellular and molecular functions such as fungal respiration and stress response pathways will be discussed in detail and resistance mechanisms will be highlighted. The fungal stress response machinery seems to be a major player in the onset of AmB resistance in A. terreus.
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Affiliation(s)
| | - Cornelia Lass-Flörl
- Division of Hygiene and Medical Microbiology, Medical University Innsbruck, Innsbruck, Austria.
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14
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Di Mambro T, Guerriero I, Aurisicchio L, Magnani M, Marra E. The Yin and Yang of Current Antifungal Therapeutic Strategies: How Can We Harness Our Natural Defenses? Front Pharmacol 2019; 10:80. [PMID: 30804788 PMCID: PMC6370704 DOI: 10.3389/fphar.2019.00080] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 01/21/2019] [Indexed: 12/19/2022] Open
Abstract
Fungal infections have aroused much interest over the last years because of their involvement in several human diseases. Immunocompromission due to transplant-related therapies and malignant cancer treatments are risk factors for invasive fungal infections, but also aggressive surgery, broad-spectrum antibiotics and prosthetic devices are frequently associated with infectious diseases. Current therapy is based on the administration of antifungal drugs, but the occurrence of resistant strains to the most common molecules has become a serious health-care problem. New antifungal agents are urgently needed and it is essential to identify fungal molecular targets that could offer alternatives for development of treatments. The fungal cell wall and plasma membrane are the most important structures that offer putative new targets which can be modulated in order to fight microbial infections. The development of monoclonal antibodies against new targets is a valid therapeutic strategy, both to solve resistance problems and to support the immune response, especially in immunocompromised hosts. In this review, we summarize currently used antifungal agents and propose novel therapeutic approaches, including new fungal molecular targets to be considered for drug development.
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Affiliation(s)
- Tomas Di Mambro
- Department of Biomolecular Sciences, University of Urbino "Carlo Bo", Urbino, Italy.,Diatheva s.r.l., Cartoceto, Italy
| | - Ilaria Guerriero
- Takis s.r.l., Rome, Italy.,Veterinary Immunotherapy and Translational Research, Rome, Italy
| | - Luigi Aurisicchio
- Takis s.r.l., Rome, Italy.,Veterinary Immunotherapy and Translational Research, Rome, Italy
| | - Mauro Magnani
- Department of Biomolecular Sciences, University of Urbino "Carlo Bo", Urbino, Italy.,Diatheva s.r.l., Cartoceto, Italy
| | - Emanuele Marra
- Takis s.r.l., Rome, Italy.,Veterinary Immunotherapy and Translational Research, Rome, Italy
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Lakhani P, Patil A, Majumdar S. Challenges in the Polyene- and Azole-Based Pharmacotherapy of Ocular Fungal Infections. J Ocul Pharmacol Ther 2018; 35:6-22. [PMID: 30481082 DOI: 10.1089/jop.2018.0089] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Polyenes and azoles constitute 2 major drug classes in the antifungal armamentarium used to treat fungal infections of the eye such as fungal keratitis, endophthalmitis, conjunctivitis, and blepharitis. These classes of drugs have come to occupy an important niche in ophthalmic antifungal therapy due to their broad spectrum of activity against a variety of filamentous and yeast-like fungi. Natamycin suspension (Natacyn®), a polyene antifungal drug, is currently the only US FDA-approved formulation for treating ophthalmic fungal infections, whereas the other polyene and azole antifungals such as amphotericin B, fluconazole, itraconazole, ketoconazole, miconazole, voriconazole, and posaconazole are routinely used off-label in the clinical setting. Despite potent antifungal activity, the clinical utility of these agents in ophthalmic infections has been challenged by their physicochemical properties, the unique ocular anatomy and physiology, selective antifungal activity, ocular and systemic toxicity, emergence of resistance and cross-resistance, and absence of reliable techniques for developing a robust in vitro-in vivo correlation. This review discusses the aforementioned challenges and the common approaches undertaken to circumnavigate the difficulties associated with the polyene- and azole-based pharmacotherapy of ophthalmic fungal infections.
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Affiliation(s)
- Prit Lakhani
- 1 Department of Pharmaceutics and Drug Delivery, School of Pharmacy, University of Mississippi, Oxford, Mississippi.,2 Research Institute of Pharmaceutical Sciences, School of Pharmacy, University of Mississippi, Oxford, Mississippi
| | - Akash Patil
- 1 Department of Pharmaceutics and Drug Delivery, School of Pharmacy, University of Mississippi, Oxford, Mississippi.,2 Research Institute of Pharmaceutical Sciences, School of Pharmacy, University of Mississippi, Oxford, Mississippi
| | - Soumyajit Majumdar
- 1 Department of Pharmaceutics and Drug Delivery, School of Pharmacy, University of Mississippi, Oxford, Mississippi.,2 Research Institute of Pharmaceutical Sciences, School of Pharmacy, University of Mississippi, Oxford, Mississippi
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16
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Helminth eggs as parasitic indicators of fecal contamination in agricultural irrigation water, biosolids, soils and pastures. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2018; 38:42-53. [PMID: 29668133 DOI: 10.7705/biomedica.v38i0.3352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 03/29/2017] [Indexed: 12/31/2022]
Abstract
INTRODUCTION A very common practice in agriculture is the disposal of wastewater and biosolids from water treatment systems due to their high nutrient content, which substantially improves crop yields. However, the presence of pathogens of fecal origin creates a sanitary risk to farmers and consumers. OBJECTIVE To determine the presence and concentration of helminth eggs in irrigation waters, biosolids, agricultural soils, and pastures. MATERIALS AND METHODS Water, biosolids, soil, and pasture samples were collected and analyzed for helminth egg detection, total eggs and viable eggs counts. The behavior of helminth eggs was evaluated in irrigation waters and dairy cattle grassland, where biosolids had been used as an organic amendment. RESULTS Concentrations between 0.1-3 total helminth eggs/L, and 0.1-1 viable helminth eggs/L were found in water. In biosolids and soil, we found 3-22 total helminth eggs/4 g of dry weight, and 2-12 viable helminth eggs/4 g of dry weight, and in grass, we found <2-9 total helminth eggs/g of fresh weight, and <1-3 viable helminth eggs/g of fresh weight. The presence of helminth eggs in each matrix varied from days to months, which may represent a sanitary risk to farmers as well as to consumers. CONCLUSIONS The presence of helminth eggs in the assessed matrixes confirms the sanitary risk of such practices. Therefore, it is important to control and incorporate regulations related to the use of wastewater and biosolids in agriculture.
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Clark-Ordóñez I, Callejas-Negrete OA, Aréchiga-Carvajal ET, Mouriño-Pérez RR. Candida species diversity and antifungal susceptibility patterns in oral samples of HIV/AIDS patients in Baja California, Mexico. Med Mycol 2017; 55:285-294. [PMID: 27630251 DOI: 10.1093/mmy/myw069] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 08/01/2016] [Indexed: 12/11/2022] Open
Abstract
Candidiasis is the most common opportunistic fungal infection in HIV patients. The aims of this study were to identify the prevalence of carriers of Candida, Candida species diversity, and in vitro susceptibility to antifungal drugs. In 297 HIV/AIDS patients in Baja California, Mexico, Candida strains were identified by molecular methods (PCR-RFLP) from isolates of oral rinses of patients in Tijuana, Mexicali, and Ensenada. 56.3% of patients were colonized or infected with Candida. In Tijuana, there was a significantly higher percentage of carriers (75.5%). Out of the 181 strains that were isolated, 71.8% were Candida albicans and 28.2% were non-albicans species. The most common non-albicans species was Candida tropicalis (12.2%), followed by Candida glabrata (8.3%), Candida parapsilosis (2.2%), Candida krusei (1.7%), and Candida guilliermondii (1.1%). Candida dubliniensis was not isolated. Two associated species were found in 11 patients. In Mexicali and Ensenada, there was a lower proportion of Candida carriers compared to other regions in Mexico and worldwide, however, in Tijuana, a border town with many peculiarities, a higher carrier rate was found. In this population, only a high viral load was associated with oral Candida carriers. Other factors such as gender, use of antiretroviral therapy, CD4+ T-lymphocyte levels, time since diagnosis, and alcohol/ tobacco consumption, were not associated with Candida carriers.
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Affiliation(s)
- Isadora Clark-Ordóñez
- Departamento de Microbiología. Centro de Investigación Científica y de Educación Superior de Ensenada. Ensenada B. C.,Facultad de Medicina. Universidad Autónoma de Baja California. Mexicali, B. C
| | - Olga A Callejas-Negrete
- Departamento de Microbiología. Centro de Investigación Científica y de Educación Superior de Ensenada. Ensenada B. C
| | - Elva T Aréchiga-Carvajal
- Departamento de Microbiología e Inmunología. Facultad de Ciencias Biológicas. Universidad Autónoma de Nuevo León. Monterrey, N. L
| | - Rosa R Mouriño-Pérez
- Departamento de Microbiología. Centro de Investigación Científica y de Educación Superior de Ensenada. Ensenada B. C
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Ku TSN, Bernardo S, Walraven CJ, Lee SA. Candidiasis and the impact of flow cytometry on antifungal drug discovery. Expert Opin Drug Discov 2017; 12:1127-1137. [PMID: 28876963 DOI: 10.1080/17460441.2017.1377179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Invasive candidiasis continues to be associated with significant morbidity and mortality as well as substantial health care costs nationally and globally. One of the contributing factors is the development of resistance to antifungal agents that are already in clinical use. Moreover, there are known treatment limitations with all of the available antifungal agents. Since traditional techniques in novel drug discovery are time consuming, high-throughput screening using flow cytometry presents as a potential tool to identify new antifungal agents that would be useful in the management of these patients. Areas covered: In this review, the authors discuss the use of automated high-throughput screening assays based upon flow cytometry to identify potential antifungals from a library comprised of a large number of bioactive compounds. They also review studies that employed the use of this research methodology that has identified compounds with antifungal activity. Expert opinion: High-throughput screening using flow cytometry has substantially decreased the processing time necessary for screening thousands of compounds, and has helped enhance our understanding of fungal pathogenesis. Indeed, the authors see this technology as a powerful tool to help scientists identify new antifungal agents that can be added to the clinician's arsenal in their fight against invasive candidiasis.
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Affiliation(s)
- Tsun Sheng N Ku
- a Section of Infectious Diseases , New Mexico VA Health Care System , Albuquerque , NM , USA.,b Division of Infectious Diseases , University of New Mexico Health Science Center , Albuquerque , NM , USA
| | - Stella Bernardo
- a Section of Infectious Diseases , New Mexico VA Health Care System , Albuquerque , NM , USA.,b Division of Infectious Diseases , University of New Mexico Health Science Center , Albuquerque , NM , USA
| | - Carla J Walraven
- c Department of Pharmaceutical Services , University of New Mexico Hospital , Albuquerque , NM , USA
| | - Samuel A Lee
- a Section of Infectious Diseases , New Mexico VA Health Care System , Albuquerque , NM , USA.,b Division of Infectious Diseases , University of New Mexico Health Science Center , Albuquerque , NM , USA
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19
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Zavrel M, White TC. Medically important fungi respond to azole drugs: an update. Future Microbiol 2015; 10:1355-73. [DOI: 10.2217/fmb.15.47] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The increased numbers of patients with compromised immune systems in the last three decades have increased the chances of life-threatening fungal infections. Numerous antifungal drugs have been developed in the last 20 years to treat these infections. The largest group, the azoles, inhibits the synthesis of fungal sterols. The use of these fungistatic azoles has subsequently led to the emergence of acquired azole resistance. The most common mechanisms that result in azole resistance include the overexpression or mutation of the azole target enzyme, and overexpression of drug transporters that are responsible for azole efflux from cells. Additional, less-frequent mechanisms have also been identified. Understanding azole resistance mechanisms is crucial for current antifungal treatment and for the future development of new treatment strategies.
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Affiliation(s)
- Martin Zavrel
- University of Missouri-Kansas City, School of Biological Sciences, Division of Cell Biology & Biophysics, 5007 Rockhill Road, BSB 404, Kansas City, MO 64110, USA
| | - Theodore C White
- University of Missouri-Kansas City, School of Biological Sciences, Division of Cell Biology & Biophysics, 5007 Rockhill Road, BSB 404, Kansas City, MO 64110, USA
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20
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Malova IO, Petrunin DD. Natamycin - antimycotic of polyene macrolides class with unusual properties. VESTNIK DERMATOLOGII I VENEROLOGII 2015. [DOI: 10.25208/0042-4609-2015-91-3-161-184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
In the current literature review issues regarding physicochemical peculiarities, mechanism ot action and satety aspects ot polyene macrolides class compound natamycin are enlightened along with the extensive clinical data upon the use ot pharmaceuticals containing this active ingredient.
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21
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Seghir A, Boucherit-Otmani Z, Belkherroubi-Sari L, Boucherit K. Cathétérisme et risque infectieux fongique au centre hospitalo-universitaire de Tlemcen : épidémiologie et sensibilité aux antifongiques. J Mycol Med 2014; 24:e179-84. [DOI: 10.1016/j.mycmed.2014.08.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Revised: 08/09/2014] [Accepted: 08/15/2014] [Indexed: 12/12/2022]
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22
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Gupta P, Nath S, Meena R, Kumar N. Comparative effects of hypoxia and hypoxia mimetic cobalt chloride on in vitro adhesion, biofilm formation and susceptibility to amphotericin B of Candida glabrata. J Mycol Med 2014; 24:e169-77. [DOI: 10.1016/j.mycmed.2014.08.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 06/26/2014] [Accepted: 08/18/2014] [Indexed: 12/19/2022]
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Mukherjee S, Mukherjee N, Saini P, Gayen P, Roy P, Sinha Babu SP. Molecular evidence on the occurrence of co-infection with Pichia guilliermondii and Wuchereria bancrofti in two filarial endemic districts of India. Infect Dis Poverty 2014; 3:13. [PMID: 24708881 PMCID: PMC4021973 DOI: 10.1186/2049-9957-3-13] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Accepted: 03/12/2014] [Indexed: 12/31/2022] Open
Abstract
Background Lymphatic filariasis (LF), a vector-borne parasitic disease, is endemic in several parts of India and mostly affects the poor or those with a low-income. The disease results in huge numbers of morbidities, disabilities, and deaths every year. Association of co-infection with other pathogens makes the condition more severe. Although co-infection is becoming a growing area of research, it is yet to emerge as a frontier research topic in filarial research specifically. This study reports the occurrence of a fungal infection in a large number of patients suffering from bancroftian filariasis in two districts of West Bengal, India. Methods Nocturnal blood samples from filarial patients containing parasites and fungus were initially co-cultured, and further the fungus was isolated and characterized. Molecular identification of the isolate was carried out by PCR-based selective amplification and sequencing of highly-conserved D1/D2 region of 26S rDNA, whereas pathogenicity was determined by amplification of the RPS0 gene. A phylogenetic tree was constructed to study the relationship between the isolate and common pathogenic yeasts. The isolate was studied for antibiotic sensitivity, whereas morphological characterization was performed by microscopic techniques. Results The isolate was identified as Pichia guilliermondii and this fungus was found to exist in co-infection with Wuchereria bancrofti in filarial patients. The fungus showed resistance to azole antifungals, griseofulvin, and, amphotericin B, whereas significant susceptibility was evident in cases of nystatin and cycloheximide. A total of 197 out of 222 patients showed this co-infection. Conclusion This study revealed, for the first time, that P. guilliermondii exists as a co-infection in microfilaraemic individuals living in a filarial endemic zone. The findings are important and have relevance to human health, especially for filarial patients.
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Affiliation(s)
| | | | | | | | | | - Santi P Sinha Babu
- Parasitology Laboratory, Department of Zoology (Centre for Advanced Studies), Visva-Bharati University, Santiniketan- 731 235, West Bengal, India.
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Millan X, Muggia V, Ostrowsky B. Antimicrobial agents, drug adverse reactions and interactions, and cancer. Cancer Treat Res 2014; 161:413-62. [PMID: 24706233 DOI: 10.1007/978-3-319-04220-6_14] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The intent of this chapter is to review the types of adverse drug reactions and interactions associated with antimicrobial agents, specifically in the setting of patients with malignancies. The initial sections will discuss categorizing and describing the mechanisms of adverse reactions and interactions. The later sections include a detailed discussion about adverse reactions and drug interactions associated with commonly used antibacterial, antiviral, and antifungal agents in this subpopulation. Where relevant, the clinical use and indication for the drugs will be reviewed. The antibacterial section will specifically address the emergence of antimicrobial resistance and drugs of last resort (newer agents, such as linezolid and daptomycin and novel uses of older previously retired agents, such as polymyxin B). The antifungal section will address the ramification of pharmacokinetic interactions and the need to measure drug levels. The chapter is not meant to be exhaustive and as such will not extensively address all antimicrobials or all interactions for each of these agents.
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Affiliation(s)
- Ximena Millan
- Division of Infectious Diseases, Montefiore Medical Center, 111 E. 210th Street, Bronx, NY, 10467-2790, USA
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Gottrup F, Apelqvist J, Bjarnsholt T, Cooper R, Moore Z, Peters E, Probst S. EWMA Document: Antimicrobials and Non-healing Wounds: Evidence, controversies and suggestions. J Wound Care 2013; 22:S1-89. [DOI: 10.12968/jowc.2013.22.sup5.s1] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- F Gottrup
- Professor of Surgery, Bispebjerg University Hospital, Copenhagen, Denmark
| | - J Apelqvist
- Senior Consultant, Associate Professor, Skåne University Hospital, Malmö, Sweden
| | - T Bjarnsholt
- Associate Professor, University of Copenhagen and Copenhagen University Hospital, Copenhagen, Denmark
| | - R Cooper
- Professor of Microbiology, Cardiff Metropolitan University, Cardiff, Wales, United Kingdom
| | - Z Moore
- Lecturer in Wound Healing & Tissue Repair, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - E.J.G. Peters
- Internist- Infectious Diseases Specialist, VU University Medical Center, Amsterdam, the Netherlands
| | - S Probst
- Lecturer, Zurich University of Applied Sciences, Winterthur, Switzerland
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Chemoprophylaxis of Fungal Infections in Granulocytopenic Patients Using Fluconazole vs Oral Amphotericin B. ACTA ACUST UNITED AC 2012. [DOI: 10.1007/bf03259575] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Canadian clinical practice guidelines for invasive candidiasis in adults. CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY 2012; 21:e122-50. [PMID: 22132006 DOI: 10.1155/2010/357076] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Candidemia and invasive candidiasis (C/IC) are life-threatening opportunistic infections that add excess morbidity, mortality and cost to the management of patients with a range of potentially curable underlying conditions. The Association of Medical Microbiology and Infectious Disease Canada developed evidence-based guidelines for the approach to the diagnosis and management of these infections in the ever-increasing population of at-risk adult patients in the health care system. Over the past few years, a new and broader understanding of the epidemiology and pathogenesis of C/IC has emerged and has been coupled with the availability of new antifungal agents and defined strategies for targeting groups at risk including, but not limited to, acute leukemia patients, hematopoietic stem cell transplants and solid organ transplants, and critical care unit patients. Accordingly, these guidelines have focused on patients at risk for C/IC, and on approaches of prevention, early therapy for suspected but unproven infection, and targeted therapy for probable and proven infection.
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Amareshwar V, Patil SJ, Goudgaon NM. Synthesis, in vitro and in vivo antifungal activity of 5-phenylthio-2,4-bisbenzyloxypyrimidine: a novel nucleobase. Indian J Pharm Sci 2011; 72:778-81. [PMID: 21969752 PMCID: PMC3178981 DOI: 10.4103/0250-474x.84593] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2009] [Revised: 07/07/2010] [Accepted: 11/03/2010] [Indexed: 11/04/2022] Open
Abstract
A pyrimidne nucleobase, 5-phenylthio-2,4-bisbenzyloxypyrimidine and its analogs were synthesized and scanned for in vitro antifungal activity using cup-plate and macrobroth dilution method against Candida albicans, Aspergillus niger, Aspergillus flavus and Aspergllus fumigatus. In the cup-plate method, 5-phenylthio-2,4-bisbenzyloxypyrimidine showed very good antifungal activity compared to clotrimazole at the concentrations of 100 and 1000 μg/ml and in the macrobroth dilution method, it showed comparable activity with respect to standard drugs fluconazole and itraconaole. In vivo antifungal activity of 5-phenylthio-2,4-bisbenzyloxypyrimidine at the dose levels of 10 and 30 mg/kg was carried by causing systemic infection of mice using the same fungi used in in vitro testing. The results from in vivo studies with 5-phenylthio-2,4-bisbenzyloxypyrimidine and fluconazole indicated that 5-phenylthio-2,4-bisbenzyloxypyrimidine had similar potency as fluconazole at both dose levels.
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The value of amphotericin B in the treatment of invasive fungal infections. J Crit Care 2011; 26:225.e1-10. [DOI: 10.1016/j.jcrc.2010.08.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2009] [Revised: 07/08/2010] [Accepted: 08/08/2010] [Indexed: 01/12/2023]
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Amphotericin B resistance leads to enhanced proteinase and phospholipase activity and reduced germ tube formation in Candida albicans. Fungal Biol 2010; 114:189-97. [DOI: 10.1016/j.funbio.2009.12.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2009] [Revised: 12/08/2009] [Accepted: 12/14/2009] [Indexed: 11/24/2022]
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31
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Zhang H, Ran Y, Li D, Liu Y, Xiang Y, Zhang R, Dai Y. Clavispora lusitaniae and Chaetomium atrobrunneum as rare agents of cutaneous infection. Mycopathologia 2009; 169:373-80. [PMID: 20020214 DOI: 10.1007/s11046-009-9266-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2009] [Accepted: 12/02/2009] [Indexed: 02/05/2023]
Abstract
We describe the first case of cutaneous infection caused by Chaetomium atrobrunneum and Clavispora lusitaniae in a one-and-a-half-year-old boy with acute and severe inflammation around his left eyelid. He presented to our outpatient center with a 6-day history and previously ineffective antibacterial therapy. Scanning electron microscopy (SEM) revealed hyphae and spores were on the surface of the crusty exudates and also penetrated into it, and the microbiology study further showed their characteristic cultural features. Fungal isolates were identified by the amplification and sequencing of the 26S RNA gene and of the ITS region, as C. lusitaniae and C. atrobrunneum. Up until now, most known clinical records of these rare species have shown them as agents of deep mycosis. Due to the emergency situation, medications were administered promptly and confirmed by subsequent fungal identification and successful therapeutic outcome. This article illustrates the importance of recognizing fungal infections, especially those caused by uncommon pathogens. Limitations in the routine identification procedures and therapeutic options of this emerging opportunistic agent are also discussed in this report.
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Affiliation(s)
- Hao Zhang
- Department of Dermatology, Sichuan University West China Hospital, Chengdu, China.
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32
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Odds FC. In Candida albicans, resistance to flucytosine and terbinafine is linked to MAT locus homozygosity and multilocus sequence typing clade 1. FEMS Yeast Res 2009; 9:1091-101. [PMID: 19799637 DOI: 10.1111/j.1567-1364.2009.00577.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
A panel of 637 isolates of Candida albicans that had been typed by multilocus sequence typing (MLST) and tested for susceptibility to amphotericin B, caspofungin, fluconazole, flucytosine, itraconazole, ketoconazole, miconazole, terbinafine and voriconazole was the material for a statistical analysis of possible associations between antifungal susceptibility and other properties. For terbinafine and flucytosine, the greatest proportion of low-susceptibility isolates, judged by two resistance breakpoints, was found in MLST clade 1 and among isolates homozygous at the MAT locus, although only three isolates showed cross-resistance to the two agents. Most instances of low susceptibility to azoles, flucytosine and terbinafine were among oropharyngeal isolates from HIV-positive individuals. Statistically significant correlations were found between terbinafine and azole minimal inhibitory concentrations (MICs), while correlations between flucytosine MICs and azole MICs were less strong. It is concluded that a common regulatory mechanism may operate to generate resistance to the two classes of agent that inhibit ergosterol biosynthesis, terbinafine and the azoles, but that flucytosine resistance, although still commonly associated with MAT homozygosity, is differently regulated.
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Affiliation(s)
- Frank C Odds
- Aberdeen Fungal Group, School of Medical Sciences, University of Aberdeen, Aberdeen AB25 2ZD, UK.
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Karlsson AJ, Pomerantz WC, Neilsen KJ, Gellman SH, Palecek SP. Effect of sequence and structural properties on 14-helical beta-peptide activity against Candida albicans planktonic cells and biofilms. ACS Chem Biol 2009; 4:567-79. [PMID: 19518070 DOI: 10.1021/cb900093r] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Beta-peptides (beta-amino acid oligomers) that mimic the amphiphilic, helical, and cationic properties of natural antimicrobial peptides have previously been shown to display antifungal activity against planktonic Candida albicans cells. Beta-peptides offer several advantages over conventional peptides composed of alpha-amino acid residues, including conformational stability, resistance to proteases, and activity at physiological salt concentrations. We examined sequence-activity relationships toward both planktonic C. albicans cells and C. albicans biofilms, and the results suggest a toxicity mechanism involving membrane disruption. A strategy for fluorescently labeling a beta-peptide without diminishing antifungal activity was devised; labeled beta-peptides penetrated the cell membrane and accumulated in the cytoplasm of both planktonic and biofilm-associated cells. The labeled beta-peptide was detected only in metabolically inactive cells, which suggests that beta-peptide entry is correlated with cell death. The presence of a beta-peptide at a concentration near the minimum inhibitory concentration completely prevented planktonic C. albicans cells from forming a biofilm, suggesting that beta-peptides may be useful in preventing fungal colonization and biofilm formation.
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Affiliation(s)
| | - William C. Pomerantz
- Department of Chemistry, University of Wisconsin−Madison, Madison, Wisconsin 53706
| | | | - Samuel H. Gellman
- Department of Chemistry, University of Wisconsin−Madison, Madison, Wisconsin 53706
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34
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Muralidharan R, Bobek L. Antifungal activity of human salivary mucin-derived peptide, MUC7 12-mer, in a murine model of oral candidiasis. ACTA ACUST UNITED AC 2008. [DOI: 10.1111/j.1747-0285.2006.00333.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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35
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Alves SH, Boff E, Pozzatti P, Scheid LA, de Loreto E, Ottoneli Oliveira LT, Aquino V, Severo LC, Santurio JM. Relationship between susceptibility of Candida spp. isolates to amphotericin B and death or survival of patients with candidemia episodes. Mycopathologia 2008; 167:65-71. [PMID: 18819017 DOI: 10.1007/s11046-008-9159-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2008] [Accepted: 09/10/2008] [Indexed: 11/24/2022]
Abstract
In this study, the susceptibility to amphotericin B of Candida spp. isolates obtained from patients with candidemia was related to their respective clinical outcomes. The susceptibility tests were carried out in three culture media: RPMI 1640, Antibiotic medium 3 and Yeast Nitrogen Base dextrose. We have found that minimal inhibitory concentrations and minimal fungicidal concentrations obtained using AM3 and YNBd media were significantly higher for Candida spp. from patients who died than for those from patients who survived the candidemia (P < 0.05). The assays with RPMI 1640 medium did not show these differences.
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Affiliation(s)
- Sydney Hartz Alves
- Department of Microbiology and Parasitology, Universidade Federal de Santa Maria, Rua dos Andradas 1985/201, Santa Maria, RS, Brazil.
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36
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Luque AG, Biasoli MS, Tosello ME, Binolfi A, Lupo S, Magaró HM. Oral yeast carriage in HIV-infected and non-infected populations in Rosario, Argentina. Mycoses 2008; 52:53-9. [PMID: 18498298 DOI: 10.1111/j.1439-0507.2008.01542.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The objectives of the present study were: (i) to assess the frequency of oral colonisation by Candida species in HIV-positive patients and to compare it with a population of HIV-negative individuals, (ii) to determine the prevalence of C. dubliniensis in both populations and (iii) to determine the susceptibility of C. dubliniensis and other Candida species isolated from HIV-positive patients to the most commonly used antifungal agents. Oral samples were obtained from 101 HIV-positive and 108 HIV-negative subjects. For yeast identification, we used morphology in cornmeal agar, the API 20C Aux, growth at 45 degrees C, d-xylose assimilation, morphology in sunflower seed agar and PCR. The frequency of isolation of Candida in HIV-positive patients was: C. albicans, 60.7%; C. dubliniensis, 20.2%; C. glabrata, 5.6%; C. krusei, 5.6%; C. tropicalis, 4.5%; others, <5%. The frequency of isolation of Candida in HIV-negative patients was: C. albicans, 73.9%; C. tropicalis, 15.5%; C. dubliniensis, 2.1%; C. glabrata, 2.1%; C. parapsilosis, 2.1%; others, <5%. The oral colonisation by yeast in the HIV-positive patients was higher than that in the HIV-negative subjects. The susceptibilities of 42 Candida isolates to three antifungal agents were determined. All isolates of C. dubliniensis were susceptible to fluconazole, although several individuals had been previously treated with this drug. Out of the 42 Candida isolates, 10 presented resistance to fluconazole and 10 to itraconazole. The presence of Candida species, resistant to commonly used antifungal agents, represents a potential risk in immunocompromised patients.
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Affiliation(s)
- A G Luque
- CEREMIC, Fac. Cs. Bioquímicas y Farmacéuticas, Rosario, Argentina.
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37
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Kanafani ZA, Perfect JR. Antimicrobial resistance: resistance to antifungal agents: mechanisms and clinical impact. Clin Infect Dis 2008; 46:120-8. [PMID: 18171227 DOI: 10.1086/524071] [Citation(s) in RCA: 382] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Despite advances in preventive, diagnostic, and therapeutic interventions, invasive fungal infections cause significant morbidity and mortality in immunocompromised patients. The burden of antifungal resistance in such high-risk patients is becoming a major concern. A better understanding of the mechanisms and clinical impact of antifungal resistance is essential to the prompt and efficient treatment of patients with invasive mycoses and to improving the outcome of such infections. Although recent guidelines have attempted to standardize antifungal susceptibility testing, limitations still exist as a result of the incomplete correlation between in vitro susceptibility and clinical response to treatment. Four major mechanisms of resistance to azoles have been identified, all of which rely on altered gene expression. Mechanisms responsible for polyene and echinocandin resistance are less well understood. In addition to discussing the molecular mechanisms of antifungal resistance, this article elaborates on the concept of clinical resistance, which is critical to the understanding of treatment failure in patients with invasive fungal infections.
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38
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Boff E, Lopes PGM, Spader T, Scheid LA, Loreto É, Dal Forno NF, Aquino V, Severo LC, Santurio JM, Alves SH. Reavaliação da suscetibilidade de Candida à anfotericina B: estudo comparativo com isolados de três hospitais do estado do Rio Grande do Sul. Rev Soc Bras Med Trop 2008; 41:36-40. [DOI: 10.1590/s0037-86822008000100007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2007] [Accepted: 12/17/2007] [Indexed: 11/22/2022] Open
Abstract
Comparou-se a suscetibilidade à anfotericina B de Candida spp isoladas de candidemias, sendo: 41 do Hospital Universitário de Santa Maria, 56 do Hospital de Clínicas de Porto Alegre e 47 da Santa Casa, Complexo Hospitalar de Porto Alegre. Os testes foram baseados no documento M27-A2 do Clinical Laboratory Standards Institute. Todavia, foram empregadas 20 concentrações de anfotericina B, variáveis entre 0,1 e 2µg/ml. Os testes foram realizados nos meios RPMI 1640 com glicose, antibiotic medium 3 e yeast nitrogen base dextrosado. O caldo antibiotic medium 3 gerou amplas faixas de concentrações inibitórias mínimas e concentrações fungicidas mínimas quando comparado aos demais. As variações de suscetibilidade entre os hospitais foram melhor detectadas no antibiotic médium 3; os isolados do Hospital Universitário de Santa Maria evidenciaram menor sensibilidade do que os da Santa Casa, Complexo Hospitalar de Porto Alegre (p < 0,05). As causas das variações de suscetibilidade não foram avaliadas mas apontam para a necessidade de vigilância da suscetibilidade a anfotericina B.
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39
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Sterling TR, Merz WG. Resistance to amphotericin B: emerging clinical and microbiological patterns. Drug Resist Updat 2007; 1:161-5. [PMID: 17092800 DOI: 10.1016/s1368-7646(98)80034-4] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/1998] [Revised: 03/11/1998] [Accepted: 03/24/1998] [Indexed: 11/16/2022]
Abstract
There has been an increasing number of reports of clinically significant amphotericin B (AmB) resistance in fungal pathogens, including Candida albicans. Concomitantly, advances in antifungal susceptibility testing have led to an improved correlation between microbiologic and clinical failure. Reports of AmB resistance, correlation of results and in vitro/in vivo correlations, mechanisms of resistance, and the transmission of resistant isolates within confined environments are reviewed. Recommendations are given regarding the clinical settings in which AmB susceptibility testing should be considered.
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Affiliation(s)
- T R Sterling
- Johns Hopkins University School of Medicine, Division of Infectious Diseases, Baltimore, MD 21287, USA
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40
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Kami M, Murashige N, Tanaka Y, Narimatsu H. Antifungal prophylaxis following reduced-intensity stem cell transplantation. Transpl Infect Dis 2006; 8:190-202. [PMID: 17116132 DOI: 10.1111/j.1399-3062.2006.00152.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Reduced-intensity stem cell transplantation (RIST) has been developed to be a novel curative option for advanced hematologic diseases. Its minimal toxicity allows for transplantation in patients with advanced age or with organ dysfunction. Young patients without comorbidity can undergo RIST as outpatients. However, fungal infection remains an important complication in RIST. Given the poor prognosis of fungal infection, prophylaxis is critical in its management. The prophylactic strategy is recently changing with the development of RIST. Hospital equipment is important for fungal prophylaxis; however, the median day for the development of fungal infection is day 100, when most RIST patients are followed as outpatients. The focus of fungal management after RIST needs to shift from in-hospital equipment to oral antifungals. Various antifungals have recently been developed and introduced for clinical use. A major change in antifungal management will probably occur within several years.
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Affiliation(s)
- M Kami
- Division of Exploratory Research, Institute of Medical Science, University of Tokyo, Tokyo, Japan.
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41
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Miller NS, Dick JD, Merz WG. Phenotypic switching in Candida lusitaniae on copper sulfate indicator agar: association with amphotericin B resistance and filamentation. J Clin Microbiol 2006; 44:1536-9. [PMID: 16597887 PMCID: PMC1448677 DOI: 10.1128/jcm.44.4.1536-1539.2006] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Candida lusitaniae is an opportunistic yeast pathogen that has the ability to develop resistance to amphotericin B (AmB). The mechanism(s) for this resistance is not well understood, although there are data supporting mutations in sterol pathways and other data supporting phenotypic switching (PS). The goal of this study was to determine whether C. lusitaniae has a PS system and to characterize any phenotypes, including any changes in AmB MICs. When 10(4) CFU of an AmB-resistant (MIC of 16 to 32 microg/ml) clinical strain was plated on yeast-peptone-dextrose (YPD) agar with 1 mM CuSO(4), three colony colors were observed: light brown (LB) >> dark brown (DB) > white (W), similar to the result for Candida glabrata. Switching did occur with high AmB resistance (MIC of 256 microg/ml) being associated with W, whereas LB and DB colonies had MICs of 2 to 8 microg/ml and 2 to 16 microg/ml, respectively. Filamentation (pseudohyphae) was associated with DB colonies. All phenotypes occurred spontaneously with greater frequency ( approximately 10(-2) to 10(-4)) than spontaneous mutations, and all phenotypes were reversible, fulfilling the two PS criteria. High AmB MICs were always associated with W colonies but not with all W colonies. Detection of PS on YPD-CuSO(4) is also similar to that in Candida glabrata, and we hypothesize that this is due to similarities in metallothionein gene expression. Phenotypic switching represents a key strategy in C. lusitaniae that confers a selective advantage during environmental challenges, including the ability to switch to AmB resistance.
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Affiliation(s)
- Nancy S Miller
- Boston Medical Center, Department of Laboratory Medicine, 88 East Newton Street H3600, Boston, MA 02118, USA.
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42
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Linares CEB, Griebeler D, Cargnelutti D, Alves SH, Morsch VM, Schetinger MRC. Catalase activity in Candida albicans exposed to antineoplastic drugs. J Med Microbiol 2006; 55:259-262. [PMID: 16476788 DOI: 10.1099/jmm.0.46263-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
An increased catalase activity in Candida spp. has been suggested as a mechanism that reduces amphotericin B activity. Furthermore, resistance to antifungal agents like amphotericin B has been reported in some cancer patients undergoing chemotherapy treatment. In this study we analysed the influence of chemotherapy agents on catalase activity in Candida albicans, the major species involved in yeast infections. Eight strains of C. albicans isolated from HIV-positive patients were exposed to cyclophosphamide, cytarabine, dacarbazine and methotrexate antineoplastic drugs at the concentrations used during therapy. Catalase activity was measured and compared to the control group. Very significant differences (P < 0.01) were found when C. albicans was exposed to methotrexate (2 microg ml(-1) = 4 microM). For cyclophosphamide (50 microg ml(-1)), cytarabine (1 microg ml(-1)) and dacarbazine (8 microg ml(-1)), no differences were found (P > 0.05) between the control and drug-exposed groups. Although more extensive studies are necessary, these data do suggest that the antineoplastic drug methotrexate contributes to the resistance to antifungal drug therapy by varying catalase activity.
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43
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44
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Hector RF. An Overview of Antifungal Drugs and Their Use for Treatment of Deep and Superficial Mycoses in Animals. ACTA ACUST UNITED AC 2005; 20:240-9. [PMID: 16317914 DOI: 10.1053/j.ctsap.2005.07.005] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Fungal infections are often challenging to manage, given the limited numbers of therapeutics and a general lack of applicable clinical literature for their use in a given animal species. This article reviews some of the underlying principles that can affect the therapeutic outcome for a given antifungal, and provides specific information from the literature that is intended to highlight the distinctive properties of the most commonly used antifungals in veterinary medicine to better facilitate their successful application in clinical practice.
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Affiliation(s)
- Richard F Hector
- Institute for Global Health, University of California San Francisco, San Francisco, CA 94105, USA.
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45
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Frosco M, Barrett JF. Importance of antifungal drug-resistance: clinical significance and need for novel therapy. Expert Opin Investig Drugs 2005; 7:175-98. [PMID: 15991951 DOI: 10.1517/13543784.7.2.175] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The incidence of fungal infections has increased dramatically over the past few decades due to the increase in the members of the population susceptible to such infections. This population includes individuals undergoing chemotherapy for cancer, those enduring long-term treatment with antibacterial agents, those receiving immunosuppressive drugs following transplantations, or those immunosuppressed due to diseases, such as AIDS, or malignancies. Newer antifungal agents, namely the triazoles, have aided in both the treatment of fungal infections and in the prevention of disease in susceptible individuals. However, resistance to the azoles, as well as to the polyenes, has resulted in clinical failures. Only a few potential antifungal targets have been exploited to date and there is a critical need for the discovery and development of novel antifungal agents that will result in improved therapy in this ever-expanding patient population. An increased intensity in the study of fungal pathogens at the molecular level holds the key to such advances.
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Affiliation(s)
- M Frosco
- Bristol-Myers Squibb Pharmaceutical Research Institute, Wallingford, CT 06492, USA
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46
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Jung WH, Warn P, Ragni E, Popolo L, Nunn CD, Turner MP, Stateva L. Deletion ofPDE2, the gene encoding the high-affinity cAMP phosphodiesterase, results in changes of the cell wall and membrane inCandida albicans. Yeast 2005; 22:285-94. [PMID: 15789349 DOI: 10.1002/yea.1199] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
A role for the cAMP-dependent pathway in regulation of the cell wall in the model yeast Saccharomyces cerevisiae has recently been demonstrated. In this study we report the results of a phenotypic analysis of a Candida albicans mutant, characterized by a constitutive activation of the cAMP pathway due to deletion of PDE2, the gene encoding the high cAMP-affinity phosphodiesterase. Unlike wild-type strains, this mutant has an increased sensitivity to cell wall and membrane perturbing agents such as SDS and CFW, and antifungals such as amphotericin B and flucytosine. Moreover, the mutant is characterized by an altered sensitivity and a significantly reduced tolerance to fluconazole. The mutant's membrane has around 30% higher ergosterol content and the cell wall glucan was 22% lower than in the wild-type. These cell wall and membrane changes are manifested by a considerable reduction in the thickness of the cell wall, which in the mutant is on average 60-65 nm, compared to 80-85 nm in the wild-type strains as revealed by electron microscopy. These results suggest that constitutive activation of the cAMP pathway affects cell wall and membrane structure, and biosynthesis, not only in the model yeast S. cerevisiae but also in the human fungal pathogen C. albicans.
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Affiliation(s)
- Won Hee Jung
- Faculty of Life Sciences, Jackson's Mill, University of Manchester, PO Box 88, Sackville Street, Manchester M60 1QD, UK
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47
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Abstract
Invasive fungal infections pose major management problems for clinicians caring for hematopoietic cell transplant patients. Two major fungal genera, Candida and Aspergillus, account for most fungal infections. Rates of systemic Candida infection range from 15% to 25%, mostly in the pre-engraftment period. Prophylaxis by fluconazole has dramatically reduced the frequency of early Candida infections. Caspofungin has recently been shown to offer an excellent alternative to amphotericin B (with less toxicity) or fluconazole (with a broader spectrum) for therapy of systemic Candida infections. Aspergillus infections occur in 15% to 20% of allogeneic hematopoietic cell transplant patients, most frequently in the post-engraftment period; they are associated with a severe diminution of cell-mediated immune responses by graft-versus-host disease and prolonged corticosteroid use. Voriconazole, a recently introduced broad-spectrum azole, has excellent activity against Aspergillus and is generally well tolerated. Voriconazole currently offers the best prospect for success and tolerance as a first-line treatment for aspergillosis. Second-line therapies include lipid formulations of amphotericin B, caspofungin, or intravenous itraconazole. Unfortunately, early initiation of therapy for aspergillosis is frequently not possible because of inaccurate diagnostics. One new diagnostic, the galactomannan assay, has recently been approved, and others are in development; these offer promise for earlier diagnosis without the need for invasive procedures. It is hoped that these new therapies and new diagnostics will usher in a new era of antifungal therapy.
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Affiliation(s)
- John R Wingard
- Blood and Marrow Transplant Program, Division of Hematology/Oncology, University of Florida Shands Cancer Center, Gainesville, USA.
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48
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Pourshafie M, Morand S, Virion A, Rakotomanga M, Dupuy C, Loiseau PM. Cloning of S-adenosyl-L-methionine:C-24-Delta-sterol-methyltransferase (ERG6) from Leishmania donovani and characterization of mRNAs in wild-type and amphotericin B-Resistant promastigotes. Antimicrob Agents Chemother 2004; 48:2409-14. [PMID: 15215088 PMCID: PMC434211 DOI: 10.1128/aac.48.7.2409-2414.2004] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2003] [Revised: 02/02/2004] [Accepted: 03/17/2004] [Indexed: 11/20/2022] Open
Abstract
The 24-alkylated sterols have been shown previously to be absent in membranes of amphotericin B (AmB)-resistant Leishmania donovani promastigotes, suggesting that the S- adenosyl-l-methionine:C-24-Delta-sterol-methyltransferase (SCMT or ERG6) was not functional or not expressed in AmB-resistant (AmB-R) parasites. From an L. donovani wild-type clone, we cloned two cDNAs with an identical open reading frame encoding a putative SCMT, the enzyme responsible for a first sterol methylation at the C-24 position. The two cDNAs differed by their 3'-untranslated region (3'-UTR) and 5'-UTR sequences. One transcript (A) had a normal structure with a spliced leader and was highly expressed in normal cells but absent in AmB-R cells. The other (B), which did not possess the spliced leader sequence, was weakly expressed in normal cells but strongly expressed in AmB-R cells. As a functional test, ERG6 null mutant Saccharomyces cerevisiae yeasts were transformed using the pYES2.1 TOPO TA expression vector containing the candidate SCMT1/ERG6 coding sequence cloned from L. donovani. The transformed yeasts exhibited C-24 alkylated sterol expression, mainly ergosterol, within their membranes, proving that the isolated cDNA encodes on a SCMT responsible for sterol methylation. In AmB-R L. donovani promastigotes, the absence of the normal transcript (A) and the expression of an abnormal species (B) devoid of a spliced leader could explain the absence of sterol methylation in these cells. Further studies using a homologous system will allow us to draw conclusions about the relationship between SCMT expression and AmB resistance in Leishmania.
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Affiliation(s)
- Mohammad Pourshafie
- UMR 8076 CNRS, Faculté de Pharmacie, Université Paris XI, 5 rue Jean-Baptiste Clément, 92290-Châtenay-Malabry, France
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49
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Moraes EMP, Prímola NS, Hamdan JS. Antifungal susceptibility of clinical and environmental isolates of Cryptococcus neoformans to four antifungal drugs determined by two techniques. Mycoses 2003; 46:164-8. [PMID: 12801356 DOI: 10.1046/j.1439-0507.2003.00872.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A total of 64 Cryptococcus neoformans strains, including clinical and environmental Brazilian isolates var. neoformans and var. gattii, were tested for susceptibility to amphotericin B, 5-flucytosine, fluconazole and itraconazole. The tests were performed according to the recommendations of National Committee of Clinical Laboratory Standards and the method of macrodilution in liquid medium of Shadomy et al. [Manual de Microbiologia Clínica, 4th ed. Buenos Aires: Editorial Medica Panamericana, 1987: 1229-38]. For most drugs there was a significant difference between the readings taken at 24 and 48 h with both methods. When the minimum inhibitory concentrations obtained by the two techniques were compared, significant differences were observed for amphotericin B and fluconazole. Overall, differences in drug susceptibility with respect to the origin of the isolates or the variety of the fungus were not observed. As an exception, the gattii variety exhibited a high resistance rate to amphotericin B when the technique of Shadomy et al. was applied, a fact possibly related to the greater difficulty for treatment of the disease caused by this fungal variety.
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Affiliation(s)
- E M P Moraes
- Department of Microbiology, Institute of Biological Sciences, Minas Gerais, Brazil
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Vanden Bossche H, Engelen M, Rochette F. Antifungal agents of use in animal health--chemical, biochemical and pharmacological aspects. J Vet Pharmacol Ther 2003; 26:5-29. [PMID: 12603774 DOI: 10.1046/j.1365-2885.2003.00456.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A limited number of antifungal agents is licensed for use in animals, however, many of those available for the treatment of mycoses in humans are used by veterinary practitioners. This review includes chemical aspects, spectra of activity, mechanisms of action and resistance, adverse reactions and drug interactions of the antifungals in current use.
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