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Parambath S, Dao A, Kim HY, Zawahir S, Alastruey Izquierdo A, Tacconelli E, Govender N, Oladele R, Colombo A, Sorrell T, Ramon-Pardo P, Fusire T, Gigante V, Sati H, Morrissey CO, Alffenaar JW, Beardsley J. Candida albicans-A systematic review to inform the World Health Organization Fungal Priority Pathogens List. Med Mycol 2024; 62:myae045. [PMID: 38935906 PMCID: PMC11210619 DOI: 10.1093/mmy/myae045] [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: 09/18/2023] [Revised: 10/20/2023] [Accepted: 04/27/2024] [Indexed: 06/29/2024] Open
Abstract
Candida albicans is a common fungal pathogen and amongst the leading causes of invasive candidiasis globally. This systematic review examines the characteristics and global impact of invasive infections caused by C. albicans. We searched on PubMed and Web of Science for studies reporting on criteria such as mortality, morbidity, drug resistance, preventability, yearly incidence, and distribution/emergence during the period from 2016 to 2021. Our findings indicate that C. albicans is the most common Candida species causing invasive disease and that standard infection control measures are the primary means of prevention. However, we found high rates of mortality associated with infections caused by C. albicans. Furthermore, there is a lack of data on complications and sequelae. Resistance to commonly used antifungals remains rare. Although, whilst generally susceptible to azoles, we found some evidence of increasing resistance, particularly in middle-income settings-notably, data from low-income settings were limited. Candida albicans remains susceptible to echinocandins, amphotericin B, and flucytosine. We observed evidence of a decreasing proportion of infections caused by C. albicans relative to other Candida species, although detailed epidemiological studies are needed to confirm this trend. More robust data on attributable mortality, complications, and sequelae are needed to understand the full extent of the impact of invasive C. albicans infections.
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Affiliation(s)
- Sarika Parambath
- Sydney Infectious Diseases Institute, The University of Sydney, Sydney, NSW, Australia
| | - Aiken Dao
- Sydney Infectious Diseases Institute, The University of Sydney, Sydney, NSW, Australia
- Westmead Institute for Medical Research, Westmead, NSW, Australia
- Westmead Hospital, Westmead, NSW, Australia
| | - Hannah Yejin Kim
- Sydney Infectious Diseases Institute, The University of Sydney, Sydney, NSW, Australia
- Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney, NSW, Australia
- Westmead Hospital, Department of Pharmacy, Westmead, NSW, Australia
| | - Shukry Zawahir
- Sydney Infectious Diseases Institute, The University of Sydney, Sydney, NSW, Australia
- Central Clinical School, The University of Sydney Faculty of Medicine and Health, Sydney NSW, Australia
| | - Ana Alastruey Izquierdo
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Evelina Tacconelli
- Department of Diagnostics and Public Health, Verona University, Verona, Italy
| | - Nelesh Govender
- National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Institute of Infection and Immunity, St George's University of London, London, UK
- MRC Centre for Medical Mycology, University of Exeter, Exeter, UK
| | - Rita Oladele
- Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos, Lagos, Nigeria
| | | | - Tania Sorrell
- Sydney Infectious Diseases Institute, The University of Sydney, Sydney, NSW, Australia
- Westmead Institute for Medical Research, Westmead, NSW, Australia
- Westmead Hospital, Westmead, NSW, Australia
| | - Pilar Ramon-Pardo
- Antimicrobial Research Division, World Health Organization, Geneva, Switzerland
| | - Terence Fusire
- Antimicrobial Research Division, World Health Organization, Geneva, Switzerland
| | - Valeria Gigante
- Antimicrobial Research Division, World Health Organization, Geneva, Switzerland
| | - Hatim Sati
- Antimicrobial Research Division, World Health Organization, Geneva, Switzerland
| | - C Orla Morrissey
- Department of Infectious Diseases, Alfred Health, VIC, Australia
- Monash University, Department of Infectious Diseases, Melbourne, VIC, Australia
| | - Jan-Willem Alffenaar
- Sydney Infectious Diseases Institute, The University of Sydney, Sydney, NSW, Australia
- Westmead Hospital, Westmead, NSW, Australia
- Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney, NSW, Australia
| | - Justin Beardsley
- Sydney Infectious Diseases Institute, The University of Sydney, Sydney, NSW, Australia
- Westmead Institute for Medical Research, Westmead, NSW, Australia
- Westmead Hospital, Westmead, NSW, Australia
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El Hachem S, Fattouh N, Chedraoui C, Finianos M, Bitar I, Khalaf RA. Sequential Induction of Drug Resistance and Characterization of an Initial Candida albicans Drug-Sensitive Isolate. J Fungi (Basel) 2024; 10:347. [PMID: 38786702 PMCID: PMC11122215 DOI: 10.3390/jof10050347] [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: 04/10/2024] [Revised: 05/07/2024] [Accepted: 05/08/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND The pathogenic fungus Candida albicans is a leading agent of death in immunocompromised individuals with a growing trend of antifungal resistance. METHODS The purpose is to induce resistance to drugs in a sensitive C. albicans strain followed by whole-genome sequencing to determine mechanisms of resistance. Strains will be assayed for pathogenicity attributes such as ergosterol and chitin content, growth rate, virulence, and biofilm formation. RESULTS We observed sequential increases in ergosterol and chitin content in fluconazole-resistant isolates by 78% and 44%. Surface thickening prevents the entry of the drug, resulting in resistance. Resistance imposed a fitness trade-off that led to reduced growth rates, biofilm formation, and virulence in our isolates. Sequencing revealed mutations in genes involved in resistance and pathogenicity such as ERG11, CHS3, GSC2, CDR2, CRZ2, and MSH2. We observed an increase in the number of mutations in key genes with a sequential increase in drug-selective pressures as the organism increased its odds of adapting to inhospitable environments. In ALS4, we observed two mutations in the susceptible strain and five mutations in the resistant strain. CONCLUSION This is the first study to induce resistance followed by genotypic and phenotypic analysis of isolates to determine mechanisms of drug resistance.
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Affiliation(s)
- Setrida El Hachem
- Department of Natural Sciences, Lebanese American University, Byblos P.O. Box 36, Lebanon; (S.E.H.); (N.F.); (C.C.)
| | - Nour Fattouh
- Department of Natural Sciences, Lebanese American University, Byblos P.O. Box 36, Lebanon; (S.E.H.); (N.F.); (C.C.)
- Department of Biology, Saint George University of Beirut, Beirut 1100-2807, Lebanon
| | - Christy Chedraoui
- Department of Natural Sciences, Lebanese American University, Byblos P.O. Box 36, Lebanon; (S.E.H.); (N.F.); (C.C.)
| | - Marc Finianos
- Department of Microbiology, Faculty of Medicine, University Hospital in Pilsen, Charles University, 32300 Pilsen, Czech Republic; (M.F.); (I.B.)
- Biomedical Center, Faculty of Medicine, Charles University, 32300 Pilsen, Czech Republic
| | - Ibrahim Bitar
- Department of Microbiology, Faculty of Medicine, University Hospital in Pilsen, Charles University, 32300 Pilsen, Czech Republic; (M.F.); (I.B.)
- Biomedical Center, Faculty of Medicine, Charles University, 32300 Pilsen, Czech Republic
| | - Roy A. Khalaf
- Department of Natural Sciences, Lebanese American University, Byblos P.O. Box 36, Lebanon; (S.E.H.); (N.F.); (C.C.)
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do Carmo PHF, Garcia MT, Figueiredo-Godoi LMA, Lage ACP, da Silva NS, Junqueira JC. Metal Nanoparticles to Combat Candida albicans Infections: An Update. Microorganisms 2023; 11:microorganisms11010138. [PMID: 36677430 PMCID: PMC9861183 DOI: 10.3390/microorganisms11010138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 12/29/2022] [Accepted: 01/03/2023] [Indexed: 01/06/2023] Open
Abstract
Candidiasis is an opportunistic mycosis with high annual incidence worldwide. In these infections, Candida albicans is the chief pathogen owing to its multiple virulence factors. C. albicans infections are usually treated with azoles, polyenes and echinocandins. However, these antifungals may have limitations regarding toxicity, relapse of infections, high cost, and emergence of antifungal resistance. Thus, the development of nanocarrier systems, such as metal nanoparticles, has been widely investigated. Metal nanoparticles are particulate dispersions or solid particles 10-100 nm in size, with unique physical and chemical properties that make them useful in biomedical applications. In this review, we focus on the activity of silver, gold, and iron nanoparticles against C. albicans. We discuss the use of metal nanoparticles as delivery vehicles for antifungal drugs or natural compounds to increase their biocompatibility and effectiveness. Promisingly, most of these nanoparticles exhibit potential antifungal activity through multi-target mechanisms in C. albicans cells and biofilms, which can minimize the emergence of antifungal resistance. The cytotoxicity of metal nanoparticles is a concern, and adjustments in synthesis approaches or coating techniques have been addressed to overcome these limitations, with great emphasis on green synthesis.
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Affiliation(s)
- Paulo Henrique Fonseca do Carmo
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos 12245-000, SP, Brazil
- Correspondence: ; Tel.: +55-12-3497-9033
| | - Maíra Terra Garcia
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos 12245-000, SP, Brazil
| | - Lívia Mara Alves Figueiredo-Godoi
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos 12245-000, SP, Brazil
| | | | - Newton Soares da Silva
- Department of Environmental Engineering, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos 12245-000, SP, Brazil
| | - Juliana Campos Junqueira
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos 12245-000, SP, Brazil
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Giordano ALPL, Pontes L, Beraquet CAG, Lyra L, Schreiber AZ. Matrix-assisted laser desorption/ionisation-time of flight mass spectrometry azole susceptibility assessment in Candida and Aspergillus species. Mem Inst Oswaldo Cruz 2023; 118:e220213. [PMID: 36921145 PMCID: PMC10014031 DOI: 10.1590/0074-02760220213] [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: 09/15/2022] [Accepted: 01/26/2023] [Indexed: 03/15/2023] Open
Abstract
BACKGROUND Matrix-assisted laser desorption/ionisation-time of flight mass spectrometry (MALDI-TOF MS) allows rapid pathogen identification and potentially can be used for antifungal susceptibility testing (AFST). OBJECTIVES We evaluated the performance of the MALDI-TOF MS in assessing azole susceptibility, with reduced incubation time, by comparing the results with the reference method Broth Microdilution. METHODS Resistant and susceptible strains of Candida (n = 15) were evaluated against fluconazole and Aspergillus (n = 15) against itraconazole and voriconazole. Strains were exposed to serial dilutions of the antifungals for 15 h. Microorganisms' protein spectra against all drug concentrations were acquired and used to generate a composite correlation index (CCI) matrix. The comparison of autocorrelations and cross-correlations between spectra facilitated by CCI was used as a similarity parameter between them, enabling the inference of a minimum profile change concentration breakpoint. Results obtained with the different AFST methods were then compared. FINDINGS The overall agreement between methods was 91.11%. Full agreement (100%) was reached for Aspergillus against voriconazole and Candida against fluconazole, and 73.33% of agreement was obtained for Aspergillus against itraconazole. MAIN CONCLUSIONS This study demonstrates MALDI-TOF MS' potential as a reliable and faster alternative for AFST. More studies are necessary for method optimisation and standardisation for clinical routine application.
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Affiliation(s)
| | - Lais Pontes
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Campinas, SP, Brasil
| | | | - Luzia Lyra
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Campinas, SP, Brasil
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Ceballos-Garzon A, Peñuela A, Valderrama-Beltrán S, Vargas-Casanova Y, Ariza B, Parra-Giraldo CM. Emergence and circulation of azole-resistant C. albicans, C. auris and C. parapsilosis bloodstream isolates carrying Y132F, K143R or T220L Erg11p substitutions in Colombia. Front Cell Infect Microbiol 2023; 13:1136217. [PMID: 37026059 PMCID: PMC10070958 DOI: 10.3389/fcimb.2023.1136217] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 03/07/2023] [Indexed: 04/08/2023] Open
Abstract
Methods Over a four-year period, 123 Candida bloodstream isolates were collected at a quaternary care hospital. The isolates were identified by MALDI-TOF MS and their fluconazole (FLC) susceptibility patterns were assessed according to CLSI guidelines. Subsequently, sequencing of ERG11, TAC1 or MRR1, and efflux pump activity were performed for resistant isolates. Results Out of 123 clinical strains,C. albicans accounted for 37.4%, followed by C. tropicalis 26.8%, C. parapsilosis 19.5%, C. auris 8.1%, C. glabrata 4.1%, C. krusei 2.4% and C. lusitaniae 1.6%. Resistance to FLC reached 18%; in addition, a high proportion of isolates were cross-resistant to voriconazole. Erg11 amino acid substitutions associated with FLC-resistance (Y132F, K143R, or T220L) were found in 11/19 (58%) of FLCresistant isolates. Furthermore, novel mutations were found in all genes evaluated. Regarding efflux pumps, 8/19 (42%) of FLC-resistant Candida spp strains showed significant efflux activity. Finally, 6/19 (31%) of FLC-resistant isolates neither harbored resistance-associated mutations nor showed efflux pump activity. Among FLC-resistant species, C. auris 7/10 (70%) and C. parapsilosis 6/24 (25%) displayed the highest percentages of resistance (C. albicans 6/46, 13%). Discussion Overall, 68% of FLC-resistant isolates exhibited a mechanism that could explain their phenotype (e.g. mutations, efflux pump activity, or both). We provide evidence that isolates from patients admitted to a Colombian hospital harbor amino acid substitutions related to resistance to one of the most commonly used molecules in the hospital setting, with Y132F being the most frequently detected.
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Affiliation(s)
- Andres Ceballos-Garzon
- Unidad de Proteomica y Micosis Humanas, Grupo de Investigación en Enfermedades Infecciosas, Departamento de Microbiología, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Ana Peñuela
- Unidad de Proteomica y Micosis Humanas, Grupo de Investigación en Enfermedades Infecciosas, Departamento de Microbiología, Pontificia Universidad Javeriana, Bogotá, Colombia
- Laboratorio Clínico, Área de Microbiología, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Sandra Valderrama-Beltrán
- Unidad de Infectología, Departamento de Medicina Interna, Facultad de Medicina, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Yerly Vargas-Casanova
- Unidad de Proteomica y Micosis Humanas, Grupo de Investigación en Enfermedades Infecciosas, Departamento de Microbiología, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Beatriz Ariza
- Laboratorio Clínico, Área de Microbiología, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Claudia M. Parra-Giraldo
- Unidad de Proteomica y Micosis Humanas, Grupo de Investigación en Enfermedades Infecciosas, Departamento de Microbiología, Pontificia Universidad Javeriana, Bogotá, Colombia
- *Correspondence: Claudia M. Parra-Giraldo,
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Botelho TKR, Danielli LJ, Seide M, Borges PP, Cruz AB. Distribution and antifungal susceptibility of Candida species isolated from clinical samples in southern Brazil. BRAZ J PHARM SCI 2022. [DOI: 10.1590/s2175-97902022e20727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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Evaluation of Identification and Susceptibility for Candida Spp. Isolated Directly from Positive Blood Culture Bottles. Int J Microbiol 2021; 2021:9364231. [PMID: 34824584 PMCID: PMC8610690 DOI: 10.1155/2021/9364231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 08/30/2021] [Accepted: 10/01/2021] [Indexed: 11/17/2022] Open
Abstract
Determination of the susceptibility profile of isolates of Candida from blood culture bottles is extremely important for correctly guiding patient pharmacotherapy. The aim of this study was to compare the results of analysis of Candida isolated directly from blood culture bottles by the VITEK MS MALDI-TOF identification system and the fluconazole disk diffusion assay with those of standard identification methods. Testing directly from the bottle allowed results 24 to 48 hours quicker than the standard method. There was a categorical agreement of 51.64% (47 of 91 samples) between the results of analysis directly from the bottle and analysis by the standard method. Regarding species identification, there was 96.15% agreement for Candida parapsilosis (25 of 26 samples). Categorical agreement between the rapid and standard disk diffusion methods was 95%, and the agreement between the rapid disk diffusion method and the broth microdilution method was 97%. Only minor errors in the rapid method were observed: 3 (5%) in the standard disk diffusion method and 2 (3%) in the broth microdilution method. Our study concluded that the rapid disk diffusion method for fluconazole is a fast, easy, reproducible, and consistent method. Its timely implementation for testing antifungal agents in the clinical microbiology laboratory can help reduce profile release times, thus helping to determine the most appropriate antifungal treatment.
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Pinheiro MJF, Costa JP, Marques F, Mira NP, Carvalho MFNN, Alves MM. Bioactive Coatings with Ag-Camphorimine Complexes to Prevent Surface Colonization by the Pathogenic Yeast Candida albicans. Antibiotics (Basel) 2021; 10:antibiotics10060638. [PMID: 34073375 PMCID: PMC8227220 DOI: 10.3390/antibiotics10060638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/22/2021] [Accepted: 05/25/2021] [Indexed: 01/08/2023] Open
Abstract
Currently there is a gap between the rate of new antifungal development and the emergence of resistance among Candida clinical strains, particularly threatened by the extreme adhesiveness of C. albicans to indwelling medical devices. Two silver camphorimine complexes, [Ag(OH){OC10H14N(C6H4)2NC10H14O}] (compound P) and [{Ag(OC10H14NC6H4CH3-p)}2(μ-O)] (compound Q), are herein demonstrated as having high inhibiting activity towards the growth of Candida albicans and Candida glabrata clinical strains resistant to azoles, the frontline antifungals used in clinical practice. Compounds P and Q were also explored as bioactive coatings to prevent colonization by C. albicans and colonize the surface of indwelling medical devices, resulting in persistent infections. Functionalization of stainless steel with polycaprolactone (PCL) matrix embedded with compounds P or Q was reported for the first time to inhibit the colonization of C. albicans by 82% and 75%, respectively. The coating of PCL loaded with Q or P did not cause cytotoxic effects in mammalian cells, demonstrating the biocompatibility of the explored approach. The identification and further exploration of new approaches for surface engineering based on new molecules that can sensitize resistant strains, as herein demonstrated for complexes P and Q, is a significant step forward to improve the successful treatment of candidiasis.
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Affiliation(s)
- M. Joana F. Pinheiro
- Department of Bioengineering, Instituto de Bioengenharia e Biociências (iBB), Instituto Superior Técnico, Avenida Rovisco Pais, 1049-001 Lisboa, Portugal;
| | - Joana P. Costa
- Centro de Química Estrutural (CQE), Departamento de Engenharia Química, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1049-001 Lisboa, Portugal;
| | - Fernanda Marques
- Centro de Ciências e Tecnologias Nucleares (CTN), Departamento de Engenharia e Ciências Nucleares, Instituto Superior Técnico, Universidade de Lisboa, Estrada Nacional 10 (km 139,7), 2695-066 Bobadela LRS, Portugal;
| | - Nuno P. Mira
- Department of Bioengineering, Instituto de Bioengenharia e Biociências (iBB), Instituto Superior Técnico, Avenida Rovisco Pais, 1049-001 Lisboa, Portugal;
- Correspondence: (N.P.M.); (M.F.N.N.C.); (M.M.A.)
| | - M. Fernanda N. N. Carvalho
- Centro de Química Estrutural (CQE), Departamento de Engenharia Química, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1049-001 Lisboa, Portugal;
- Correspondence: (N.P.M.); (M.F.N.N.C.); (M.M.A.)
| | - Marta M. Alves
- Centro de Química Estrutural (CQE), Departamento de Engenharia Química, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1049-001 Lisboa, Portugal;
- Correspondence: (N.P.M.); (M.F.N.N.C.); (M.M.A.)
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Fanou BA, Klotoe JR, Fah L, Dougnon V, Koudokpon CH, Toko G, Loko F. Ethnobotanical survey on plants used in the treatment of candidiasis in traditional markets of southern Benin. BMC Complement Med Ther 2020; 20:288. [PMID: 32957970 PMCID: PMC7507638 DOI: 10.1186/s12906-020-03080-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 09/13/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Candidiasis, an opportunistic cosmopolitan disease is nowadays like bacterial infections which is a real public health problem. In view of the emergence of Candida strains resistant to existing antifungal agents, alternative solutions should be considered. This is the purpose of this ethnobotanical survey, which aims to identify the medicinal plant species traditionally used to treat candidiasis in traditional markets of southern Benin. METHODS The study was performed from October 2015 to January 2018 in the traditional markets of Southern-Benin. Data were collected by two complementary methods: triplet purchase of medicinal recipes (ATRM) from herbalists markets and semi-structured interview (ISS) from traditional healers. RESULTS A total of 109 species of medicinal plants belonging to 44 families have been listed and identified. The most frequently cited species were Pteleopsis suberosa Engl. & Diels, Lantana camara L., Cyanthillium cinereum (L.) H. Rob, Ocimum gratissimum L. and Lippia multiflora Moldenke with respectively 43.84, 39.73 and 34.25% citation frequencies for the last three species respectively. Leguminosae (20.18%), Euphorbiaceae (5.50%) and Apocynaceae (5.50%) were the most represented botanical families. Leafy stems were more used than other plant organs. The decoction and the oral route were the most appropriate methods of preparation and administration reported by traditional healers. CONCLUSION Benin's plant cover is made up of a wide variety of medicinal plant species used in the traditionnal treatment of candidiasis and which may constitute new sources of medicines to be developed.
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Affiliation(s)
- Brice Armand Fanou
- Unité de Recherche en Microbiologie Appliquée et Pharmacologie des substances naturelles (URMAPha), Laboratoire de Recherche en Biologie Appliquée (LARBA), Ecole Polytechnique d'Abomey-Calavi (EPAC), Université d'Abomey-Calavi, 01BP2009, Cotonou, Bénin
| | - Jean Robert Klotoe
- Unité de Recherche en Microbiologie Appliquée et Pharmacologie des substances naturelles (URMAPha), Laboratoire de Recherche en Biologie Appliquée (LARBA), Ecole Polytechnique d'Abomey-Calavi (EPAC), Université d'Abomey-Calavi, 01BP2009, Cotonou, Bénin. .,Ecole Normale Supérieure de Natitingou, Université Nationale des Sciences, Technologie, Ingénierie et Mathématiques, BP72, Natitingou, Benin.
| | - Lauris Fah
- Unité de Recherche en Microbiologie Appliquée et Pharmacologie des substances naturelles (URMAPha), Laboratoire de Recherche en Biologie Appliquée (LARBA), Ecole Polytechnique d'Abomey-Calavi (EPAC), Université d'Abomey-Calavi, 01BP2009, Cotonou, Bénin
| | - Victorien Dougnon
- Unité de Recherche en Microbiologie Appliquée et Pharmacologie des substances naturelles (URMAPha), Laboratoire de Recherche en Biologie Appliquée (LARBA), Ecole Polytechnique d'Abomey-Calavi (EPAC), Université d'Abomey-Calavi, 01BP2009, Cotonou, Bénin
| | - Charles Hornel Koudokpon
- Unité de Recherche en Microbiologie Appliquée et Pharmacologie des substances naturelles (URMAPha), Laboratoire de Recherche en Biologie Appliquée (LARBA), Ecole Polytechnique d'Abomey-Calavi (EPAC), Université d'Abomey-Calavi, 01BP2009, Cotonou, Bénin
| | - Ghislaine Toko
- Centre de Recherche Enthomologique de Cotonou (CREC), Cotonou, Benin
| | - Frédéric Loko
- Unité de Recherche en Microbiologie Appliquée et Pharmacologie des substances naturelles (URMAPha), Laboratoire de Recherche en Biologie Appliquée (LARBA), Ecole Polytechnique d'Abomey-Calavi (EPAC), Université d'Abomey-Calavi, 01BP2009, Cotonou, Bénin
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Ambrósio JAR, Pinto BCDS, da Silva BGM, Passos JCDS, Beltrame Junior M, Costa MS, Simioni AR. BSA nanoparticles loaded-methylene blue for photodynamic antimicrobial chemotherapy (PACT): effect on both growth and biofilm formation by Candida albicans. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2020; 31:2182-2198. [DOI: 10.1080/09205063.2020.1795461] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
| | | | | | | | - Milton Beltrame Junior
- Instituto de Pesquisa e Desenvolvimento – IP&D, Universidade do Vale do Paraíba – UNIVAP, São José dos Campos, Brazil
| | - Maricilia Silva Costa
- Instituto de Pesquisa e Desenvolvimento – IP&D, Universidade do Vale do Paraíba – UNIVAP, São José dos Campos, Brazil
| | - Andreza Ribeiro Simioni
- Instituto de Pesquisa e Desenvolvimento – IP&D, Universidade do Vale do Paraíba – UNIVAP, São José dos Campos, Brazil
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Howard KC, Dennis EK, Watt DS, Garneau-Tsodikova S. A comprehensive overview of the medicinal chemistry of antifungal drugs: perspectives and promise. Chem Soc Rev 2020; 49:2426-2480. [PMID: 32140691 DOI: 10.1039/c9cs00556k] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The emergence of new fungal pathogens makes the development of new antifungal drugs a medical imperative that in recent years motivates the talents of numerous investigators across the world. Understanding not only the structural families of these drugs but also their biological targets provides a rational means for evaluating the merits and selectivity of new agents for fungal pathogens and normal cells. An equally important aspect of modern antifungal drug development takes a balanced look at the problems of drug potency and drug resistance. The future development of new antifungal agents will rest with those who employ synthetic and semisynthetic methodology as well as natural product isolation to tackle these problems and with those who possess a clear understanding of fungal cell architecture and drug resistance mechanisms. This review endeavors to provide an introduction to a growing and increasingly important literature, including coverage of the new developments in medicinal chemistry since 2015, and also endeavors to spark the curiosity of investigators who might enter this fascinatingly complex fungal landscape.
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Affiliation(s)
- Kaitlind C Howard
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, Lexington, KY 40536-0596, USA.
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12
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Lee MS, Yang YL, Wu CY, Chen YL, Lee CK, Tzean SS, Lee TH. Efficient identification of fungal antimicrobial principles by tandem MS and NMR database. J Food Drug Anal 2019; 27:860-868. [PMID: 31590757 PMCID: PMC9306986 DOI: 10.1016/j.jfda.2019.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/19/2019] [Accepted: 06/10/2019] [Indexed: 02/08/2023] Open
Abstract
The continuous re-isolation of the known and non-applicable compounds that is time-consuming and wasting resources is still a critical problem in the discovery of bioactive entities from natural resources. To efficiently address the problem, high performance liquid chromatography-diode array detector-microfractionation (HPLC-DAD-microfractionation) guided by disk agar diffusion assay was developed, and the active compounds were further identified using the tandem mass spectrometry (MS/MS)-based molecular networking. Of 150 fungal strains screened, the methanolic extracts of Phoma herbarum PPM7487, Cryptosporiopsis ericae PPM7405, and Albifimbria verrucaria PPM945 exhibited potent antimicrobial activity against Candida albicans SC5314 and Cryptococcus neoformans H99 in the preliminary agar diffusion assay. The concept of OSMAC (one strain many compounds) was employed in the fungal cultures in order to enrich the diversity of the 2nd metabolites in this study. HPLC coupled with off-line bioactivity-directed profiling of the extracts enabled a precise localization of the compounds responsible for the conspicuous antimicrobial activity. The purified active compounds were identified based mainly on MS/MS database, and further supported by 13C nuclear magnetic resonance (NMR) spectral data compared to the literatures. In addition to nineteen known compounds, a new trichothecene derivative 1, namely trichoverrin D, was isolated and identified through this protocol. The antifungal activities of all the pure isolates were evaluated, and the structure activity relationships were also inferred. This report has demonstrated the combination of HPLC microfractination and MS/MS coupled by NMR spectral dereplication for speeding up the antimicrobial natural products discovery process.
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Affiliation(s)
- Ming-Shian Lee
- School of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Yu-Liang Yang
- Agricultural Biotechnology Research Center, Academia Sinica, Taipei, Taiwan
| | - Chia-Yen Wu
- Department of Plant Pathology and Microbiology, National Taiwan University, Taipei, Taiwan
| | - Ying-Lien Chen
- Department of Plant Pathology and Microbiology, National Taiwan University, Taipei, Taiwan
| | - Ching-Kuo Lee
- Graduate Institute of Pharmacognosy, Taipei Medical University, Taipei, Taiwan
| | - Shean-Shong Tzean
- Department of Plant Pathology and Microbiology, National Taiwan University, Taipei, Taiwan
| | - Tzong-Huei Lee
- Institute of Fisheries Science, National Taiwan University, Taipei, Taiwan.
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Sardari A, Zarrinfar H, Mohammadi R. Detection of ERG11 point mutations in Iranian fluconazole-resistant Candida albicans isolates. Curr Med Mycol 2019; 5:7-14. [PMID: 31049452 PMCID: PMC6488286 DOI: 10.18502/cmm.5.1.531] [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] [Indexed: 01/16/2023] Open
Abstract
Background and Purpose Candidiasis is referred to a group of superficial and deep-tissue fungal infections often caused by Candida albicans. The superficial infections affect the oral, oropharynx, esophagus, and vaginal mucosa. The treatment of choice for these infections is the use of azoles, such as fluconazole. However, the increased use of these antifungal agents has led to the emergence of azole-resistant isolates of C. albicans. Different mechanisms have been suggested for the development of drug resistance, such as mutations in the encoding gene ERG11. Mutations in ERG11 result in changes in the ERG11p spatial construction and reduce the affinity between the protein and azole. This study aimed to determine the susceptibility profile of C. albicans clinical isolates to fluconazole using microdilution method. The present research was also targeted toward the detection of mutations that might be related to fluconazole resistance by the amplification and sequencing of ERG11 gene. Materials and Methods This study was conducted on a total of 216 clinical isolates obtained from Mashhad, Isfahan, and Tehran cities in Iran, during 2016-2018. The clinical isolates were identified using molecular techniques. Furthermore, minimum inhibitory concentration (MICs) was determined according to the clinical and laboratory standards institute M27-A3 and M27-S4 documents. The concentration range for fluconazole was obtained as 0.063-64 μg/ml. In the resistant strains, ERG11 genes were amplified by specific primers. Subsequently, cycle sequencing reactions were performed on purified polymerase chain reaction (PCR) products in forward and reverse directions. Finally, the results were analyzed by MEGA (version 7) and Gene Runner software (version 6.5.30). Results Out of 216 strains, 100 (46.3%) species were identified as C. albicans. The MIC values for fluconazole had a range of 0.125-16 μg/ml with the MIC50 and MIC90 values of 0.5 and 1 μg/ml, respectively. Totally, 41 nucleotide changes were detected among 4 resistant isolates. In this regard, 4 out of 41 mutations in codons caused changes in ERG11p; however, these mutations did not lead to fluconazole resistance. Conclusion Fluconazole resistance among clinical isolates is not merely due to the changes in ERG11p. This resistance may be also related to some other mechanisms, such as the prevention of the intracellular accumulation of the antifungal agent and alteration of the target enzyme to diminish drug binding.
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Affiliation(s)
- Ali Sardari
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Zarrinfar
- Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Rasoul Mohammadi
- Department of Medical Parasitology and Mycology, School of Medicine, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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14
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Gizińska M, Staniszewska M, Ochal Z. Novel Sulfones with Antifungal Properties: Antifungal Activities and Interactions with Candida spp. Virulence Factors. Mini Rev Med Chem 2019; 19:12-21. [PMID: 30246638 DOI: 10.2174/1389557518666180924121209] [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: 03/01/2018] [Revised: 07/05/2018] [Accepted: 07/09/2018] [Indexed: 02/08/2023]
Abstract
Since candidiasis is so difficult to eradicate with an antifungal treatment and the existing antimycotics display many limitations, hopefully new sulfone derivatives may overcome these deficiencies. It is pertinent to study new strategies such as sulfone derivatives targeting the virulence attributes of C. albicans that differentiate them from the host. During infections, the pathogenic potential of C. albicans relies on the virulence factors as follows: hydrolytic enzymes, transcriptional factors, adhesion, and development of biofilms. In the article we explored how the above-presented C. albicans fitness and virulence attributes provided a robust response to the environmental stress exerted by sulfones upon C. albicans; C. albicans fitness and virulence attributes are fungal properties whose inactivation attenuates virulence. Our understanding of how these mechanisms and factors are inhibited by sulfones has increased over the last years. As lack of toxicity is a prerequisite for medical approaches, sulfones (non-toxic as assessed in vitro and in vivo) may prove to be useful for reducing C. albicans pathogenesis in humans. The antifungal activity of sulfones dealing with these multiple virulence factors and fitness attributes is discussed.
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Affiliation(s)
- Małgorzata Gizińska
- National Institute of Public Health-National Institute of Hygiene, Chocimska 24, 00-791 Warsaw, Poland
| | - Monika Staniszewska
- National Institute of Public Health-National Institute of Hygiene, Chocimska 24, 00-791 Warsaw, Poland
| | - Zbigniew Ochal
- Faculty of Chemistry, Warsaw University of Technology, Noakowskiego 3, 00-664 Warsaw, Poland
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15
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Mubarak Z, Humaira A, Gani BA, Muchlisin ZA. Preliminary study on the inhibitory effect of seaweed Gracilaria verrucosa extract on biofilm formation of Candida albicans cultured from the saliva of a smoker. F1000Res 2018; 7:684. [PMID: 30210788 PMCID: PMC6107980 DOI: 10.12688/f1000research.14879.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/29/2018] [Indexed: 11/23/2022] Open
Abstract
Background:Candida albicans is an opportunistic fungus that might infect the oral cavity. Increased colony numbers of
C. albicans in the mouth can be caused by multiple factors, such as smoking, weakened immune system, antibiotics use and immune-compromised condition. Smoking can increase expression of virulence factors of
C. albicans and make it stronger. One virulence factor of
C. albicans is biofilm formation. The ability of creating biofilm makes
C. albicans more tolerant to commercial antifungal agents. The objective of this preliminary study was to examine the ability of the seaweed
G.verrucosa extracts to inhibit the formation of biofilm by
C. albicans isolated from the saliva of a smoker. Methods: The extract of
G. verrucosa was prepared by maceration using 96% methanol and subjected for phytochemical analysis.
C. albicans was isolated from the saliva of a smoker who voluntarily participated in the study after providing informed consent. In triplicate, the fungus was cultured in the growth medium containing increased concentrations of
G. verrucosa (6.25, 12.5, 25, 50, 75 and 100% ).The same reaction using fluconazole 0.31 µg/ml
C. albicans was prepared as positive control. Biofilm formation was accessed based on optical density of cell mixtures using an ELISA reader. The data obtained were subjected to Kruskal-Wallis test at a significance limit of 0.05. Results: Methanol extract of seaweed
G. verrucosa contained three bio-active compounds namely steroids, terpenoid, and tannins. Inhibitory activity of seaweed extracts on
C. albicans biofilm formation increased as their concentration increased. The highest inhibitory effect was recorded at fungus culture treated with seaweed concentration of 25% at 24 hours of time exposure. Conclusions: Seaweed
G. verrucosa extract contained steroids, terpenoids and tannins that were able to effectively inhibit the formation of biofilm by
C. albicans at the concentration of 25%
after 24 hours of time exposure.
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Affiliation(s)
- Zaki Mubarak
- Faculty of Dentistry, Syiah Kuala University, Banda Aceh, 23111, Indonesia
| | - Adintya Humaira
- Faculty of Dentistry, Syiah Kuala University, Banda Aceh, 23111, Indonesia
| | - Basri A Gani
- Faculty of Dentistry, Syiah Kuala University, Banda Aceh, 23111, Indonesia
| | - Zainal A Muchlisin
- Faculty of Marine and Fisheries, Syiah Kuala University, Banda Aceh, 23111, Indonesia
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Candida albicans - Biology, molecular characterization, pathogenicity, and advances in diagnosis and control – An update. Microb Pathog 2018; 117:128-138. [DOI: 10.1016/j.micpath.2018.02.028] [Citation(s) in RCA: 141] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 02/04/2018] [Accepted: 02/13/2018] [Indexed: 12/16/2022]
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Mattos K, Rodrigues LC, Oliveira KMPD, Diniz PF, Marques LI, Araujo AA, Chang MR. Variability in the clinical distributions of Candida species and the emergence of azole-resistant non-Candida albicans species in public hospitals in the Midwest region of Brazil. Rev Soc Bras Med Trop 2017; 50:843-847. [DOI: 10.1590/0037-8682-0163-2017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 08/24/2017] [Indexed: 11/21/2022] Open
Affiliation(s)
| | | | | | | | | | | | - Marilene Rodrigues Chang
- Universidade Federal de Mato Grosso do Sul, Brazil; Universidade Federal de Mato Grosso do Sul, Brazil; Universidade Federal de Mato Grosso do Sul, Brazil
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Clinical and Microbiological Characteristics of Breakthrough Candidemia in Allogeneic Hematopoietic Stem Cell Transplant Recipients in a Japanese Hospital. Antimicrob Agents Chemother 2017; 61:AAC.01791-16. [PMID: 28115352 DOI: 10.1128/aac.01791-16] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 01/14/2017] [Indexed: 12/29/2022] Open
Abstract
Few data on breakthrough candidemia (BC), defined as candidemia that develops on administration of antifungal agents (AFAs), in allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients are available. The medical and microbiological records of recipients of an allo-HSCT obtained between December 2008 and December 2014 were reviewed. Of 768 allo-HSCT cases, 26 developed BC. Among the 26 causative strains, 22 strains were stored and identified by sequencing. The following species were isolated: Candida parapsilosis (9 strains), C. glabrata (4 strains), C. guilliermondii (3 strains), and other Candida species (6 strains). The AFAs being used when BC developed were micafungin (17 cases), liposomal amphotericin B (5 cases), itraconazole (2 cases), and voriconazole (2 cases). All 17 cases who developed BC during micafungin administration were administered 150 mg/day of micafungin. The susceptibilities of the causative Candida species to the administered AFAs when breakthrough occurred ranged from susceptible to resistant. Especially, 85% of the Candida species that caused BC during micafungin administration were susceptible to micafungin. Additionally, 75% of the strains were wild type for susceptibility to the administered AFAs when breakthrough occurred. Systemic steroid administration and a longer severe neutropenic phase (≥5 days) were independent risk factors for BC (P = 0.016 and P = 0.015, respectively). BC developed in allo-HSCT recipients even when they received a sufficient dose of AFA, including micafungin, to which the causative Candida species were susceptible and/or had wild-type susceptibility in vitro Systemic steroid administration and a longer severe neutropenic phase were host-based factors associated with BC.
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Alizadeh F, Khodavandi A, Zalakian S. Quantitation of ergosterol content and gene expression profile of ERG11 gene in fluconazole-resistant Candida albicans. Curr Med Mycol 2017; 3:13-19. [PMID: 29302625 PMCID: PMC5747584 DOI: 10.29252/cmm.3.1.13] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Background and Purpose: The frequency of opportunistic fungal infections in immunocompromised patients, especially by Candida species, has sharply increased in the last few decades. The objective of this study was to analyse the ergosterol content and gene expression profiling of clinical isolates of fluconazole-resistant Candida albicans. Materials and Methods: Sixty clinical samples were identified and collected from immunocompromised patients, namely recurrent oral, vaginal, and cutaneous candidiasis, during 2015-16. Antifungal susceptibility testing of fluconazole against clinical Candida species was performed according to Clinical and Laboratory Standards Institute guidelines. Ergosterol content and gene expression profiling of sterol 14α-demethylase (ERG11) gene in fluconazole-susceptible and –resistant C. albicans were investigated. Results: The specimens consisted of C. albicans (46.67%), Candida krusei (41.67%), and Candida tropicalis (11.67%). All the isolates were resistant to fluconazole. No significant reduction was noted in total cellular ergosterol content in comparison with untreated controls in terms of fluconazole-resistant C. albicans. The expressionlevel of ERG11 gene was down-regulated in fluconazole-susceptible C. albicans. Eventually, the expression pattern of ERG11 gene revealed no significant changes in fluconazole-resistant isolates compared to untreated controls. The results revealed no significant differences between fluconazole-susceptible and –resistant C. albicans sequences by comparison with ERG11 reference sequence. Conclusion: Our findings provide an insight into the mechanism of fluconazole resistance in C. albicans. The mechanisms proposed for clinical isolates of fluconazole-resistant C. albicans are alteration in sterol biosynthesis, analysis of expression level of ERG11 gene, and analysis of gene sequences. Nonetheless, further studies are imperative to find molecular mechanisms that could be targeted to control fluconazole resistance.
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Affiliation(s)
- F Alizadeh
- Department of Microbiology, Yasooj Branch, Islamic Azad University, Yasooj, Iran
| | - A Khodavandi
- Department of Biology, Gachsaran Branch, Islamic Azad University, Gachsaran, Iran
| | - S Zalakian
- Department of Microbiology, Yasooj Branch, Islamic Azad University, Yasooj, Iran
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