Anti-Candida activity of existing antibiotics and their derivatives when used alone or in combination with antifungals

Anti-Candida, docking studies, and in vitro metabolism-mediated cytotoxicity evaluation of Eugenol derivatives

The high morbidity and mortality rates of Candida infections, especially among immunocompromised patients, are related to the increased resistance rate of these species and the limited therapeutic arsenal. In this context, we evaluated the anti-Candida potential and the cytotoxic profile of eugenol derivatives. Anti-Candida activity was evaluated on C. albicans and C. parapsilosis strains by minimum inhibitory concentration (MIC), scanning electron microscopy (SEM), and molecular docking calculations at the site of the enzyme lanosterol-14-α-demethylase active site, responsible for ergosterol formation. The cytotoxic profile was evaluated in HepG2 cells, in the presence and absence of the metabolizing system (S9 system). The results indicated compounds 1b and 1d as the most active ones. The compounds have anti-Candida activity against both strains with MIC ranging from 50 to 100 μg ml^-1 . SEM analyses of 1b and 1d indicated changes in the envelope architecture of both C. albicans and C. parapsilosis like the ones of eugenol and fluconazole, respectively. Docking results of the evaluated compounds indicated a similar binding pattern of fluconazole and posaconazole at the lanosterol-14-α-demethylase binding site. In the presence of the S9 system, compound 1b showed the same cytotoxicity profile as fluconazole (1.08 times) and compound 1d had 1.23 times increase in cytotoxicity. Eugenol and other evaluated compounds showed a significant increase in cytotoxicity. Our results suggest compound 1b as a promising starting point candidate to be used in the design of new anti-Candida agent prototypes.

SCREENING OF MEDICINAL AND AROMATIC PLANTS EXTRACTS FOR THE SYNERGISM WITH FLUCONAZOLE AGAINST CANDIDA ALBICANS AND CANDIDA TROPICALIS FUNGI ASSOCIATED WITH DENTURE STOMATITIS

OBJECTIVE

The aim: To conduct a primary screening of the ability of aqueous-ethanol extracts of medicinal plants to enhance the effect of fluconazole against resistant strains of Candida sp. associated with denture stomatitis, to justify the potential use of combined antifungal therapy.

PATIENTS AND METHODS

Materials and methods: 40 biochemical tests using the VITEK 2 system with the use of VITEK 2 YST ID card (Biomerieux, France). The computer programs UTHSCSA ImageTool 2.0 and Microsoft Office Excel 2003 were used for statistical processing of the results.

RESULTS

Results: 114 extracts out of 166 studied ones (68.7 « 0.28%) showed direct antifungal activity in relation to C. tropicalis strain, 74 extracts (44.6 « 0.30%) turned out to be highly active (d IZ > 10 mm). Only 50 extracts out of 166 studied ones (30.1 « 0.28%) showed antifungal activity against C. albicans strain, 26 extracts (15.7 « 0.22%) were highly active (d IZ > 10 mm). Significant direct antifungal activity both against C. albicans strain and C. tropicalis strain was demonstrated by the extracts of the leaves of Sophora japonica, thallus of Mnium cuspidatum Hedw. (M.silvaticum Lindb.), herbs of Euphorbia amygdaloides L., Lathyrus niger (L.) Bernh., Betonica officinalis L. s. l., flowers of Primula officinalis Hill., roots of Scrophularia nodosa L.

CONCLUSION

Conclusions: 1. Aqueous-ethanolic extracts of medicinal and aromatic plants of Ukrainian flora have direct antifungal activity against azole resistant C. albicans and C. tropicalis (44,6«0,30% and 15,7«0,22% of tested extracts respectively) associated with denture stomatitis as well restore their sensitivity to fluconazole (44,6«0,30% and 15,7«0,22% of extracts respectively).

Evaluation of the antifungal activity in vitro of midazolam against fluconazole-resistant Candida spp. isolates

Aim: The purpose of this study was to evaluate the antifungal activity of midazolam, alone and in association with azoles, against isolates of clinical Candida spp. in planktonic and biofilm form. Materials & methods: The antifungal activity was observed using the broth microdilution technique. Flow cytometry tests were performed to investigate the probable mechanism of action and the comet test and cytotoxicity test were applied to evaluate DNA damage. Results: Midazolam (MIDAZ) showed antifungal activity against planktonic cells (125-250 μg/ml) and reduced the viability of Candida spp. biofilms (125 a 2500 μg/ml). The interaction of MIDAZ against Candida spp. biofilms was observed through scanning electron microscopy, causing alteration of their appearance. Therefore, MIDAZ has antifungal potential against Candida spp.

Caspofungin and Polymyxin B Reduce the Cell Viability and Total Biomass of Mixed Biofilms of Carbapenem-Resistant Pseudomonas aeruginosa and Candida spp

Pseudomonas aeruginosa and Candida spp. are biofilm-forming pathogens commonly found colonizing medical devices, being mainly associated with pneumonia and bloodstream infections. The coinfection by these pathogens presents higher mortality rates when compared to those caused by a single microbial species. This study aimed to evaluate the antibiofilm activity of echinocandins and polymyxin B (PMB) against polymicrobial biofilms of carbapenem-resistant (CR) Pseudomonas aeruginosa and Candida spp. (C. albicans, C. parapsilosis, C. tropicalis, and C. glabrata). In addition, we tested the antimicrobial effect on their planktonic and monomicrobial biofilm counterparties. Interestingly, beyond inhibition of planktonic [minimum inhibitory concentration (MIC) = 0.5 μg/ml] and biofilm [minimum biofilm inhibitory concentration (MBIC)₅₀ ≤ 2–8 μg/ml] growth of P. aeruginosa, PMB was also effective against planktonic cells of C. tropicalis (MIC = 2 μg/ml), and polymicrobial biofilms of CR P. aeruginosa with C. tropicalis (MBIC₅₀ ≤ 2 μg/ml), C. parapsilosis (MBIC₅₀ = 4–16 μg/ml), C. glabrata (MBIC₅₀ = 8–16 μg/ml), or C. albicans (MBIC₅₀ = 8–64 μg/ml). On the other hand, while micafungin (MFG) showed highest inhibitory activity against planktonic (MIC ≤ 0.008–0.5 μg/ml) and biofilm (MBIC₅₀ ≤ 2–16 μg/ml) growth of Candida spp.; caspofungin (CAS) displays inhibitory activity against planktonic cells (MIC = 0.03–0.25 μg/ml) and monomicrobial biofilms (MBIC₅₀ ≤ 2–64 μg/ml) of Candida spp., and notably on planktonic and monomicrobial biofilms of CR P. aeruginosa (MIC or MBIC₅₀ ≥ 64 μg/ml). Particularly, for mixed biofilms, while CAS reduced significantly viable cell counts of CR P. aeruginosa and Candida spp. at ≥32 and ≥ 2 μg/ml, respectively; PMB was effective in reducing viable cells of CR P. aeruginosa at ≥2 μg/ml and Candida spp. at ≥8 μg/ml. Similar reduction of viable cells was observed for CAS (32–64 μg/ml) combined with PMB (2 μg/ml). These findings highlight the potential of PMB and CAS for the treatment of polymicrobial infections caused by Candida spp. and critical priority CR P. aeruginosa.

The yeast, the antifungal, and the wardrobe: a journey into antifungal resistance mechanisms of Candida tropicalis

Candida tropicalis is a prominent non-Candida albicans Candida species involved in cases of candidemia, mainly causing infections in patients in intensive care units and (or) those presenting neutropenia. In recent years, several studies have reported an increase in the recovery rates of azole-resistant C. tropicalis isolates. Understanding C. tropicalis resistance is of great importance, since resistant strains are implicated in persistent or recurrent and breakthrough infections. In this review, we address the main mechanisms underlying C. tropicalis resistance to the major antifungal classes used to treat candidiasis. The main genetic basis involved in C. tropicalis antifungal resistance is discussed. A better understanding of the epidemiology of resistant strains and the mechanisms involved in C. tropicalis resistance can help improve diagnosis and assessment of the antifungal susceptibility of this Candida species to improve clinical management.