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Song D, Liu H, Huang Y, Dongari-Bagtzoglou A, Lei Y. High-Throughput Monitoring of Pathogenic Fungal Growth Using Whole Slide Imaging for Rapid Antifungal Susceptibility Assessment. ANAL LETT 2023; 57:2412-2425. [PMID: 39005971 PMCID: PMC11245173 DOI: 10.1080/00032719.2023.2297301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 12/16/2023] [Indexed: 07/16/2024]
Abstract
Invasive fungal infections are a major health threat with high morbidity and mortality, highlighting the urgent need for rapid diagnostic tools to detect antifungal resistance. Traditional culture-based antifungal susceptibility testing (AFST) methods often fall short due to their lengthy process. In our previous research, we developed a whole-slide imaging (WSI) technique for the high-throughput assessment of bacterial antibiotic resistance. Building on this foundation, this study expands the application of WSI by adapting it for rapid AFST through high-throughput monitoring of the growth of hundreds of individual fungi. Due to the distinct "budding" growth patterns of fungi, we developed a unique approach that utilizes specific cell number change to determine fungi replication, instead of cell area change used for bacteria in our previous study, to accurately determine the growth rates of individual fungal cells. This method not only accelerates the determination of antifungal resistance by directly observing individual fungal cell growth, but also yields accurate results. Employing Candida albicans as a representative model organism, reliable minimum inhibitory concentration (MIC) of fluconazole inhibiting 100% cells of Candida albicans (denoted as MIC100) was obtained within 3h using the developed method, while the modified broth dilution method required 72h for the similar reliable result. In addition, our approach was effectively utilized to test blood culture samples directly, eliminating the need to separate the fungi from whole blood samples spiked with Candida albicans. These features indicate the developed method holds great potential serving as a general tool in rapid antifungal susceptibility testing and MIC determination.
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Affiliation(s)
- Donghui Song
- Department of Biomedical Engineering, University of Connecticut, Storrs, Connecticut, USA
| | - Haomin Liu
- Department of Chemical and Biomolecular Engineering, University of Connecticut, Storrs, Connecticut, USA
| | - Yikun Huang
- Department of Biomedical Engineering, University of Connecticut, Storrs, Connecticut, USA
| | - Anna Dongari-Bagtzoglou
- Department of Oral Health and Diagnostic Sciences, Health Center, University of Connecticut, Farmington, Connecticut, USA
| | - Yu Lei
- Department of Biomedical Engineering, University of Connecticut, Storrs, Connecticut, USA
- Department of Chemical and Biomolecular Engineering, University of Connecticut, Storrs, Connecticut, USA
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2
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Pahwa R, Ahuja M. Nanocellulose-gellan cross-linked scaffolds for vaginal delivery of fluconazole. Int J Biol Macromol 2023; 229:668-683. [PMID: 36592850 DOI: 10.1016/j.ijbiomac.2022.12.273] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/09/2022] [Accepted: 12/24/2022] [Indexed: 12/31/2022]
Abstract
The objective of this research is to formulate lyophilized fluconazole-loaded nanocellulose-gellan scaffolds cross-linked using trisodium trimetaphosphate as a vaginal drug delivery system. The effect of polymers (nanocellulose and gellan gum) and cross-linking agents on drug release and mucoadhesive strength were determined by approaching a two-factor three-level central composite experimental design. The optimal formulation of the fluconazole-loaded cross-linked rice or wheat nanocellulose-gellan based scaffolds comprised of the concentration of polymers (4.91 % w/v or 4.99 % w/v) and trisodium trimetaphosphate (16.43 % w/v or 15.83 % w/v), respectively. The infrared spectra confirmed the cross-linking of nanocellulose and gellan gum while the thermal graph revealed the higher thermal stability of cross-linked scaffolds. The diffractogram of the scaffolds unveiled their amorphous nature while the electron micrographs depict the porous nature of the fluconazole-loaded nanocellulose-gellan scaffolds. The phosphorylated cross-linked nanocellulose-gellan scaffolds represent more swelling (8-fold higher), porosity (>83 %), tensile strength (>34 MPa), and mucoadhesive strength (>1940 mN), and less enzymatic degradation rate over the non cross-linked scaffolds. The optimal batch of cross-linked nanocellulose-gellan scaffolds provided a sustained release of 99 % of fluconazole over 24 h with 1.19-fold higher ex-vivo vaginal permeation over the native scaffolds. In addition, the phosphorylated nanocellulose-gellan based scaffolds exhibit improved antifungal activity and non-cytotoxicity.
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Affiliation(s)
- Rimpy Pahwa
- Drug Delivery Research Laboratory, Department of Pharmaceutical Sciences, Guru Jambheshwar University of Science and Technology, Hisar 125001, Haryana, India
| | - Munish Ahuja
- Drug Delivery Research Laboratory, Department of Pharmaceutical Sciences, Guru Jambheshwar University of Science and Technology, Hisar 125001, Haryana, India.
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3
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Chen M, Li Y, Liu H, Zhang D, Shi QS, Zhong XQ, Guo Y, Xie XB. High value valorization of lignin as environmental benign antimicrobial. Mater Today Bio 2023; 18:100520. [PMID: 36590981 PMCID: PMC9800644 DOI: 10.1016/j.mtbio.2022.100520] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 12/08/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022] Open
Abstract
Lignin is a natural aromatic polymer of p-hydroxyphenylpropanoids with various biological activities. Noticeably, plants have made use of lignin as biocides to defend themselves from pathogen microbial invasions. Thus, the use of isolated lignin as environmentally benign antimicrobial is believed to be a promising high value approach for lignin valorization. On the other hand, as green and sustainable product of plant photosynthesis, lignin should be beneficial to reduce the carbon footprint of antimicrobial industry. There have been many reports that make use of lignin to prepare antimicrobials for different applications. However, lignin is highly heterogeneous polymers different in their monomers, linkages, molecular weight, and functional groups. The structure and property relationship, and the mechanism of action of lignin as antimicrobial remains ambiguous. To show light on these issues, we reviewed the publications on lignin chemistry, antimicrobial activity of lignin models and isolated lignin and associated mechanism of actions, approaches in synthesis of lignin with improved antimicrobial activity, and the applications of lignin as antimicrobial in different fields. Hopefully, this review will help and inspire researchers in the preparation of lignin antimicrobial for their applications.
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Affiliation(s)
- Mingjie Chen
- Key Laboratory of Agricultural Microbiomics and Precision Application (MARA), Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Key Laboratory of Agricultural Microbiome (MARA), State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, 510070, China
| | - Yan Li
- Key Laboratory of Agricultural Microbiomics and Precision Application (MARA), Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Key Laboratory of Agricultural Microbiome (MARA), State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, 510070, China
- Liaoning Key Lab of Lignocellulose Chemistry and BioMaterials, Liaoning Collaborative Innovation Center for Lignocellulosic Biorefinery, College of Light Industry and Chemical Engineering, Dalian Polytechnic University, Dalian, 116034, China
| | - Huiming Liu
- Key Laboratory of Agricultural Microbiomics and Precision Application (MARA), Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Key Laboratory of Agricultural Microbiome (MARA), State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, 510070, China
| | - Dandan Zhang
- Key Laboratory of Agricultural Microbiomics and Precision Application (MARA), Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Key Laboratory of Agricultural Microbiome (MARA), State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, 510070, China
| | - Qing-Shan Shi
- Key Laboratory of Agricultural Microbiomics and Precision Application (MARA), Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Key Laboratory of Agricultural Microbiome (MARA), State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, 510070, China
| | - Xin-Qi Zhong
- Department of Neonatology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China
| | - Yanzhu Guo
- Liaoning Key Lab of Lignocellulose Chemistry and BioMaterials, Liaoning Collaborative Innovation Center for Lignocellulosic Biorefinery, College of Light Industry and Chemical Engineering, Dalian Polytechnic University, Dalian, 116034, China
| | - Xiao-Bao Xie
- Key Laboratory of Agricultural Microbiomics and Precision Application (MARA), Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Key Laboratory of Agricultural Microbiome (MARA), State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, 510070, China
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4
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Zare-Bidaki M, Maleki A, Ghanbarzadeh N, Nikoomanesh F. Expression pattern of drug-resistance genes ERG11 and TAC1 in Candida albicans Clinical isolates. Mol Biol Rep 2022; 49:11625-11633. [PMID: 36169896 DOI: 10.1007/s11033-022-07878-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 08/10/2022] [Accepted: 08/16/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Candida albicans (C. albicans) is an opportunistic fungus and the most common cause of vulvovaginal candidiasis (VVC). In recent years, the use of antifungal drugs has led to the incidence of drug-resistant C. albicans strains. The purpose of this study is twofold: to determine the pattern of drug susceptibility and the relationship between demographic factors and the incidence of drug resistance among C. albicans isolates and to investigate the expression pattern of drug-resistance genes ERG11 and TAC1 in C. albicans isolates. METHODS AND RESULTS This descriptive cross-sectional study was conducted on 50 C. albicans isolates from women with VVC. Antifungal susceptibility of the isolates was tested by M27-A3/S4 broth micro dilution method following the Clinical and Laboratory Standards Institute (CLSI) guidelines. High susceptibility rates were recorded for itraconazole and voriconazole (68%), followed by ketoconazole (46%). Fluconazole had the lowest susceptibility to C. albicans with susceptibility of 36%. The change in ERG11 and TAC1 genes expression was determined by qPCR. The mean ∆Ct values of ERG11 and TAC1genes were significantly different between fluconazole-resistant and susceptible groups (p < 0.001). Interestingly, we found that 77% of fluconazole-susceptible isolates had significantly upregulated ERG11 gene (2.9-99.0 fold). In addition, the expression of TAC1 was upregulated in 44% of fluconazole-susceptible isolates (3.86-89.8 fold). CONCLUSION Our finding revealed that incidence of drug resistance in C. albicans is not simply controlled by genes but is a multi-factorial phenomenon, where several factors and mechanisms are involved in the process of drug resistance.
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Affiliation(s)
- Majid Zare-Bidaki
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Anis Maleki
- Student Research committee, Birjand University of Medical University, Birjand, Iran
| | - Nahid Ghanbarzadeh
- Department of Gynecology and Obstetrics, Birjand University of Medical University, Birjand, Iran
| | - Fatemeh Nikoomanesh
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran.
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Žitek T, Postružnik V, Knez Ž, Golle A, Dariš B, Knez Marevci M. Arnica Montana L. Supercritical Extraction Optimization for Antibiotic and Anticancer Activity. Front Bioeng Biotechnol 2022; 10:897185. [PMID: 35620474 PMCID: PMC9127360 DOI: 10.3389/fbioe.2022.897185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 04/25/2022] [Indexed: 12/26/2022] Open
Abstract
Arnica montana L. flower heads are known for their antioxidant, antimicrobial, and anticancer activity. The aim of this work was to optimize the process of supercritical CO2 extraction, to achieve high extraction yield and high content of biologically active components, and to confirm the antimicrobial and anticancer activity of the extract. The influence of pressure and temperature on the total phenolic content, antioxidant activity, and proanthocyanidin content was evaluated. The pressure and temperature were found to be interdependent. A temperature of 60°C and a pressure of 30 MPa resulted in a high extraction yield, antioxidant activity and phenolic content. The content of proanthocyanidins was highest at a pressure between 18 and 24 MPa. The extracts inhibited three different microorganisms successfully; Staphylococcus aureus, Escherichia coli and Candida albicans, at concentrations ranging from 0.1 to 5.16 mg/ml and showed anticancer activity decrease up to 85% at a concentration of 0.5 mg/ml.
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Affiliation(s)
- Taja Žitek
- Laboratory for Separation Processes and Product Design, Faculty of Chemistry and Chemical Engi-neering, University of Maribor, Maribor, Slovenia
| | - Vesna Postružnik
- Laboratory for Separation Processes and Product Design, Faculty of Chemistry and Chemical Engi-neering, University of Maribor, Maribor, Slovenia
| | - Željko Knez
- Laboratory for Separation Processes and Product Design, Faculty of Chemistry and Chemical Engi-neering, University of Maribor, Maribor, Slovenia.,Faculty of Medicine, University of Maribor, Maribor, Slovenia
| | - Andrej Golle
- National Laboratory for Health, Environment, and Food, Maribor, Slovenia
| | - Barbara Dariš
- Faculty of Medicine, University of Maribor, Maribor, Slovenia
| | - Maša Knez Marevci
- Laboratory for Separation Processes and Product Design, Faculty of Chemistry and Chemical Engi-neering, University of Maribor, Maribor, Slovenia
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Molecular Identification and Antifungal Susceptibility Patterns of Candida Species Isolated from Candidemia Patients in Yasuj, Southwestern Iran. Jundishapur J Microbiol 2021. [DOI: 10.5812/jjm.117643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Candidemia is the most common systemic infection in hospitalized patients causing high mortality. Hence, the diagnosis of this infection in the early stage with appropriate antifungal therapy is paramount. Objectives: The study aimed at molecular identification of Candida species isolated from candidemia patients and evaluation of the in vitro antifungal susceptibility patterns of these strains to fluconazole, amphotericin B, and caspofungin. Methods: In the present study, 800 hospitalized patients who were suspected to have candidemia were sampled. Candida species were isolated and identified based on morphological characteristics and PCR-sequencing of the ITS1-5.8S-ITS2 region. Antifungal susceptibility tests for fluconazole, amphotericin B, and caspofungin were performed according to the Clinical and Laboratory Standards Institute protocol M27-A3. Also, clinical data were recorded from the patients' records. Results: Twenty-seven patients among the sample of hospitalized patients were found to have candidemia. A total of 33.3% of candidemia patients were treated with amphotericin B, in which case the mortality rate was 14.8%. The majority of patients (59%) were from the neonatal intensive care unit, and premature birth was the most common underlying condition. Candida albicans (n = 18; 66.6%) was the most common species isolated from blood cultures, followed by C. parapsilosis (n = 7; 25.9%), C. pelliculosa (n = 1; 3.7%), and C. tropicalis (n = 1; 3.7%). Only one C. albicans isolate resistant to fluconazole (minimum inhibitory concentration = 32 µg/mL). Conclusions: Generally, C. albicans has been the most frequent causative agent of candidemia. Resistance to antifungal drugs among candidemia agents was rare. Also, the identification of Candida isolates at the species level with in vitro antifungal susceptibility tests helps manage candidemia patients better and decrease the mortality rate among them.
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7
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Biernasiuk A, Berecka-Rycerz A, Gumieniczek A, Malm M, Łączkowski KZ, Szymańska J, Malm A. The newly synthesized thiazole derivatives as potential antifungal compounds against Candida albicans. Appl Microbiol Biotechnol 2021; 105:6355-6367. [PMID: 34410437 PMCID: PMC8374424 DOI: 10.1007/s00253-021-11477-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 07/15/2021] [Accepted: 07/19/2021] [Indexed: 01/19/2023]
Abstract
Abstract Recently, the occurrence of candidiasis has increased dramatically, especially in immunocompromised patients. Additionally, their treatment is often ineffective due to the resistance of yeasts to antimycotics. Therefore, there is a need to search for new antifungals. A series of nine newly synthesized thiazole derivatives containing the cyclopropane system, showing promising activity against Candida spp., has been further investigated. We decided to verify their antifungal activity towards clinical Candida albicans isolated from the oral cavity of patients with hematological malignancies and investigate the mode of action on fungal cell, the effect of combination with the selected antimycotics, toxicity to erythrocytes, and lipophilicity. These studies were performed by the broth microdilution method, test with sorbitol and ergosterol, checkerboard technique, erythrocyte lysis assay, and reversed phase thin-layer chromatography, respectively. All derivatives showed very strong activity (similar and even higher than nystatin) against all C. albicans isolates with minimal inhibitory concentration (MIC) = 0.008–7.81 µg/mL Their mechanism of action may be related to action within the fungal cell wall structure and/or within the cell membrane. The interactions between the derivatives and the selected antimycotics (nystatin, chlorhexidine, and thymol) showed additive effect only in the case of combination some of them and thymol. The erythrocyte lysis assay confirmed the low cytotoxicity of these compounds as compared to nystatin. The high lipophilicity of the derivatives was related with their high antifungal activity. The present studies confirm that the studied thiazole derivatives containing the cyclopropane system appear to be a very promising group of compounds in treatment of infections caused by C. albicans. However, this requires further studies in vivo. Key points • The newly thiazoles showed high antifungal activity and some of them — additive effect in combination with thymol. • Their mode of action may be related with the influence on the structure of the fungal cell wall and/or the cell membrane. • The low cytotoxicity against erythrocytes and high lipophilicity of these derivatives are their additional good properties. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1007/s00253-021-11477-7.
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Affiliation(s)
- Anna Biernasiuk
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Medical University of Lublin, Chodźki 1, 20-093, Lublin, Poland.
| | - Anna Berecka-Rycerz
- Department of Medicinal Chemistry, Faculty of Pharmacy, Medical University of Lublin, Jaczewskiego 4, 20-090, Lublin, Poland
| | - Anna Gumieniczek
- Department of Medicinal Chemistry, Faculty of Pharmacy, Medical University of Lublin, Jaczewskiego 4, 20-090, Lublin, Poland
| | - Maria Malm
- Department of Medicinal Informatics and Statistics with E-Learning Lab, Faculty of Health Sciences, Medical University of Lublin, Jaczewskiego 4, Lublin, 20-090, Poland
| | - Krzysztof Z Łączkowski
- Department of Chemical Technology and Pharmaceuticals, Faculty of Pharmacy, Collegium Medicum, Nicolaus Copernicus University, Jurasza 2, 85-089, Bydgoszcz, Poland
| | - Jolanta Szymańska
- Department of Integrated Paediatric Dentistry, Chair of Integrated Dentistry, Faculty of Medical Dentistry, Medical University of Lublin, Lubartowska 58, 20-94, Lublin, Poland
| | - Anna Malm
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Medical University of Lublin, Chodźki 1, 20-093, Lublin, Poland
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Assessing the Bioactive Profile of Antifungal-Loaded Calcium Sulfate against Fungal Biofilms. Antimicrob Agents Chemother 2021; 65:AAC.02551-20. [PMID: 33753336 PMCID: PMC8316021 DOI: 10.1128/aac.02551-20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/14/2021] [Indexed: 11/20/2022] Open
Abstract
Calcium sulfate (CS) has been used clinically as a bone- or void-filling biomaterial, and its resorptive properties have provided the prospect for its use as a release mechanism for local antibiotics to control biofilms. Here, we aimed to test CS beads loaded with three antifungal drugs against planktonic and sessile fungal species to assess whether these antifungal beads could be harnessed to provide consistent release of antifungals at biofilm-inhibitory doses. A panel of different fungal species (n = 15) were selected for planktonic broth microdilution testing with fluconazole (FLZ), amphotericin B (AMB), and caspofungin (CSP). After establishing planktonic inhibition, antifungal CS beads were introduced to fungal biofilms (n = 5) to assess biofilm formation and cell viability through a combination of standard quantitative and qualitative biofilm assays. Inoculation of a hydrogel substrate, packed with antifungal CS beads, was also used to assess diffusion through a semidry material, to mimic active infection in vivo In general, antifungals released from loaded CS beads were all effective at inhibiting the pathogenic fungi over 7 days within standard MIC ranges for these fungi. We observed a significant reduction of pregrown fungal biofilms across key fungal pathogens following treatment, with visually observable changes in cell morphology and biofilm coverage provided by scanning electron microscopy. Assessment of biofilm inhibition also revealed reductions in total and viable cells across all organisms tested. These data show that antifungal-loaded CS beads produce a sustained antimicrobial effect that inhibits and kills clinically relevant fungal species in vitro as planktonic and biofilm cells.
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Gilroy C, Raab O, Hanna P. Pathology in Practice. J Am Vet Med Assoc 2021; 257:161-164. [PMID: 32597735 DOI: 10.2460/javma.257.2.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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10
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Sharma D, Singh SS, Baindara P, Sharma S, Khatri N, Grover V, Patil PB, Korpole S. Surfactin Like Broad Spectrum Antimicrobial Lipopeptide Co-produced With Sublancin From Bacillus subtilis Strain A52: Dual Reservoir of Bioactives. Front Microbiol 2020; 11:1167. [PMID: 32595619 PMCID: PMC7300217 DOI: 10.3389/fmicb.2020.01167] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 05/07/2020] [Indexed: 01/31/2023] Open
Abstract
An antimicrobial substance producing strain designated as A52 was isolated from a marine sediment sample and identified as Bacillus sp., based on 16S rRNA gene sequence analysis. The ANI and dDDH analysis of the genome sequence displayed high identity with two strains of B. subtilis sub sp. subtilis. Strain A52 yielded two antimicrobial peptides (AMPs) that differed in activity spectrum. MALDI mass spectrometry analysis of HPLC purified fractions revealed mass of peptides as 3881.6 and 1061.9 Da. The antiSMASH analysis of genome sequence unraveled presence of identical biosynthetic cluster involved in production of sublancin from B. subtilis sub sp. subtilis strain 168, which yielded peptide with identical mass. The low molecular weight peptide is found to be a cyclic lipopeptide containing C16 β-hydroxy fatty acid that resembled surfactin-like group of biosurfactants. However, it differed in fatty acid composition and antimicrobial spectrum in comparison to other surfactins produced by strains of B. subtilis. It exhibited broad spectrum antibacterial activity, inhibited growth of pathogenic strains of Candida and filamentous fungi. Further, it exhibited hemolytic activity, but did not show phytotoxic effect in seed germination experiment. The emulgel formulation of surfactin-like lipopeptide showed antimicrobial activity in vitro and did not show any irritation effects in animal studies using BALB/c mice. Moreover, surfactin-like lipopeptide displayed synergistic activity with fluconazole against Candida, indicating its potential for external therapeutic applications.
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Affiliation(s)
- Deepika Sharma
- Council of Scientific and Industrial Research (CSIR) - Institute of Microbial Technology, Chandigarh, India
| | - Shelley Sardul Singh
- Council of Scientific and Industrial Research (CSIR) - Institute of Microbial Technology, Chandigarh, India
| | - Piyush Baindara
- Council of Scientific and Industrial Research (CSIR) - Institute of Microbial Technology, Chandigarh, India
| | - Shikha Sharma
- Council of Scientific and Industrial Research (CSIR) - Institute of Microbial Technology, Chandigarh, India
| | - Neeraj Khatri
- Council of Scientific and Industrial Research (CSIR) - Institute of Microbial Technology, Chandigarh, India
| | - Vishakha Grover
- Dr. Harvansh Singh Judge Institute of Dental Sciences & Hospital, Panjab University, Chandigarh, India
| | - Prabhu B Patil
- Council of Scientific and Industrial Research (CSIR) - Institute of Microbial Technology, Chandigarh, India
| | - Suresh Korpole
- Council of Scientific and Industrial Research (CSIR) - Institute of Microbial Technology, Chandigarh, India
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11
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Ghaddar N, Anastasiadis E, Halimeh R, Ghaddar A, Dhar R, AlFouzan W, Yusef H, El Chaar M. Prevalence and antifungal susceptibility of Candida albicans causing vaginal discharge among pregnant women in Lebanon. BMC Infect Dis 2020; 20:32. [PMID: 31931738 PMCID: PMC6958632 DOI: 10.1186/s12879-019-4736-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 12/24/2019] [Indexed: 01/11/2023] Open
Abstract
Background Vaginal candidiasis is frequent in pregnant women and is associated with sepsis and adverse neonatal outcomes. This study determined the prevalence of candida species in symptomatic pregnant women and evaluated the antifungal susceptibility profile of the isolated Candida strains. It also aimed to explore whether Candida species predicts gestational complications and adverse neonatal outcomes. Methods A total of 258 pregnant women with vaginal discharge at 35 to 37 week of gestation participated in this study. Vaginal swabs from these patients were collected at various obstetrics and gynecology clinics in Lebanon for a period of 14 months. Candida isolates were identified at species level and antifungal susceptibility of Candida albicans to fluconazole (FCZ), amphotericin B (AMB), itraconazole (ICZ) and voriconazole (VCZ) was determined by the agar-based E-test method. Results Among 258 women tested, 100 (39%) were positive for Candida species. C. albicans, C. glabrata and C. krusei were isolated from 42, 41 and 17% of the women, respectively. C. albicans was significantly associated only with gestational diabetes while C. krusei or C. glabrata had significant positive associations with other gestational complications. The antifungal susceptibility tests of C. albicans isolates revealed 97.5, 90, 87.5 and 97.5% susceptibility to AMB, FCZ, ICZ and VCZ, respectively. Conclusion The current study revealed high incidence of both C. albicans and non-C. albicans Candida strains causing vulvovaginitis among pregnant women in Beirut, Lebanon. Candida screening as antenatal follow up is advised to minimize the risk of adverse neonatal outcome or gestational complications.
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Affiliation(s)
- Nahed Ghaddar
- Faculty of Science, Biological Sciences Department, Beirut Arab University, Beirut, Lebanon
| | - Elie Anastasiadis
- Department of Obstetrics and Gynecology, Saint George Hospital, Beirut, Lebanon.,Faculty of Medicine, University of Balamand, Beirut, Lebanon
| | - Rawad Halimeh
- Department of Obstetrics and Gynecology, Saint George Hospital, Beirut, Lebanon
| | - Ali Ghaddar
- Department of Biomedical Sciences, Lebanese International University, Beirut, Lebanon
| | - Rita Dhar
- Faculty of Health Sciences, University of Balamand, P.O.Box 166378 Ashrafieh, Beirut, 1100-2807, Lebanon
| | - Wadha AlFouzan
- Microbiology Unit, Department of Laboratories, Farwania Hospital, Sabah Al Nasser, Kuwait.,Faculty of Health Sciences, University of Balamand, P.O.Box 166378 Ashrafieh, Beirut, 1100-2807, Lebanon
| | - Hoda Yusef
- Faculty of Science, Biological Sciences Department, Beirut Arab University, Beirut, Lebanon
| | - Mira El Chaar
- Department of Microbiology, Health Sciences Center, Kuwait University, Jabriya, Kuwait.
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12
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Esentürk İ, Balkan T, Özhan G, Döşler S, Güngör S, Erdal MS, Sarac AS. Voriconazole incorporated nanofiber formulations for topical application: preparation, characterization and antifungal activity studies against Candida species. Pharm Dev Technol 2020; 25:440-453. [DOI: 10.1080/10837450.2019.1706563] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- İmren Esentürk
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Istanbul University, Istanbul, Turkey
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Health Sciences, Istanbul, Turkey
| | - Timuçin Balkan
- Polymer Science and Technology, Istanbul Technical University, Istanbul, Turkey
- TÜPRAS Energy Center (KUTEM), Koç University, Istanbul, Turkey
| | - Gül Özhan
- Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Istanbul University, Istanbul, Turkey
| | - Sibel Döşler
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Istanbul University, Istanbul, Turkey
| | - Sevgi Güngör
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Istanbul University, Istanbul, Turkey
| | - M. Sedef Erdal
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Istanbul University, Istanbul, Turkey
| | - Abdulkadir Sezai Sarac
- Polymer Science and Technology, Istanbul Technical University, Istanbul, Turkey
- Nanoscience and Nanoengineering, Istanbul Technical University, Istanbul, Turkey
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Candida Bloodstream Infection: Changing Pattern of Occurrence and Antifungal Susceptibility over 10 Years in a Tertiary Care Saudi Hospital. CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY 2019; 2019:2015692. [PMID: 31929847 PMCID: PMC6935793 DOI: 10.1155/2019/2015692] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 09/12/2019] [Accepted: 11/06/2019] [Indexed: 01/04/2023]
Abstract
Background Candida has emerged as one of the most important pathogens that cause bloodstream infection (BSI).Understanding the current Candida BSI trends, the dominant species causing disease and the mortality associated with this infection are crucial to optimize therapeutic and prophylaxis measures. Objectives To study the epidemiology and to evaluate the risk factors, prognostic factors, and mortality associated with candidemia and to compare these findings with previously published studies from Saudi Arabia. Design A retrospective medical record review. Setting Tertiary hospital in Riyadh. Patients and Methods The analysis included all cases of Candida blood stream infection who are >18 years old over the period from 2013 to 2018. Continuous variables were compared using the parametric T-test while categorical variables were compared using the Chi-squared test. Main Outcome Measure Incidence, resistance, and hospital outcomes in Candida blood stream infection. Sample Size 324 patients. Results Three hundred and twenty-four episodes of Candida blood stream infections were identified. Median age of patients was 49.7 SD ± 28.1 years, and 53% of patients were males. More than half of the patients had an underlying disease involving the abdomen or laparotomy, 78% had an indwelling intravenous catheter, and 62% had suffered a bacterial infection within 2 weeks prior to candidemia. Candida albicans represents 33% of all isolates with decreasing trend overtime. There was an increase in the number of nonalbicans Candida overtime with Candida tropicalis in the lead (20%). Use of broad spectrum antibiotics (82%), prior ICU admission (60%) and use of central venous catheters (58%) were the most prevalent predisposing factors of candidemia. Azole resistance was variable overtime. Resistance to caspofungin remained very low (1.9%). Fourteen days crude mortality was 37% for ICU patients and 26.7% in non-ICU patients, while hospital crude mortality was 64.4% and 46.7%, respectively. Conclusion There is an increasing trend of nonalbicans Candida blood stream infection. Fluconazole resistance remained low to C. albicans. Most isolates remain susceptible to caspofungin, voriconazole, and amphotericin B. Candida bloodstream infection is associated with high 14-day hospital mortality.
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Aslani N, Shokohi T, Ataollahi MR, Ansari S, Gholampour Y, Khani Jeihooni A, Afsarian MH. In vitro activity of four triazole antifungal drugs against clinically common and uncommon yeast species. Curr Med Mycol 2019; 5:14-19. [PMID: 32104739 PMCID: PMC7034789 DOI: 10.18502/cmm.5.4.1949] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Background and Purpose: Incidence of fungal infections caused by opportunistic fungal pathogens, such as yeasts and yeast-like species, has undergone an increase in otherwise healthy individuals. These pathogens account for high mortality and show reduced susceptibility to the routine antifungal drugs. Accordingly, antifungal susceptibility testing is an urgent need in the determination of the susceptibility spectrum of antifungals and selection of appropriate antifungal agents for the management of patients with fungal infection. Materials and Methods: The present study was conducted on 110 yeast strains belonging to 15 species recovered from clinical specimens. Susceptibility of the isolates to four antifungal drugs (i.e., fluconazole, itraconazole, voriconazole, and posaconazole) was tested according to the Clinical and Laboratory Standards Institute guidelines M27-A3 and M27-S4. Results: Fluconazole exhibited no activity against 4.3% (n=2) of C. albicans isolates, whereas the remaining 44 isolates had a minimum inhibitory concentration (MIC) range of 0.125-4 μg/ml. Voriconazole had the lowest geometric mean MIC (0.03 µg/ml) against all isolated yeast species, followed by posaconazole (0.07 µg/ml), itraconazole (0.10 µg/ml), and fluconazole (0.60 µg/ml). Overall, all of the isolates had reduced voriconazole MICs with a MIC range of 0.016-0.5 μg/ml, except for one isolate of C. albicans that had a MIC of 1 μg/ml. Candida haemulonii as a multidrug-resistant fungus showed a fluconazole MIC of > 64 μg/ml. Conclusion: The current study provides insight into the antifungal susceptibility profiles of clinically common and uncommon yeast species to four triazole antifungal agents. According to our findings, voriconazole was the most active agent. Awareness about antifungal susceptibility patterns is highly helpful in the selection of appropriate antifungal drugs and identification of the efficiency of the currently used agents.
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Affiliation(s)
- Narges Aslani
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Tahereh Shokohi
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Reza Ataollahi
- Department of Medical Immunology, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Saham Ansari
- Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yousef Gholampour
- Department of Internal Medicine, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Ali Khani Jeihooni
- Department of Public Health, School of Health, Fasa University of Medical Sciences, Fasa, Iran
| | - Mohammad Hosein Afsarian
- Department of Medical Mycology and Parasitology, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
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15
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Arikan-Akdagli S, Gülmez D, Doğan Ö, Çerikçioğlu N, Doluca Dereli M, Birinci A, Yıldıran ŞT, Ener B, Öz Y, Metin DY, Hilmioğlu-Polat S, Kalkancı A, Koç N, Erturan Z, Fındık D. First multicentre report of in vitro resistance rates in candidaemia isolates in Turkey. J Glob Antimicrob Resist 2019; 18:230-234. [DOI: 10.1016/j.jgar.2019.04.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 03/29/2019] [Accepted: 04/03/2019] [Indexed: 10/27/2022] Open
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16
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Ghazi S, Rafei R, Osman M, El Safadi D, Mallat H, Papon N, Dabboussi F, Bouchara JP, Hamze M. The epidemiology of Candida species in the Middle East and North Africa. J Mycol Med 2019; 29:245-252. [PMID: 31400864 DOI: 10.1016/j.mycmed.2019.07.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 06/30/2019] [Accepted: 07/09/2019] [Indexed: 12/23/2022]
Abstract
In recent decades, the epidemiology of invasive candidiasis (IC) has progressively changed worldwide. This notably includes emergence of several Candida species. Although some surveillance programs provided global trends in IC epidemiology, data from countries from the Middle East and North Africa (MENA) remain scarce. In this manuscript, we reviewed the existing available data on the epidemiology of Candida species associated with IC, particularly candidemia, in MENA region regarding species distribution. As witnessed worldwide, an evident shift of Candidaalbicans towards non-albicansCandida (NAC) has been observed in the MENA region. The worrying emergence of multi-drug resistant Candida species in MENA calls for a better understanding of their epidemiology. This represents an essential prerequisite for the implementation of effective infection control strategies and surveillance systems to prevent IC among high-risk patients.
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Affiliation(s)
- S Ghazi
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - R Rafei
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - M Osman
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - D El Safadi
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - H Mallat
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - N Papon
- Groupe d'Etude des Interactions Hôte-Pathogène, GEIHP, EA 3142, SFR ICAT 4208, UNIV Angers, UNIV Brest, Institut de Biologie en Santé, IRIS, CHU Angers, 4, rue Larrey, 49933 Angers cedex 9, France
| | - F Dabboussi
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - J-P Bouchara
- Groupe d'Etude des Interactions Hôte-Pathogène, GEIHP, EA 3142, SFR ICAT 4208, UNIV Angers, UNIV Brest, Institut de Biologie en Santé, IRIS, CHU Angers, 4, rue Larrey, 49933 Angers cedex 9, France
| | - M Hamze
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon.
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17
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Ochiai A, Ogawa K, Fukuda M, Ohori M, Kanaoka T, Tanaka T, Taniguchi M, Sagehashi Y. Rice Defensin OsAFP1 is a New Drug Candidate against Human Pathogenic Fungi. Sci Rep 2018; 8:11434. [PMID: 30061724 PMCID: PMC6065317 DOI: 10.1038/s41598-018-29715-w] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 07/17/2018] [Indexed: 12/28/2022] Open
Abstract
Fungal infections, such as candidiasis and aspergillosis, are some of the most frequent infections in humans. Although antifungal drugs are available for the treatment of these infections, antifungal agents with new mechanisms of action should be developed because of the increasing incidence of drug-resistant pathogens in recent years. In this study, a basic functional analysis of rice defensin OsAFP1, a novel antifungal drug candidate, was conducted. OsAFP1 exerted fungicidal activity against Candida albicans, the most common pathogenic fungus in humans, at 4 μM concentration, but it did not inhibit the growth of human pathogenic bacteria. In addition, OsAFP1 retained structural stability after heat treatment at 100 °C for 10 min and after serum treatment at 37 °C for 24 h. A propidium iodide (PI) uptake assay and mutational analysis revealed that amino acid residues within the C-terminal γ-core motif of OsAFP1, particularly Leu-39 and Lys-41, play an important role in its antifungal activity. Further, PI uptake and apoptosis assays suggested that OsAFP1 exerts its antifungal activity by inducing apoptosis of target cells. Immunohistochemistry showed that the OsAFP1 target molecule was located in the cell wall. These findings indicate that OsAFP1 may be developed into a potent antifungal drug.
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Affiliation(s)
- Akihito Ochiai
- Department of Materials Science and Technology, Faculty of Engineering, Niigata University, Niigata, Japan.
| | - Kodai Ogawa
- Department of Materials Science and Technology, Faculty of Engineering, Niigata University, Niigata, Japan
| | - Minami Fukuda
- Department of Materials Science and Technology, Faculty of Engineering, Niigata University, Niigata, Japan
| | - Masahiro Ohori
- Department of Materials Science and Technology, Faculty of Engineering, Niigata University, Niigata, Japan
| | - Takumi Kanaoka
- Department of Materials Science and Technology, Faculty of Engineering, Niigata University, Niigata, Japan
| | - Takaaki Tanaka
- Department of Materials Science and Technology, Faculty of Engineering, Niigata University, Niigata, Japan
| | - Masayuki Taniguchi
- Department of Materials Science and Technology, Faculty of Engineering, Niigata University, Niigata, Japan
| | - Yoshiyuki Sagehashi
- Hokkaido Agricultural Research Center, National Agriculture and Food Research Organization (NARO), Hokkaido, Japan.
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In Vitro Susceptibilities of Non-albicans Candida Species to Echinocandins, Azoles, and Amphotericin B in Tokat, Turkey. Jundishapur J Microbiol 2018. [DOI: 10.5812/jjm.59404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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19
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Sharifzadeh A, Khosravi AR, Shokri H, Shirzadi H. Potential effect of 2-isopropyl-5-methylphenol (thymol) alone and in combination with fluconazole against clinical isolates of Candida albicans, C. glabrata and C. krusei. J Mycol Med 2018; 28:294-299. [PMID: 29661606 DOI: 10.1016/j.mycmed.2018.04.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 04/04/2018] [Accepted: 04/05/2018] [Indexed: 01/06/2023]
Abstract
Limitations of antifungals used in the treatment of candidiasis, as the development of resistant strains, are known by the scientific community. In this context, the aim of this study was to investigate the activity of 2-isopropyl-5-methylphenol (thymol) in combination with fluconazole (FLZ) against clinical Candida strains. The antifungal activity of thymol along with FLZ was evaluated by the Clinical Laboratory Standards Institute (CLSI) M27-A2 broth microdilution method. In addition, synergism was observed for clinical strains of Candida spp. with combination of thymol-FLZ evaluated by the chequerboard microdilution method. The mean of minimum inhibitory concentration (MIC) values of thymol and FLZ were 49.37 and 0.475μg/ml for C. albicans, 51.25 and 18.80μg/ml for C. glabrata and 70 and 179.20μg/ml for C. krusei strains, respectively. Thymol in combination with FLZ exhibited the synergistic effects against all species of Candida tested. FICI values for thymol plus FLZ ranged from 0.366 to 0.607 for C. albicans strains, 0.367 to 0.482 for C. glabrata strains, and 0.375 to 0.563 for C. krusei strains. No antagonistic activity was seen in the strains tested. Thymol was found to have a fungicidal effect on Candida species and a synergistic effect when combined with FLZ.
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Affiliation(s)
- A Sharifzadeh
- Mycology Research Center, Faculty of Veterinary Medicine, University of Tehran, Azadi street, Tehran, Iran.
| | - A R Khosravi
- Mycology Research Center, Faculty of Veterinary Medicine, University of Tehran, Azadi street, Tehran, Iran
| | - H Shokri
- Department of Pathobiology, Faculty of Veterinary Medicine, Amol University of Special Modern Technologies, Amol, Iran
| | - H Shirzadi
- Mycology Research Center, Faculty of Veterinary Medicine, University of Tehran, Azadi street, Tehran, Iran
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20
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In vitro susceptibility of Candida albicans clinical isolates to eight antifungal agents in Ouagadougou (Burkina Faso). J Mycol Med 2017; 27:469-475. [DOI: 10.1016/j.mycmed.2017.07.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Revised: 06/10/2017] [Accepted: 07/01/2017] [Indexed: 01/31/2023]
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21
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Hall D, Bonifas R, Stapert L, Thwaites M, Shinabarger DL, Pillar CM. In vitro potency and fungicidal activity of CD101, a novel echinocandin, against recent clinical isolates of Candida spp. Diagn Microbiol Infect Dis 2017; 89:205-211. [PMID: 28826987 DOI: 10.1016/j.diagmicrobio.2017.07.007] [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: 10/24/2016] [Revised: 07/13/2017] [Accepted: 07/14/2017] [Indexed: 01/05/2023]
Abstract
Candida infections vary in severity and manifestation. Common infections include invasive bloodstream infections among hospitalized/immunocompromised patients and vulvovaginal candidiasis among women. Echinocandins and azoles are commonly utilized to treat Candida infections, although echinocandin use has been restricted to indications amenable to once-daily IV administration. CD101, a novel echinocandin with a long plasma half-life and enhanced stability, is in development for once-weekly IV administration for the treatment of candidemia and invasive candidiasis. In this study, the MIC of CD101 and comparators against 500 recent clinical Candida isolates was determined per Clinical and Laboratory Standards Institute guidelines. For select isolates, the minimum fungicidal concentration (MFC; n=49) and time-kill (n=9) of CD101 and comparators was evaluated. The MIC50/90s (μg/mL; n=100/species) for CD101, anidulafungin, fluconazole, and amphotericin B, respectively, were: C. albicans (0.008/0.03, 0.004/0.008, 0.25/4, 0.25/0.5), C. tropicalis (0.008/0.03, 0.004/0.015, 0.5/2, 0.5/1), C. parapsilosis (1/1, 0.5/2, 0.5/1, 0.5/1), C. glabrata (0.03/0.03, 0.03/0.03, 8/>32, 0.5/0.5), and C. krusei (0.03/0.03, 0.03/0.03, 32/>32, 1/1). CD101 MICs were comparable to anidulafungin and both maintained potency against fluconazole-resistant isolates. Against rare anidulafungin-resistant isolates, the MICs of CD101 and anidulafungin were elevated vs. anidulafungin-susceptible isolates. Similar to anidulafungin, CD101 was fungicidal with an MFC:MIC ratio ≤4 for 95% of evaluable isolates and resulted in 3-log killing by 24-48h for all isolates evaluated by time-kill. The potent fungicidal activity of CD101 highlights the potential clinical utility of CD101 IV for the treatment of invasive candidiasis and candidemia.
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22
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Gonçalves S, Silva PM, Felício MR, de Medeiros LN, Kurtenbach E, Santos NC. Psd1 Effects on Candida albicans Planktonic Cells and Biofilms. Front Cell Infect Microbiol 2017. [PMID: 28649561 PMCID: PMC5465278 DOI: 10.3389/fcimb.2017.00249] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Candida albicans is an important human pathogen, causing opportunistic infections. The adhesion of planktonic cells to a substrate is the first step for biofilm development. The antimicrobial peptide (AMP) Psd1 is a defensin isolated from Pisum sativum seeds. We tested the effects of this AMP on C. albicans biofilms and planktonic cells, comparing its activity with amphotericin B and fluconazole. Three C. albicans variants were studied, one of them a mutant deficient in glucosylceramide synthase, conferring resistance to Psd1 antifungal action. Atomic force microscopy (AFM) was used to assess morphological and biomechanical changes on fungal cells. Surface alterations, with membrane disruption and leakage of cellular contents, were observed. Cytometry assays and confocal microscopy imaging showed that Psd1 causes cell death, in a time and concentration-dependent manner. These results demonstrate Psd1 pleiotropic action against a relevant fungal human pathogen, suggesting its use as natural antimycotic agent.
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Affiliation(s)
- Sónia Gonçalves
- Faculdade de Medicina, Instituto de Medicina Molecular, Universidade de LisboaLisbon, Portugal
| | - Patrícia M Silva
- Faculdade de Medicina, Instituto de Medicina Molecular, Universidade de LisboaLisbon, Portugal
| | - Mário R Felício
- Faculdade de Medicina, Instituto de Medicina Molecular, Universidade de LisboaLisbon, Portugal
| | - Luciano N de Medeiros
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de JaneiroRio de Janeiro, Brazil
| | - Eleonora Kurtenbach
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de JaneiroRio de Janeiro, Brazil
| | - Nuno C Santos
- Faculdade de Medicina, Instituto de Medicina Molecular, Universidade de LisboaLisbon, Portugal
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Mermutluoglu C, Deveci O, Dayan S, Aslan E, Bozkurt F, Tekin R. Antifungal Susceptibility and Risk Factors in Patients with Candidemia. Eurasian J Med 2017; 48:199-203. [PMID: 28149146 DOI: 10.5152/eurasianmed.2016.0021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the antifungal susceptibility, typology, and risk factors of candidemia among adult and pediatric inpatients at a university hospital. MATERIALS AND METHODS A case-control study was designed, and data collected between December 2013 and December 2014 were retrospectively evaluated. The case group consisted of patients with candidemia. The control group was selected from the inpatients that did not develop candidemia but were admitted in the same clinic and during the same period as the candidemia group. The diagnosis of candidemia was based on a compatible clinical picture and positive blood culture of Candida spp. The demographic characteristics, sequential organ failure assessment (SOFA) scores, comorbidities, use of invasive devices, antibiotics administered, and duration of antibiotic uses were compared between both the groups. RESULTS Out of the 84 patients, 42 (50%) were included in the case group, and the remaining 42 (50%) were included in the control group. Out of all the patients, 31 (36.9%) were female, and 53 (63.1%) were male. When the clinical findings of the case and control groups were compared, the prevalence of nosocomial infections, sepsis, candiduria, and fever was statistically significantly higher in the case group. Among the isolated group in the study, 22 (52.4%) were identified as C. albicans, while the others were non-albicans Candida strains. The C. albicans strain (4.5%) was resistant to fluconazole, while 7 among the non-albicans Candida strains (35%) were resistant to fluconazole. In the case group, abdominal surgery, CVP catheter presence, TPN, endotracheal intubation, frequency of blood transfusion, and SOFA scores were significantly higher than the control groups. The logistic regression test demonstrated that TPN and blood transfusion are the most important risk factors for candidemia (OR=8.14 and OR=5.96, respectively). CONCLUSION The invasive Candida infections continue to be a major health problem in Turkey and in our hospital. Particularly, it was observed that it is important to perform invasive procedures, antibiotic administration and parenteral nutrition carefully in patients hospitalized in the ICU.
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Affiliation(s)
- Cigdem Mermutluoglu
- Clinic of Infectious diseases and Clinical Microbiology, Diyarbakır Training and Research Hospital, Diyarbakır, Turkey
| | - Ozcan Deveci
- Department of Infectious diseases and Clinical Microbiology, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Saim Dayan
- Department of Infectious diseases and Clinical Microbiology, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Emel Aslan
- Department of Infectious diseases and Clinical Microbiology, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Fatma Bozkurt
- Department of Infectious diseases and Clinical Microbiology, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Recep Tekin
- Department of Infectious diseases and Clinical Microbiology, Dicle University School of Medicine, Diyarbakır, Turkey
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Wang H, Xu YC, Hsueh PR. Epidemiology of candidemia and antifungal susceptibility in invasive Candida species in the Asia-Pacific region. Future Microbiol 2016; 11:1461-1477. [PMID: 27750452 DOI: 10.2217/fmb-2016-0099] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
In the Asia-Pacific region, Candida albicans is the predominant Candida species causing invasive candidiasis/candidemia in Australia, Japan, Korea, Hong Kong, Malaysia, Singapore and Thailand whereas C. tropicalis is the most frequently encountered Candida species in Pakistan and India. Invasive isolates of C. albicans, C. parapsilosis complex and C. tropicalis remain highly susceptible to fluconazole (>90% susceptible). Fluconazole resistance (6.8-15%), isolates with the non-wild-type phenotype for itraconazole susceptibility (3.9-10%) and voriconazole (5-17.8%), and echinocandin resistance (2.1-2.2% in anidulafungin and 2.2% in micafungin) among invasive C. glabrata complex isolates are increasing in prevalence. Moreover, not all isolates of C. tropicalis have been shown to be susceptible to fluconazole (nonsusceptible rate, 5.7-11.6% in China) or voriconazole (nonsusceptible rate, 5.7-9.6% in China).
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Affiliation(s)
- He Wang
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.,Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Ying-Chun Xu
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Po-Ren Hsueh
- Departments of Laboratory Medicine & Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
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Dagi HT, Findik D, Senkeles C, Arslan U. Identification and antifungal susceptibility of Candida species isolated from bloodstream infections in Konya, Turkey. Ann Clin Microbiol Antimicrob 2016; 15:36. [PMID: 27245756 PMCID: PMC4888423 DOI: 10.1186/s12941-016-0153-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 05/23/2016] [Indexed: 12/12/2022] Open
Abstract
Background In this study, our aim was to identify Candida species isolated from bloodstream infections and to determine their susceptibilities to various antifungal agents to demonstrate the local resistance profiles and to guide empirical treatment for clinicians. Methods Two hundred Candida isolates (95 Candida albicans, 105 non-albicans Candida strains) were included in the study. Candida species were identified by conventional, biochemical and molecular methods. Antifungal susceptibility tests for amphotericin B, fluconazole, voriconazole, posaconazole, caspofungin and anidulafungin were performed with broth microdilution method according to the Clinical and Laboratory Standards Institute M27-A3 document. Results Of the 200 Candida strains, the most prevalent species were C. albicans (47.5 %), Candida glabrata (18.0 %) and Candida parapsilosis complex (14.0 %). All Candida species except for three (1.5 %) Candida kefyr strains were susceptible to amphotericin B. Only one (2.8 %) C. glabrata was resistant to fluconazole (MIC ≥ 64 μg/ml), and the others (97.2 %) exhibited dose-dependent susceptibility. All species, but C. glabrata strains, were susceptible to fluconazole. Resistance to voriconazole, posaconazole, caspofungin and anidulafungin was not detected in any strain. Conclusion Candida albicans were susceptible to all antifungal drugs. Three C. kefyr strains were resistant to amphotericin B. Only one C. glabrata was resistant to fluconazole. All the strains were susceptible to voriconazole, posaconazole, caspofungin and anidulafungin. In vitro antifungal susceptibility tests should be performed to select of appropriate and effective antifungal therapy, and monitor the development of resistance.
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Affiliation(s)
- Hatice Turk Dagi
- Department of Microbiology, Faculty of Medicine, Selcuk University, Alaeddin Keykubat Campus, 42131, Konya, Selcuklu, Turkey.
| | - Duygu Findik
- Department of Microbiology, Faculty of Medicine, Selcuk University, Alaeddin Keykubat Campus, 42131, Konya, Selcuklu, Turkey
| | - Cigdem Senkeles
- Department of Microbiology, Faculty of Medicine, Selcuk University, Alaeddin Keykubat Campus, 42131, Konya, Selcuklu, Turkey
| | - Ugur Arslan
- Department of Microbiology, Faculty of Medicine, Selcuk University, Alaeddin Keykubat Campus, 42131, Konya, Selcuklu, Turkey
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Mertas A, Garbusińska A, Szliszka E, Jureczko A, Kowalska M, Król W. The influence of tea tree oil (Melaleuca alternifolia) on fluconazole activity against fluconazole-resistant Candida albicans strains. BIOMED RESEARCH INTERNATIONAL 2015; 2015:590470. [PMID: 25722982 PMCID: PMC4334616 DOI: 10.1155/2015/590470] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 09/17/2014] [Accepted: 10/12/2014] [Indexed: 11/21/2022]
Abstract
The aim of this study was to evaluate the activity of fluconazole against 32 clinical strains of fluconazole-resistant Candida albicans, and C. albicans ATCC 10231 reference strain, after their exposure to sublethal concentrations of tea tree oil (TTO) or its main bioactive component terpinen-4-ol. For all tested fluconazole-resistant C. albicans strains TTO and terpinen-4-ol minimal inhibitory concentrations (MICs) were low, ranging from 0.06% to 0.5%. The 24-hour exposure of fluconazole-resistant C. albicans strains to fluconazole with sublethal dose of TTO enhanced fluconazole activity against these strains. Overall, 62.5% of isolates were classified as susceptible, 25.0% exhibited intermediate susceptibility, and 12.5% were resistant. For all of the tested clinical strains the fluconazole MIC decreased from an average of 244.0 μg/mL to an average of 38.46 μg/mL, and the fluconazole minimal fungicidal concentrations (MFC) decreased from an average of 254.67 μg/mL to an average of 66.62 μg/mL. Terpinen-4-ol was found to be more active than TTO, and strongly enhanced fluconazole activity against fluconazole-resistant C. albicans strains. The results of this study demonstrate that combining natural substances such as TTO and conventional drug such as fluconazole, may help treat difficult yeast infections.
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Affiliation(s)
- Anna Mertas
- Department of Microbiology and Immunology, Medical University of Silesia in Katowice, Jordana 19, 41-808 Zabrze, Poland
| | - Aleksandra Garbusińska
- Department of Microbiology and Immunology, Medical University of Silesia in Katowice, Jordana 19, 41-808 Zabrze, Poland
| | - Ewelina Szliszka
- Department of Microbiology and Immunology, Medical University of Silesia in Katowice, Jordana 19, 41-808 Zabrze, Poland
| | - Andrzej Jureczko
- Department of Microbiology and Immunology, Medical University of Silesia in Katowice, Jordana 19, 41-808 Zabrze, Poland
| | - Magdalena Kowalska
- Department of Microbiology and Immunology, Medical University of Silesia in Katowice, Jordana 19, 41-808 Zabrze, Poland
| | - Wojciech Król
- Department of Microbiology and Immunology, Medical University of Silesia in Katowice, Jordana 19, 41-808 Zabrze, Poland
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