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Prophylaxis of Invasive Fungal Infection in Neonates: A Narrative Review for Practical Purposes. J Fungi (Basel) 2023; 9:jof9020164. [PMID: 36836279 PMCID: PMC9962596 DOI: 10.3390/jof9020164] [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: 01/11/2023] [Revised: 01/21/2023] [Accepted: 01/22/2023] [Indexed: 01/28/2023] Open
Abstract
Candida albicans is the most frequent cause of invasive fungal disease in preterm and/or low birth weight neonates, followed by Candida parapsilosis, whilst infections from other species are rare. Considering the severity of the disease, associated with poor clinical signs and diagnostic difficulties, primary prophylaxis becomes relevant. This paper summarizes the pathogenesis and clinical presentation of invasive candidiasis in neonates, focusing on prophylaxis. For late onset invasive disease, e.g., those occurring after the 3rd (or 7th according to some definitions) day of life possible approaches are the use of fluconazole, recommended in case of weight <1000 g or <1500 g if the local incidence of invasive candidiasis is higher than 2%, or the use of nystatin (for patients < 1500 g). Micafungin must be used in case of colonization by Candida auris, or in centers with a high prevalence of this pathogen. Concurrently, correct management of the central venous catheter and isolation procedures, with special regard to patients colonized by resistant strains, are fundamental. Other approaches such as reduced use of H2 blockers and broad-spectrum antibiotics (e.g., 3rd generation cephalosporins or carbapenems) and promotion of breast feeding proved useful. Reduction of early-onset infections (those occurring in the first 3 days of life) can also be obtained by treating maternal vulvo-vaginal candidiasis, which can represent a fastidious problem during pregnancy. In this case, topic azoles (the only recommendable treatment) can represent a kind of "prophylaxis" of early neonatal candidiasis. However, it must always be remembered that prophylaxis reduces the risk of invasive candidiasis but can not completely eliminate its occurrence, with the parallel risk of selecting for antifungal-resistant strains. Clinicians must maintain a high level of suspicion to start an appropriate therapy and strict epidemiological surveillance to identify the occurrence of clusters and the appearance of strains resistant to prophylaxis.
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Matotou HRS, Sangare I, Bisseye C, Akotet MKB, Bamba S. [Biodiversity of isolated fungal flora at the reanimation service of the University Hospital Souro Sanou of Bobo-Dioulasso, Burkina Faso]. Pan Afr Med J 2021; 38:299. [PMID: 34178218 PMCID: PMC8197055 DOI: 10.11604/pamj.2021.38.299.27596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 02/04/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction les maladies nosocomiales demeurent un problème majeur de santé publique en Afrique subsaharienne notamment au Burkina Faso. Cette étude avait pour but de déterminer la biodiversité de la flore fongique identifiée au service de réanimation du Centre Hospitalier Universitaire Souro Sanou (CHUSS) de Bobo-Dioulasso. Méthodes l´étude transversale descriptive s´est déroulée d´août 2016 à janvier 2017. La flore fongique a été recherchée dans l´air ambiant et les espaces de réanimation. Les prélèvements ont été ensemencés et incubés pendant 3 à 4 jours à 37°C à l´étuve. L´identification des colonies fongiques était macroscopique et microscopique pour les champignons filamenteux. Le test de blastèse, les milieux chromogéniques et le test d´agglutination au latex ont servi à l´identification d´espèces de Candida. Résultats sur les 200 prélèvements collectés au total, 176 ont poussé sur la gélose Sabouraud-Chloramphénicol. La prévalence globale de la flore fongique était de 88% (176/200). Les moisissures étaient les agents fongiques majoritairement retrouvés (66,9%). Parmi les huit genres de moisissures identifiés, Aspergillus était le genre le plus représenté (48,9%) tandis qu´Aspergillus fumigatus était l´espèce la plus fréquemment rencontrée (32,9%). Conclusion la décontamination régulière des niches fongiques devraient être systématiques dans le service de réanimation du CHUSS de Bobo-Dioulasso.
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Affiliation(s)
- Hadry Roger Sibi Matotou
- Institut Supérieur des Sciences de la Santé, Université Nazi Boni, 01 BP 1091, Bobo-Dioulasso, Burkina Faso.,Université des Sciences de la Santé, Département de Parasitologie-Mycologie, BP 4009 Libreville, Gabon
| | - Ibrahim Sangare
- Institut Supérieur des Sciences de la Santé, Université Nazi Boni, 01 BP 1091, Bobo-Dioulasso, Burkina Faso.,Service de Parasitologie-Mycologie, Département des Laboratoires, Centre Hospitalier Universitaire Souro Sanou, 01 BP 676, Bobo-Dioulasso, Burkina Faso
| | - Cyrille Bisseye
- Laboratoire de Biologie Moléculaire et Cellulaire, Université des Sciences et Techniques de Masuku, BP 943, Franceville, Gabon
| | | | - Sanata Bamba
- Institut Supérieur des Sciences de la Santé, Université Nazi Boni, 01 BP 1091, Bobo-Dioulasso, Burkina Faso.,Service de Parasitologie-Mycologie, Département des Laboratoires, Centre Hospitalier Universitaire Souro Sanou, 01 BP 676, Bobo-Dioulasso, Burkina Faso
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Antifungal Susceptibility of Non-albicans Candida Species in A Tertiary Care Hospital, Bulgaria. Jundishapur J Microbiol 2020. [DOI: 10.5812/jjm.101767] [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: Emerging non-albicans Candida (NAC) species are a major threat because of their intrinsic or acquired resistance to routinely applied antifungal agents. Objectives: The purpose of our study was to reveal in vitro activity of nine antifungal agents against NAC isolates. Methods: A total of 67 NAC (27 Candida glabrata, 10 C. tropicalis, 6 C. krusei, 6 C. parapsilosis, 4 C. lusitaniae, 4 C. lipolytica, etc.) were identified and tested. The antifungal susceptibility was estimated on the basis of minimum inhibitory concentrations (MIC). Results: Overall, 13 species were determined, of which C. glabrata was the most common (40.3%), followed by C. tropicalis (14.9%), C. krusei, and C. parapsilosis (8.9 % each). Forty-nine NAC isolates (73.13%) demonstrated decreased susceptibility to one or more antifungals, and 18 of them were resistant to all azoles. Out of 27 C. glabrata, 12 (44.4%) were resistant to fluconazole with MICs: 32 - >128 µg/mL and 15 (55.6%) were intermediate with MICs: 8 - 16 µg/mL Non-albicans Candida revealed a good susceptibility to echinocandins. Amphotericin B resistance was found in 5.97% of the isolates. Of particular interest was the detection of 6 (8.95%) multidrug-resistant NAC, which expressed resistance to azoles and echinocandins and/or amphotericin B. Conclusions: About one-fourth of the studied NAC were resistant to all azoles. These findings as well as the detection of several multidrug-resistant isolates determine the necessity of susceptibility testing of clinically important yeast isolates and control of the antifungal drugs in our hospital.
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Antifungal and anti-biofilm activity of designed derivatives from kyotorphin. Fungal Biol 2020; 124:316-326. [DOI: 10.1016/j.funbio.2019.12.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 11/29/2019] [Accepted: 12/06/2019] [Indexed: 01/06/2023]
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5
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de Oliveira AS, Palomino-Salcedo DL, Zapp E, Brondani D, Hoppe TD, Brondani PB, Meier L, Johann S, Ferreira LLG, Andricopulo AD. Molecular Docking and Quantum Studies of Lawsone Dimers Derivatives: New Investigation of Antioxidant Behavior and Antifungal Activity. Curr Top Med Chem 2019; 20:182-191. [PMID: 31868147 DOI: 10.2174/1568026620666191223092723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 11/07/2019] [Accepted: 12/02/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND In general, fungal species are characterized by their opportunistic character and can trigger various infections in immunocompromised hosts. The emergence of infections associated with high mortality rates is due to the resistance mechanisms that these species develop. METHODS This phenomenon of resistance denotes the need for the development of new and effective therapeutic approaches. In this paper, we report the investigation of the antioxidant and antifungal behavior of dimeric naphthoquinones derived from lawsone whose antimicrobial and antioxidant potential has been reported in the literature. RESULTS Seven fungal strains were tested, and the antioxidant potential was tested using the combination of the methodologies: reducing power, total antioxidant capacity and cyclic voltammetry. Molecular docking studies (PDB ID 5V5Z and 1EA1) were conducted which allowed the derivation of structureactivity relationships (SAR). Compound 1-i, derived from 3-methylfuran-2-carbaldehyde showed the highest antifungal potential with an emphasis on the inhibition of Candida albicans species (MIC = 0.5 µg/mL) and the highest antioxidant potential. CONCLUSION A combination of molecular modeling data and in vitro assays can help to find new solutions to this major public health problem.
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Affiliation(s)
- Aldo S de Oliveira
- Department of Exact Sciences and Education, Federal University of Santa Catarina, (UFSC), Blumenau, SC, Brazil.,Laboratory of Medicinal and Computational Chemistry, Center for Research and Innovation in Biodiversity and Drug Discovery, Institute of Physics of Sao Carlos, University of Sao Paulo, Sao Carlos, SP, Brazil
| | - David L Palomino-Salcedo
- Laboratory of Medicinal and Computational Chemistry, Center for Research and Innovation in Biodiversity and Drug Discovery, Institute of Physics of Sao Carlos, University of Sao Paulo, Sao Carlos, SP, Brazil
| | - Eduardo Zapp
- Department of Exact Sciences and Education, Federal University of Santa Catarina, (UFSC), Blumenau, SC, Brazil
| | - Daniela Brondani
- Department of Exact Sciences and Education, Federal University of Santa Catarina, (UFSC), Blumenau, SC, Brazil
| | - Thaynara D Hoppe
- Department of Exact Sciences and Education, Federal University of Santa Catarina, (UFSC), Blumenau, SC, Brazil
| | - Patrícia B Brondani
- Department of Exact Sciences and Education, Federal University of Santa Catarina, (UFSC), Blumenau, SC, Brazil
| | - Lidiane Meier
- Department of Exact Sciences and Education, Federal University of Santa Catarina, (UFSC), Blumenau, SC, Brazil
| | - Susana Johann
- Department of Microbiology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Leonardo L G Ferreira
- Laboratory of Medicinal and Computational Chemistry, Center for Research and Innovation in Biodiversity and Drug Discovery, Institute of Physics of Sao Carlos, University of Sao Paulo, Sao Carlos, SP, Brazil
| | - Adriano D Andricopulo
- Laboratory of Medicinal and Computational Chemistry, Center for Research and Innovation in Biodiversity and Drug Discovery, Institute of Physics of Sao Carlos, University of Sao Paulo, Sao Carlos, SP, Brazil
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van Schalkwyk E, Iyaloo S, Naicker SD, Maphanga TG, Mpembe RS, Zulu TG, Mhlanga M, Mahlangu S, Maloba MB, Ntlemo G, Sanyane K, Mawela D, Govender NP. Large Outbreaks of Fungal and Bacterial Bloodstream Infections in a Neonatal Unit, South Africa, 2012-2016. Emerg Infect Dis 2019; 24:1204-1212. [PMID: 29912684 PMCID: PMC6038734 DOI: 10.3201/eid2407.171087] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Candidemia is a major cause of healthcare-associated infections. We describe a large outbreak of Candida krusei bloodstream infections among infants in Gauteng Province, South Africa, during a 4-month period; a series of candidemia and bacteremia outbreaks in the neonatal unit followed. We detected cases by using enhanced laboratory surveillance and audited hospital wards by environmental sampling and epidemiologic studies. During July-October 2014, among 589 patients, 48 unique cases of C. krusei candidemia occurred (8.2% incidence). Risk factors for candidemia on multivariable analyses were necrotizing enterocolitis, birthweight <1,500 g, receipt of parenteral nutrition, and receipt of blood transfusion. Despite initial interventions, outbreaks of bloodstream infection caused by C. krusei, rarer fungal species, and bacterial pathogens continued in the neonatal unit through July 29, 2016. Multiple factors contributed to these outbreaks; the most functional response is to fortify infection prevention and control.
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Sanches MD, Mimura LAN, Oliveira LRC, Ishikawa LLW, Garces HG, Bagagli E, Sartori A, Kurokawa CS, Fraga-Silva TFC. Differential Behavior of Non- albicans Candida Species in the Central Nervous System of Immunocompetent and Immunosuppressed Mice. Front Microbiol 2019; 9:2968. [PMID: 30671026 PMCID: PMC6332706 DOI: 10.3389/fmicb.2018.02968] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 11/18/2018] [Indexed: 12/16/2022] Open
Abstract
The genus Candida includes commensal fungi that can cause local and systemic infections, frequently involving vital organs as the central nervous system (CNS). Candida spp. occupy the fourth place among infections that affect the CNS. Although the incidence of Candida albicans is decreasing among patients under immunosuppressive therapies, the incidence of non-albicans Candida is increasing. In this context, the objective of this work was to evaluate the ability of non-albicans Candida species to spread to the CNS of immunocompetent and immunosuppressed mice. Adult female C57BL/6 mice were treated with prednisolone, intravenously infected with Candida glabrata, Candida krusei and Candida parapsilosis yeasts and then evaluated at the 3rd and 14th days after infection. All Candida species disseminated to the brain from immunocompetent animals and induced local inflammation at the third day post-infection. The immunosuppression resulted in body weight loss, leukopenia and reduced IL-2 production by spleen cell cultures. Higher fungal loads were recovered from the CNS of immunosuppressed mice. Inflammatory infiltration associated to a Th1 subset profile was higher in brain samples from C. krusei immunosuppressed mice compared with immunocompetent ones. Additionally, C. krusei was able to transform into pseudohypha inside microglia in vitro infected cells and also to induce elevated nitric oxide production. Altogether, these results indicate that C. glabrata, C. krusei and C. parapsilosis are able to disseminate to the CNS and promote local inflammation in both immunocompetent and immunosuppressed mice. C. krusei displayed a distinct behavior at the CNS triggering a local Th1 profile. The possible contribution of these non-albicans Candida species to other CNS pathologies as multiple sclerosis, Parkinson’s and Alzheimer’s diseases deserves further attention.
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Affiliation(s)
| | - Luiza A N Mimura
- Institute of Biosciences, São Paulo State University (UNESP), Botucatu, Brazil
| | | | | | - Hans G Garces
- Institute of Biosciences, São Paulo State University (UNESP), Botucatu, Brazil
| | - Eduardo Bagagli
- Institute of Biosciences, São Paulo State University (UNESP), Botucatu, Brazil
| | - Alexandrina Sartori
- Institute of Biosciences, São Paulo State University (UNESP), Botucatu, Brazil
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Antifungal Susceptibility Profiles of Candida Species Isolated from Ahvaz Jundishapur Educational Hospitals. Jundishapur J Microbiol 2018. [DOI: 10.5812/jjm.78851] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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9
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Antifungal Prophylaxis in Children Receiving Antineoplastic Chemotherapy. CURRENT FUNGAL INFECTION REPORTS 2018. [DOI: 10.1007/s12281-018-0311-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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10
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Sakita KM, Faria DR, Silva EMD, Tobaldini-Valério FK, Kioshima ES, Svidzinski TIE, Bonfim-Mendonça PDS. Healthcare workers' hands as a vehicle for the transmission of virulent strains of Candida spp.: A virulence factor approach. Microb Pathog 2017; 113:225-232. [PMID: 29074432 DOI: 10.1016/j.micpath.2017.10.044] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 09/11/2017] [Accepted: 10/22/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Although the majority of Candida infections are thought to come from endogenous sources, the healthcare workers' (HCWs) hands are being increasingly reported as vehicles for the transmission of pathogens. The aim of the present study was to evaluate the susceptibility of yeast isolated from the HCWs' hands and ICU (Intensive Care Unit) surfaces to antifungal agents and to determine the virulence potential and the genetic similarity between the same. METHODS The susceptibility of yeasts from the HCWs' hands (n = 57) and ICU surfaces (n = 98) to conventional antifungals (fluconazole, voriconazole, amphotericin B and micafungin) was evaluated using the broth microdilution assay accordance with CLSI M27-A3. Additionally, some virulence factors such as adhesion and biofilm capacity on abiotic surfaces and on endothelial cells were evaluated, as well as germ tube formation. The similarity among yeast isolates were evaluated by the RAPD technique using the P4, OPA18 and OPE18 primers. RESULTS Five species of Candida were found on the HCWs' hands (C. albicans, C. parapsilosis (sensu stricto), C. glabrata, C. tropicalis and C. krusei) and two on ICU surfaces (C. albicans and C. parapsilosis (sensu stricto)). The isolates from hands had higher resistance rates, with C. glabrata having the highest indices (100% FLU; 100% MFG). The similarity of C. albicans from HCWs and ICU surfaces was ≥80% according to the three primers analyzed. Candida spp. from hands had a greater potential for adhesion and biofilm formation on abiotic surfaces (p < 0.05). C. albicans from ICU surfaces had the greatest potential of adhesion on endothelial cells after 2 and 24 h, and presented high filamentation in SEM images and formed more and larger germ tubes (p < 0.05). CONCLUSION the present study showed the significant virulence potential of yeasts transmitted in the hospital environment for the first time. Additionally, healthy people working in the ICU can carry these yeasts, which are capable of surviving in hospital surfaces, on their hands, offering a risk to patients, especially those who are immunocompromised.
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Affiliation(s)
- Karina Mayumi Sakita
- Division of Medical Mycology, Teaching and Research Laboratory in Clinical Analyses, Department of Clinical Analysis of State University of Maringá, Paraná, Brazil
| | - Daniella Renata Faria
- Division of Medical Mycology, Teaching and Research Laboratory in Clinical Analyses, Department of Clinical Analysis of State University of Maringá, Paraná, Brazil
| | - Eliane Martins da Silva
- Division of Medical Mycology, Teaching and Research Laboratory in Clinical Analyses, Department of Clinical Analysis of State University of Maringá, Paraná, Brazil
| | - Flávia Kelly Tobaldini-Valério
- Division of Medical Mycology, Teaching and Research Laboratory in Clinical Analyses, Department of Clinical Analysis of State University of Maringá, Paraná, Brazil
| | - Erika Seki Kioshima
- Division of Medical Mycology, Teaching and Research Laboratory in Clinical Analyses, Department of Clinical Analysis of State University of Maringá, Paraná, Brazil
| | - Terezinha Inez Estivalet Svidzinski
- Division of Medical Mycology, Teaching and Research Laboratory in Clinical Analyses, Department of Clinical Analysis of State University of Maringá, Paraná, Brazil
| | - Patricia de Souza Bonfim-Mendonça
- Division of Medical Mycology, Teaching and Research Laboratory in Clinical Analyses, Department of Clinical Analysis of State University of Maringá, Paraná, Brazil.
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Frequency of Candida Species Isolated from Patients in Children’s Medical Center, Tehran, Iran. ARCHIVES OF PEDIATRIC INFECTIOUS DISEASES 2017. [DOI: 10.5812/pedinfect.62410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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12
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Souza MN, Ortiz SO, Mello MM, Oliveira FDM, Severo LC, Goebel CS. COMPARISON BETWEEN FOUR USUAL METHODS OF IDENTIFICATION OF Candida SPECIES. Rev Inst Med Trop Sao Paulo 2016; 57:281-7. [PMID: 26422150 PMCID: PMC4616911 DOI: 10.1590/s0036-46652015000400002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Infection by Candidaspp. is associated with high mortality rates, especially when treatment is not appropriate and/or not immediate. Therefore, it is necessary to correctly identify the genus and species of Candida. The aim of this study was to compare the identification of 89 samples of Candida spp. by the manual methods germ tube test, auxanogram and chromogenic medium in relation to the ID 32C automated method. The concordances between the methods in ascending order, measured by the Kappa index were: ID 32C with CHROMagar Candida(κ = 0.38), ID 32C with auxanogram (κ = 0.59) and ID 32C with germ tube (κ = 0.9). One of the species identified in this study was C. tropicalis,which demonstrated a sensitivity of 46.2%, a specificity of 95.2%, PPV of 80%, NPV of 81.1%, and an accuracy of 80.9% in tests performed with CHROMagar Candida;and a sensitivity of 76.9%, a specificity of 96.8%, PPV of 90.9%, NPV of 91%, and an accuracy of 91% in the auxanogram tests. Therefore, it is necessary to know the advantages and limitations of methods to choose the best combination between them for a fast and correct identification of Candidaspecies.
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Affiliation(s)
| | | | | | | | - Luiz Carlos Severo
- Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, BR
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Berberine Antifungal Activity in Fluconazole-Resistant Pathogenic Yeasts: Action Mechanism Evaluated by Flow Cytometry and Biofilm Growth Inhibition in Candida spp. Antimicrob Agents Chemother 2016; 60:3551-7. [PMID: 27021328 PMCID: PMC4879420 DOI: 10.1128/aac.01846-15] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 03/19/2016] [Indexed: 01/21/2023] Open
Abstract
The incidence of fungal infections and, in particular, the incidence of fungal antibiotic resistance, which is associated with biofilm formation, have significantly increased, contributing to morbidity and mortality. Thus, new therapeutic strategies need to be developed. In this context, natural products have emerged as a major source of possible antifungal agents. Berberine is a protoberberine-type isoquinoline alkaloid isolated from the roots, rhizomes, and stem bark of natural herbs, such as Berberis aquifolium, Berberis vulgaris, Berberis aristata, and Hydrastis canadensis, and of Phellodendron amurense. Berberine has been proven to have broad antibacterial and antifungal activity. In the present study, the potential antifungal effect of berberine against fluconazole-resistant Candida and Cryptococcus neoformans strains, as well as against the biofilm form of Candida spp., was assessed. The antifungal effect of berberine was determined by a broth microdilution method (the M27-A3 method of the Clinical and Laboratory Standards Institute) and flow cytometry techniques, in which the probable mechanism of action of the compound was also assessed. For biofilm assessment, a colorimetric 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay was used to determine the susceptibility of sessile cells. The isolates used in the study belonged to the Laboratory of Bioprospection and Experiments in Yeast (LABEL) of the Federal University of Ceará. After 24 and 72 h, fluconazole-resistant Candida and Cryptococcus neoformans strains showed berberine MICs equal to 8 μg/ml and 16 μg/ml, respectively. Cytometric analysis showed that treatment with berberine caused alterations to the integrity of the plasma and mitochondrial membranes and DNA damage, which led to cell death, probably by apoptosis. Assessment of biofilm-forming isolates after treatment showed statistically significant reductions in biofilm cell activity (P < 0.001).
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Savastano C, de Oliveira Silva E, Gonçalves LL, Nery JM, Silva NC, Dias ALT. Candida glabrata among Candida spp. from environmental health practitioners of a Brazilian Hospital. Braz J Microbiol 2016; 47:367-72. [PMID: 26991302 PMCID: PMC4874588 DOI: 10.1016/j.bjm.2015.05.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Accepted: 05/29/2015] [Indexed: 11/30/2022] Open
Abstract
The incidence of the species Candida albicans and non-albicans Candida was evaluated in a Brazilian Tertiary Hospital from the environment and health practitioners. In a 12-month period we had a total positivity of 19.65% of Candida spp. The most recurring non-albicans Candida species was C. glabrata (37.62%), generally considered a species of low virulence, but with a higher mortality rate than C. albicans. Subsequently, C. parapsilosis (25.74%) and C. tropicalis (16.86%) were the second and third most commonly isolated species. Considering the total samples collected from the emergency room and from the inpatient and the pediatric sector, 19.10% were positive for Candida spp., with the predominance of non-albicans Candida species (89.42%). The high percentage of positivity occurred in the hands (24.32%) and the lab coats (21.88%) of the health care assistants. No sample of C. albicans presented a profile of resistance to the drugs. All the non-albicans Candida species presented a decreased susceptibility to miconazole and itraconazole, but they were susceptible to nystatin. Most of the isolates were susceptible to fluconazole and amphotericin B. As expected, a high resistance rate was observed in C. glabrata and C. krusei, which are intrinsically less susceptible to this antifungal agent. The contamination of environmental surfaces by Candida spp. through hand touching may facilitate the occurrence of Candida infections predominantly in immunocompromised patients. In addition to that, the antifungal agents used should be carefully evaluated considering local epidemiologic trends in Candida spp. infections, so that therapeutic choices may be better guided.
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Affiliation(s)
- Catarina Savastano
- Microbiology and Immunology Department, Federal University of Alfenas (UNIFAL-MG), Alfenas, Minas Gerais, Brazil
| | - Elisa de Oliveira Silva
- Microbiology and Immunology Department, Federal University of Alfenas (UNIFAL-MG), Alfenas, Minas Gerais, Brazil
| | - Lindyanne Lemos Gonçalves
- Microbiology and Immunology Department, Federal University of Alfenas (UNIFAL-MG), Alfenas, Minas Gerais, Brazil
| | - Jéssica Maria Nery
- Microbiology and Immunology Department, Federal University of Alfenas (UNIFAL-MG), Alfenas, Minas Gerais, Brazil
| | - Naiara Chaves Silva
- Microbiology and Immunology Department, Federal University of Alfenas (UNIFAL-MG), Alfenas, Minas Gerais, Brazil
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Important Mycoses in Children in South America. CURRENT FUNGAL INFECTION REPORTS 2016. [DOI: 10.1007/s12281-016-0249-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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16
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Neto JBA, da Silva CR, Neta MAS, Campos RS, Siebra JT, Silva RAC, Gaspar DM, Magalhães HIF, de Moraes MO, Lobo MDP, Grangeiro TB, Carvalho TSC, Diogo EBT, da Silva Júnior EN, Rodrigues FAR, Cavalcanti BC, Júnior HVN. Antifungal activity of naphthoquinoidal compounds in vitro against fluconazole-resistant strains of different Candida species: a special emphasis on mechanisms of action on Candida tropicalis. PLoS One 2014; 9:e93698. [PMID: 24817320 PMCID: PMC4015898 DOI: 10.1371/journal.pone.0093698] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 03/09/2014] [Indexed: 11/19/2022] Open
Abstract
In recent decades, the incidence of candidemia in tertiary hospitals worldwide has substantially increased. These infections are a major cause of morbidity and mortality; in addition, they prolong hospital stays and raise the costs associated with treatment. Studies have reported a significant increase in infections by non-albicans Candida species, especially C. tropicalis. The number of antifungal drugs on the market is small in comparison to the number of antibacterial agents available. The limited number of treatment options, coupled with the increasing frequency of cross-resistance, makes it necessary to develop new therapeutic strategies. The objective of this study was to evaluate and compare the antifungal activities of three semisynthetic naphthofuranquinone molecules against fluconazole-resistant Candida spp. strains. These results allowed to us to evaluate the antifungal effects of three naphthofuranquinones on fluconazole-resistant C. tropicalis. The toxicity of these compounds was manifested as increased intracellular ROS, which resulted in membrane damage and changes in cell size/granularity, mitochondrial membrane depolarization, and DNA damage (including oxidation and strand breakage). In conclusion, the tested naphthofuranquinones (compounds 1-3) exhibited in vitro cytotoxicity against fluconazole-resistant Candida spp. strains.
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MESH Headings
- Animals
- Antifungal Agents/chemical synthesis
- Antifungal Agents/chemistry
- Antifungal Agents/pharmacology
- Candida/classification
- Candida/drug effects
- Candida/genetics
- Candida tropicalis/drug effects
- Candida tropicalis/genetics
- Candida tropicalis/metabolism
- Cell Line
- Cell Survival/drug effects
- DNA Damage
- DNA, Fungal/chemistry
- DNA, Fungal/genetics
- DNA, Fungal/metabolism
- DNA, Ribosomal Spacer/chemistry
- DNA, Ribosomal Spacer/genetics
- Drug Resistance, Fungal/drug effects
- Fibroblasts/cytology
- Fibroblasts/drug effects
- Fluconazole/pharmacology
- Membrane Potential, Mitochondrial/drug effects
- Microbial Sensitivity Tests
- Models, Chemical
- Molecular Sequence Data
- Molecular Structure
- Naphthoquinones/chemical synthesis
- Naphthoquinones/chemistry
- Naphthoquinones/pharmacology
- Phosphatidylserines
- RNA, Ribosomal, 5.8S/genetics
- Reactive Oxygen Species/metabolism
- Sequence Analysis, DNA
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Affiliation(s)
- João B. A. Neto
- Department of Clinical and Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection and Experiments in Yeast (LABEL), Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Cecília R. da Silva
- Department of Clinical and Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection and Experiments in Yeast (LABEL), Federal University of Ceará, Fortaleza, Ceará, Brazil
- Department of Pathology and Legal Medicine, School of Medicine, Laboratory of Bioprospection and Experiments in Yeast (LABEL), Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Maria A. S. Neta
- Department of Clinical and Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection and Experiments in Yeast (LABEL), Federal University of Ceará, Fortaleza, Ceará, Brazil
- Department of Pathology and Legal Medicine, School of Medicine, Laboratory of Bioprospection and Experiments in Yeast (LABEL), Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Rosana S. Campos
- Department of Clinical and Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection and Experiments in Yeast (LABEL), Federal University of Ceará, Fortaleza, Ceará, Brazil
- Department of Pathology and Legal Medicine, School of Medicine, Laboratory of Bioprospection and Experiments in Yeast (LABEL), Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Janaína T. Siebra
- Department of Clinical and Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection and Experiments in Yeast (LABEL), Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Rose A. C. Silva
- Department of Clinical and Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection and Experiments in Yeast (LABEL), Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Danielle M. Gaspar
- Department of Physiology and Pharmacology, Laboratory of Experimental Oncology, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Hemerson I. F. Magalhães
- Department of Clinical and Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection and Experiments in Yeast (LABEL), Federal University of Ceará, Fortaleza, Ceará, Brazil
- Department of Pharmaceutical Sciences, Center for Toxicological Assistance, University Federal of Paraíba, Paraíba, Brazil
| | - Manoel O. de Moraes
- Department of Physiology and Pharmacology, Laboratory of Experimental Oncology, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Marina D. P. Lobo
- Department of Biology, ScienceCenter, Molecular Genetics Laboratory, Federal University of Ceará, Ceará, Brazil
| | - Thalles B. Grangeiro
- Department of Biology, ScienceCenter, Molecular Genetics Laboratory, Federal University of Ceará, Ceará, Brazil
| | - Tatiane S. C. Carvalho
- Natural Products Research Nucleus, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Emilay B. T. Diogo
- Department of Chemistry, Institute of Exact Sciences, Laboratory of Synthetic and Heterocyclic Chemistry, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Eufrânio N. da Silva Júnior
- Department of Chemistry, Institute of Exact Sciences, Laboratory of Synthetic and Heterocyclic Chemistry, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Felipe A. R. Rodrigues
- Department of Physiology and Pharmacology, Laboratory of Experimental Oncology, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Bruno C. Cavalcanti
- Department of Pathology and Legal Medicine, School of Medicine, Laboratory of Bioprospection and Experiments in Yeast (LABEL), Federal University of Ceará, Fortaleza, Ceará, Brazil
- Department of Physiology and Pharmacology, Laboratory of Experimental Oncology, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Hélio V. N. Júnior
- Department of Clinical and Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection and Experiments in Yeast (LABEL), Federal University of Ceará, Fortaleza, Ceará, Brazil
- Department of Pathology and Legal Medicine, School of Medicine, Laboratory of Bioprospection and Experiments in Yeast (LABEL), Federal University of Ceará, Fortaleza, Ceará, Brazil
- Department of Physiology and Pharmacology, Laboratory of Experimental Oncology, Federal University of Ceará, Fortaleza, Ceará, Brazil
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