1
|
Yong E, Zhu X, Weng J, Ng MJM, Khoo YM, Lo ZJ. Role of therapeutic treatment with antiseptic solutions in the care of diabetic foot ulcers. J Wound Care 2025; 34:S4-S13. [PMID: 40173121 DOI: 10.12968/jowc.2025.34.sup4c.s4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2025]
Abstract
BACKGROUND Diabetic foot ulcers (DFUs) are a prevalent and severe complication of diabetes, leading to significant morbidity, impaired health-related quality of life (HRQoL) and economic burden on healthcare systems. The complexity of DFUs often results in prolonged healing and high recurrence rates. Effective management strategies are crucial for improving outcomes and reducing complications. AIM This study aimed to review the efficacy of antiseptic solutions in the treatment and care of DFUs. METHOD A literature analysis was conducted to review clinical studies and guidelines on the use and efficacy of antiseptic solutions, particularly Octenisept® (0.1% octenidine dihydrochloride and 2% 2-phenoxyethanol). The review focused on the antimicrobial properties, biofilm-disruption capabilities and wound healing outcomes associated with the use of antiseptic solutions in DFU management. RESULTS Antiseptic solutions have potential to reduce bioburden, disrupt biofilm and modulate healing. There is a need to balance antimicrobial clinical efficacy with tolerability and cytotoxicity. The use and choice of adjunctive antiseptic solutions must be tailored to the patient, as antimicrobial efficacy can vary for antiseptic solutions, particularly for hypochlorous solutions. It is important to use products according to their instructions, with consideration of minimum contact time to maximise clinical efficacy. Low-pressure irrigation is adjunctive, and concurrent wound-bed preparation, including debridement, frequent inspection, infection and moisture control, remain important. CONCLUSIONS The therapeutic application of antiseptic solutions in DFU care presents a promising approach to enhancing wound healing and reducing infection risks. Integrating these solutions into standard wound care protocols could lower the incidence of complications, improve HRQoL and decrease the economic burden associated with diabetic foot disease. Further large-scale studies are recommended to validate these findings and refine guidelines for antiseptic use in DFU management.
Collapse
Affiliation(s)
- Enming Yong
- Consultant, Vascular Surgery Service, Department of General Surgery, Tan Tock Seng Hospital, Singapore
| | - Xiaoli Zhu
- Senior Nurse Clinician, Nursing Services, National Healthcare Group Polyclinics, Singapore
| | - Jiayi Weng
- Medical Officer, Department of Orthopaedics, Woodlands Health, Singapore
| | - Marcus Jia Ming Ng
- Resident, Plastic, Reconstructive and Aesthetic Surgery Service, Tan Tock Seng Hospital, Singapore
| | | | - Zhiwen Joseph Lo
- Head and Senior Consultant, Vascular Surgery Service, Department of Surgery, Woodlands Health, Singapore
| |
Collapse
|
2
|
Rassan MA, Ewaisha R, Zeitoun H, Shehat MG. Promising antifungal properties of the orally active autophagy inhibitor SBP-7455 against fluconazole-resistant Candida clinical isolates. Lett Appl Microbiol 2025; 78:ovaf055. [PMID: 40216409 DOI: 10.1093/lambio/ovaf055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2024] [Revised: 03/03/2025] [Accepted: 04/10/2025] [Indexed: 04/24/2025]
Abstract
Candida species, the single most common cause of fungal infections, are major opportunistic pathogens. Novel antifungal agents are needed to address the threat of Candida infections resistant to first-line antifungal agents and those that are multi-drug resistant, both being increasingly reported. Here, we explore the antifungal properties of the novel autophagy inhibitor SBP-7455, whose anticancer effects have been recently described. Using broth microdilution, SBP-7455 inhibited the fluconazole-resistant standard C. albicans strain with minimum inhibitory concentration (MIC) values of 43.91 and 21.95 µM in the presence and absence of d-glucose, respectively. SBP-7455 inhibited the growth of six fluconazole-resistant Candida clinical isolates (MIC range 5.48-87.82 µM). Using the checkerboard assay, the fluconazole-resistant standard strain (MIC > 250 µg/ml) was rendered sensitive (MIC = 3.9 µg/ml) to fluconazole when combined with SBP-7455, but combining SBP-7455 with chloroquine was antagonistic. Compared with control, SBP-7455 treated cell membranes showed disrupted integrity and bulging on SEM images. Treatment with SBP-7455 significantly (P < 0.01) increased reduced glutathione levels with no significant change in nitric oxide levels, possibly adapting to oxidative stress induced by autophagy inhibition. Taken together, our results report for the first time the promising antifungal effects of the dual autophagy inhibitor SBP-7455 against fluconazole-resistant Candida, worthy of further investigation.
Collapse
Affiliation(s)
- Mark A Rassan
- Department of Biotechnology, Institute of Graduate Studies and Research, Alexandria University, Alexandria, 21526, Egypt
| | - Radwa Ewaisha
- Department of Microbiology and Immunology, Faculty of Pharmacy, Alexandria University, Alexandria , 21521, Egypt
| | - Hend Zeitoun
- Department of Microbiology and Immunology, Faculty of Pharmacy, Alexandria University, Alexandria , 21521, Egypt
| | - Michael G Shehat
- Department of Microbiology and Immunology, Faculty of Pharmacy, Alexandria University, Alexandria , 21521, Egypt
| |
Collapse
|
3
|
Dhoonmoon L, Malanovic N. Enhancing patient outcomes: the role of octenidine-based irrigation solutions in managing sore and irritated peristomal skin. J Wound Care 2025; 34:S4-S11. [PMID: 40314603 DOI: 10.12968/jowc.2025.34.sup4d.s4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2025]
Abstract
This article explores the potential benefits of cleansing damaged peristomal skin with an octenidine-based antimicrobial irrigation solution.
Collapse
Affiliation(s)
- Luxmi Dhoonmoon
- Nurse Consultant Tissue Viability, London North West University Healthcare NHS Foundation Trust, UK
| | - Nermina Malanovic
- Senior Scientist (Institute of Molecular Bioscience, Field of Excellence BioHealth), University of Graz, Austria
| |
Collapse
|
4
|
Laky M, Brandl S, Arslan M, Boryshchuk D, Cześnikiewicz-Guzik M, Rausch-Fan X, Moritz A, Laky B. Color stability of frequently used aesthetic restorative materials following in vitro exposure to chlorhexidine- and octenidine-based mouthrinses. BMC Oral Health 2025; 25:450. [PMID: 40148856 PMCID: PMC11951763 DOI: 10.1186/s12903-025-05811-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2024] [Accepted: 03/14/2025] [Indexed: 03/29/2025] Open
Abstract
BACKGROUND Long-term color match is one of the most important characteristics of aesthetic restorative materials as discoloration constitutes a primary reason for otherwise unnecessary replacements. The aim of the present in vitro study was to evaluate the color stability of frequent dental materials (ceramic, composite, orthodontic adhesive) induced by common antiseptic mouthrinses taking into account black tea consumption and mechanical cleaning. METHODS Twenty-four disc-shaped specimens (8 × 2 mm) were made of the materials Ceram.x Spectra™ ST HV, Ceram.x Spectra™ flow, Ceramill® Zolid HT+ PS and Unitek™ Transbond™ LR. Each of the following solutions was tested on six pieces per material: Chlorhexamed forte (CHX), octenident® (OCTD), octenimed® (OCTM) and artificial saliva (control). Dental samples underwent a total of 30 discoloration cycles in which they were alternatively placed into artificial saliva, black tea and respective mouthrinse or only in artificial saliva. After every 10 cycles, discs were mechanically cleaned with toothbrush and toothpaste. After 30 cycles, dental specimens were submitted to professional polishing. Color shifts were measured at different time-points using the VITA Easyshade® V spectrophotometer and displayed as total color difference ∆E (mean ± standard error). A post-hoc Tukey test (⍺ = 0.05) was applied to the mean ∆E values after 30 cycles to determine discoloration discrepancies between various mouthrinses as well as the control. Moreover, photos of individual discs were taken at all measurement times to visualize potential color changes by eye. RESULTS All mouthrinses showed major color shifts in the clinically visible range compared to the control on all different dental materials tested. However, CHX caused significantly more discoloration than OCTM and OCTD. Established color changes could be almost completely removed by simple brushing and even further by professional polishing to clinically acceptable levels on all tested materials. CONCLUSIONS Prolonged application of antiseptic mouthrinses may cause discoloration on different restorative materials. To maintain aesthetically satisfying conditions, patients should be educated about the importance of daily mechanical tooth brushing and regular professional polishing.
Collapse
Affiliation(s)
- Markus Laky
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.
- Department of Periodontology, Prophylaxis and Oral Medicine, Jagiellonian University, Krakow, Poland.
| | - Stefanie Brandl
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Muazzez Arslan
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Daniela Boryshchuk
- Institute of Medical Statistics, Center for Medical Data Science, Medical University of Vienna, Vienna, Austria
| | - Marta Cześnikiewicz-Guzik
- Department of Periodontology, Prophylaxis and Oral Medicine, Jagiellonian University, Krakow, Poland
- School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Xiaohui Rausch-Fan
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Andreas Moritz
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Brenda Laky
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
- Austrian Research Group for Regenerative and Orthopedic Medicine (AURROM), Vienna, 1050, Austria
- Austrian Society of Regenerative Medicine, Vienna, 1010, Austria
- Sigmund Freud Private University Vienna, Vienna, Austria
| |
Collapse
|
5
|
Rodríguez‐Cerdeira C, Pinto‐Almazán R, Saunte DML, Hay R, Szepietowski JC, Moreno‐Coutiño G, Skerlev M, Prohic A, Martínez‐Herrera E. Virulence and resistance factors of Nakaseomyces glabratus (formerly known as Candida glabrata) in Europe: A systematic review. J Eur Acad Dermatol Venereol 2025; 39:377-388. [PMID: 39136534 PMCID: PMC11760688 DOI: 10.1111/jdv.20273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 07/01/2024] [Indexed: 01/25/2025]
Abstract
BACKGROUND Nakaseomyces glabratus (N. glabratus) formerly known as Candida glabrata (C. glabrata), is an endogenous opportunistic pathogen, which is generally located in the gastrointestinal tract but can spread in immunocompromised patients. N. glabratus is the second most common pathogen that causes candidemia in several countries. N. glabratus virulence factors may increase antifungal resistance and reduce the number of available treatment options. High resistance to azoles and increasing resistance to echinocandins have been previously reported in N. glabratus. OBJECTIVE To establish the distribution of N. glabratus isolates in Europe and its drug susceptibility/resistance in each country over the last 7 years. METHODS The search was performed across three databases: PubMed, Scopus and Scielo, using the MeSH terms: "Candida glabrata", "Nakaseomyces glabratus", "Europe", "resistance" and "Epidemiology" exclusively in English. All available information from January 2002 to December 2022 was included, excluding reviews, meta-analyses and book chapters. RESULTS Fifty-seven articles with information on antifungal susceptibility in Europe were retrieved and analysed with a total of 15,400 reported C. glabrata isolates. Remarkably, nations that presented the maximum number of cases during the study period included the United Kingdom (n = 7241, 47.02%), France (n = 3190, 20.71%), Spain (n = 900, 5.84%), Hungary (n = 745, 4.84%) and Italy (n = 486, 3.16%). C. glabrata isolates presented resistance to azoles [voriconazole (n = 2225, 14.45%), fluconazole (n = 1612, 10.47%), itraconazole (n = 337, 2.19%) and clotrimazole (n = 89, 0.58%)], increased resistance to echinocandins, especially to anidulafungin (n = 138, 0.89%), and high sensitivity to amphotericin B. CONCLUSIONS The number of candidemia cases associated with triazole-resistant N. glabratus isolates have been increasing in Europe. Therefore, echinocandins and amphotericin B can be considered optional empirical treatments; however, antifungal susceptibility testing is required to determine the best therapeutic options.
Collapse
Affiliation(s)
- Carmen Rodríguez‐Cerdeira
- Dermatology DepartmentHospital Vithas VigoVigoSpain
- Fundación VithasGrupo Hospitalario VithasMadridSpain
- Department of Health SciencesUniversity of VigoVigoSpain
| | - Rodolfo Pinto‐Almazán
- Fundación VithasGrupo Hospitalario VithasMadridSpain
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de MedicinaInstituto Politécnico Nacional, Plan de San Luis y Díaz MirónCiudad de MéxicoMexico
| | - Ditte M. L. Saunte
- Department of DermatologyZealand University HospitalRoskildeDenmark
- Health Sciences FacultyUniversity of CopenhagenCopenhagenDenmark
| | - R. Hay
- Department of DermatologyKings College Hospital NHS TrustLondonUK
| | - Jacek C. Szepietowski
- Department of Dermatology, Venereology and AllergologyWroclaw Medical UniversityWroclawPoland
| | | | - Mihael Skerlev
- Department of Dermatology and VenereologyZagreb University School of Medicine and Zagreb University HospitalZagrebCroatia
| | - Asja Prohic
- Department of DermatovenereologyUniversity Clinical Center of SarajevoSarajevoBosnia and Herzegovina
| | - Erick Martínez‐Herrera
- Fundación VithasGrupo Hospitalario VithasMadridSpain
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de MedicinaInstituto Politécnico Nacional, Plan de San Luis y Díaz MirónCiudad de MéxicoMexico
| |
Collapse
|
6
|
Spettel K, Bumberger D, Kriz R, Frank S, Loy M, Galazka S, Suchomel M, Lagler H, Makristathis A, Willinger B. In vitro long-term exposure to chlorhexidine or triclosan induces cross-resistance against azoles in Nakaseomyces glabratus. Antimicrob Resist Infect Control 2025; 14:2. [PMID: 39849551 PMCID: PMC11755926 DOI: 10.1186/s13756-024-01511-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 12/16/2024] [Indexed: 01/30/2025] Open
Abstract
BACKGROUND Topical antiseptics are crucial for preventing infections and reducing transmission of pathogens. However, commonly used antiseptic agents have been reported to cause cross-resistance to other antimicrobials in bacteria, which has not yet been described in yeasts. This study aims to assess the in vitro efficacy of antiseptics against clinical and reference isolates of Candida albicans and Nakaseomyces glabratus, and whether prolonged exposure to antiseptics promotes the development of antifungal (cross)resistance. METHODS A high-throughput approach for in vitro resistance development was established to simultaneously expose 96 C. albicans and N. glabratus isolates to increasing concentrations of a given antiseptic - chlorhexidine, triclosan or octenidine. Susceptibility testing and whole genome sequencing of yeast isolates pre- and post-exposure were performed. RESULTS Long-term exposure to antiseptics does not result in the development of stable resistance to the antiseptics themselves. However, 50 N. glabratus isolates acquired resistance to azole antifungals after long-term exposure to triclosan or chlorhexidine, revealing newly acquired mutations in the PDR1 and PMA1 genes. CONCLUSIONS Chlorhexidine as well as triclosan, but not octenidine, were able to introduce selective pressure promoting resistance to azole antifungals. Although we assessed this phenomenon only in vitro, these findings warrant critical monitoring in clinical settings.
Collapse
Affiliation(s)
- Kathrin Spettel
- Division of Clinical Microbiology, Department of Laboratory Medicine, Medical University of Vienna, Vienna, 1090, Austria
- Section Biomedical Science, Health Sciences, FH Campus Wien University of Applied Sciences, Vienna, 1100, Austria
| | - Dominik Bumberger
- Division of Clinical Microbiology, Department of Laboratory Medicine, Medical University of Vienna, Vienna, 1090, Austria
| | - Richard Kriz
- Section Biomedical Science, Health Sciences, FH Campus Wien University of Applied Sciences, Vienna, 1100, Austria
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, Vienna, 1090, Austria
| | - Sarah Frank
- Division of Clinical Microbiology, Department of Laboratory Medicine, Medical University of Vienna, Vienna, 1090, Austria
| | - Madita Loy
- Division of Clinical Microbiology, Department of Laboratory Medicine, Medical University of Vienna, Vienna, 1090, Austria
| | - Sonia Galazka
- Division of Data, Statistics and Risk Assessment, Austrian Agency for Health and Food Safety AGES, Vienna, 1220, Austria
| | - Miranda Suchomel
- Institute for Hygiene and Applied Immunology, Medical University of Vienna, Vienna, 1090, Austria
| | - Heimo Lagler
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, Vienna, 1090, Austria
| | - Athanasios Makristathis
- Division of Clinical Microbiology, Department of Laboratory Medicine, Medical University of Vienna, Vienna, 1090, Austria
| | - Birgit Willinger
- Division of Clinical Microbiology, Department of Laboratory Medicine, Medical University of Vienna, Vienna, 1090, Austria.
| |
Collapse
|
7
|
Marchionatti E, Constant C, Steiner A. Preoperative skin asepsis in bovine surgery: an outcome-blinded 3-arm randomized clinical trial under non-sterile operating room conditions. Front Vet Sci 2024; 11:1446649. [PMID: 39711800 PMCID: PMC11660802 DOI: 10.3389/fvets.2024.1446649] [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: 06/10/2024] [Accepted: 10/25/2024] [Indexed: 12/24/2024] Open
Abstract
Background Surgical site infections (SSI) following clean abdominal surgery in cattle pose significant economic and welfare concerns. Preoperative skin asepsis aims to minimize microbial load over the surgical field before and throughout surgery to minimize its risk. While chlorhexidine (CHX) and povidone-iodine (PVI) are commonly used antiseptics for this purpose, our study introduces the so far unexplored use of octenidine (OCT) in veterinary surgery. Methods We compared in a single-center, prospective, randomized, outcome-blinded, 3-arm trial the effectiveness of an OCT-based protocol to CHX- and PVI-based protocols. Cattle aged 2 years or older, needing a clean standing flank laparotomy (e.g., exploratory laparotomy, right flank omentopexy, left flank abomasopexy), were eligible. Exclusion criteria comprised skin abnormalities, recent antibiotic use, or debilitating conditions with systemic involvement or distant site infections. Patients were randomized 1:1:1 with concealed allocation using unique identifiers. Skin bacterial reduction (immediate [IRF] and delayed [DRF] reduction factors), SSI rate, and wound scores were evaluated. Wound scores were rated on a 0 to 6 scale, considering the presence and severity of discharge and swelling. Results Out of 373 assessed cattle, 126 were included and randomized: PVI (n = 42), CHX (n = 41), OCT (n = 43). All protocols significantly reduced bacterial counts, with PVI exhibiting lower IRF. No significant differences were observed in DRF. The summer season and duration of surgical procedures had a negative impact on IRF and DRF in all groups, respectively. Nine of 118 patients (7.6%) with complete follow-up developed SSI. Higher wound scores were associated with development of SSI. Wound scores ≥3 at day 10 postoperatively predicted SSI with high sensitivity and specificity. Microbial flora in SSI included typical skin bacteria and opportunistic pathogens. Conclusion All protocols met minimum FDA standards in reducing bacterial colonization. While limited by sample size and single-center design, this study confirms the OCT-based protocol as a valuable option for preoperative skin asepsis in clean abdominal bovine surgery.
Collapse
Affiliation(s)
- Emma Marchionatti
- Clinic for Ruminants, Department of Clinical Veterinary Science, Vetsuisse Faculty, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences (GHS), University of Bern, Bern, Switzerland
| | | | - Adrian Steiner
- Clinic for Ruminants, Department of Clinical Veterinary Science, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| |
Collapse
|
8
|
Dumitrel SI, Matichescu A, Dinu S, Buzatu R, Popovici R, Dinu DC, Bratu DC. New Insights Regarding the Use of Relevant Synthetic Compounds in Dentistry. Molecules 2024; 29:3802. [PMID: 39202881 PMCID: PMC11357206 DOI: 10.3390/molecules29163802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2024] [Revised: 08/05/2024] [Accepted: 08/08/2024] [Indexed: 09/03/2024] Open
Abstract
Worldwide, synthetic compounds are used for both in-office and at-home dental care. They are a valuable resource for both prophylactic and curative treatments for various dental problems, such as tooth decay, periodontal diseases, and many more. They are typically preferred due to their broad range of actions and ability to produce targeted, rapid, and long-lasting effects. Using a 0.12% chlorhexidine mouthwash is capable of reducing the plaque index from 47.69% to 2.37% and the bleeding index from 32.93% to 6.28% after just 2 weeks. Mouthwash with 0.1% OCT is also highly effective, as it significantly lowered the median plaque index and salivary bacterial counts in 152 patients in 5 days compared to a control group (p < 0.0001), while also reducing the gingival index (p < 0.001). When povidone-iodine was used as an irrigant during the surgical removal of mandibular third molars in 105 patients, it resulted in notably lower pain scores after 2 days compared to a control group (4.57 ± 0.60 vs. 5.71 ± 0.45). Sodium hypochlorite is excellent for root canal disinfection, as irrigating with 1% NaOCl completely eliminated the bacteria from canals in 65% patients. A 0.05% CPC mouthwash proved effective for perioperative patient care, significantly decreasing gingival bleeding (p < 0.001) and suppressing Streptococcus levels even one week post-surgery. Lastly, a 6% H2O2 paint-on varnish and 6% H2O2 tray formulations successfully bleached the teeth of 40 patients, maintaining a noticeably whiter appearance up to the 6-month follow-up, with significant color differences from the baseline (p < 0.005). Synthetic compounds have a large research base, which also provides a greater awareness of their mechanism of action and potential adverse effects. For a better understanding of how they work, several methods and assays are performed. These are protocolary techniques through which a compound's efficacy and toxicity are established.
Collapse
Affiliation(s)
- Stefania-Irina Dumitrel
- Department of Toxicology, Drug Industry, Management and Legislation, Faculty of Pharmacy, Victor Babes University of Medicine and Pharmacy, 2nd Eftimie Murgu Sq., 300041 Timisoara, Romania;
| | - Anamaria Matichescu
- Department of Preventive, Community Dentistry and Oral Health, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 14A Tudor Vladimirescu Ave., 300173 Timisoara, Romania
- Translational and Experimental Clinical Research Centre in Oral Health, Victor Babes University of Medicine and Pharmacy, 14A Tudor Vladimirescu Ave., 300173 Timisoara, Romania
| | - Stefania Dinu
- Department of Pedodontics, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 9 No., Revolutiei 1989 Bv., 300041 Timisoara, Romania;
- Pediatric Dentistry Research Center, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 9 No., Revolutiei 1989 Bv., 300041 Timisoara, Romania
| | - Roxana Buzatu
- Department of Dental Aesthetics, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 9 No., Revolutiei 1989 Bv., 300041 Timisoara, Romania;
| | - Ramona Popovici
- Department of Management, Legislation and Communication in Dentistry, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 9 No., Revolutiei 1989 Bv., 300041 Timisoara, Romania;
| | - Dorin Cristian Dinu
- Family Dental Clinic, Private Practice, 24 Budapesta Street, 307160 Dumbravita, Romania;
| | - Dana Cristina Bratu
- Department of Orthodontics II, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy Timisoara, 9 No., Revolutiei 1989 Bv., 300041 Timisoara, Romania;
| |
Collapse
|
9
|
Balakrishnan D, Lee CI. Photodynamic impact of curcumin enhanced silver functionalized graphene nanocomposites on Candida virulence. DISCOVER NANO 2024; 19:71. [PMID: 38683264 PMCID: PMC11058173 DOI: 10.1186/s11671-024-04017-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 04/18/2024] [Indexed: 05/01/2024]
Abstract
Candida species are escalating resistance to conventional antifungal treatments, intensifying their virulence, and obstructing the effectiveness of antifungal medications. Addressing this challenge is essential for effectively managing Candida infections. The overarching objective is to advance the development of more efficient and precise therapies tailored to counter Candida infections. This study focuses on developing antifungal combined drugs using curcumin-enhanced silver-functionalized graphene nanocomposites (Cur-AgrGO) to effectively target key virulence factors of C. albicans, C. tropicalis, and C. glabrata (Candida spp.). The green reduction of graphene oxide (GO) using bioentities and active molecules makes this approach cost-effective and environmentally friendly. The nanocomposites were characterized using various techniques. Combining Cur-AgrGO with photodynamic therapy (PDT) demonstrated effective antifungal and antibiofilm activity with delayed growth and metabolism. The nanocomposites effectively suppressed hyphal transition and reduced key virulence factors, including proteinases, phospholipases, ergosterol levels, and cell membrane integrity. The findings suggest that Cur-AgrGO + PDT has potential as a treatment option for Candida infections. This innovative approach holds promise for treating Candida infections.
Collapse
Affiliation(s)
| | - Cheng-I Lee
- Department of Biomedical Sciences, National Chung Cheng University, Min-Hsiung, Chiayi, 62102, Taiwan, ROC.
- Center for Nano Bio-Detections, National Chung Cheng University, Min-Hsiung, Chiayi, 62102, Taiwan, ROC.
- Center for Innovative Research On Aging Society (CIRAS), National Chung Cheng University, Min-Hsiung, Chiayi, 62102, Taiwan, ROC.
- Advanced Institute of Manufacturing With High-Tech Innovations, National Chung Cheng University, Chiayi, 62102, Taiwan, ROC.
| |
Collapse
|
10
|
Gugsch F, Tan CK, Oh DY, Paßvogel L, Steinhauer K. Efficacy of octenidine- and chlorhexidine-based wash-mitts against Candida albicans and Candida auris - a comparative study. J Hosp Infect 2024; 143:91-96. [PMID: 37949371 DOI: 10.1016/j.jhin.2023.10.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 10/13/2023] [Accepted: 10/22/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Management of outbreaks of the newly emerging pathogen Candida auris may include use of antimicrobial wash-mitts for decolonization. However, currently there is little clinical evidence to support the wide adoption of 'whole-body decolonization' as part of the protocol to effectively manage C. auris outbreaks. The aim of this study was to investigate the chemical tolerance of C. auris compared with the surrogate test organism Candida albicans as established in the European Standards (EN). METHODS Two commercially available antiseptic-impregnated wash-mitts based on either chlorhexidine digluconate (CHG) or octenidine dihydrochloride (OCT) were studied. Comparison of susceptibility of C. auris and C. albicans was investigated based on the standardized test protocol EN 13624. Experiments were conducted using the impregnation liquid squeezed from the wash-mitts at a contact time of 30 s at different concentrations between 0.5% and 97% in the presence of low organic soiling. FINDINGS Yeasticidal efficacy according to EN 13624 was found for the OCT wash-mitts at 30 s at ≥10% concentration with C. albicans. In comparison, reduction ≥4 log10 was found at a much lower concentration of ≥1% for both C. auris strains. For the CHG wash-mitts, efficacy against C. albicans was below 2 log10 reduction at 97% concentration within 30 s. Efficacy against the two C. auris strains was around 3 log10 reduction. CONCLUSION Both C. auris strains were found to be significantly more susceptible when compared with C. albicans. Data also demonstrate that not all antiseptic-impregnated wash-mitts are equally effective against C. auris with OCT having a higher efficacy compared with CHG.
Collapse
Affiliation(s)
- F Gugsch
- bactologicum GmbH, Itzehoe, Germany
| | - C K Tan
- bactologicum GmbH, Itzehoe, Germany
| | - D Y Oh
- Schülke & Mayr GmbH, Norderstedt, Germany
| | - L Paßvogel
- Schülke & Mayr GmbH, Norderstedt, Germany
| | - K Steinhauer
- bactologicum GmbH, Itzehoe, Germany; University of Applied Sciences, Kiel, Germany.
| |
Collapse
|
11
|
Fang T, Xiong J, Wang L, Feng Z, Hang S, Yu J, Li W, Feng Y, Lu H, Jiang Y. Unexpected Inhibitory Effect of Octenidine Dihydrochloride on Candida albicans Filamentation by Impairing Ergosterol Biosynthesis and Disrupting Cell Membrane Integrity. Antibiotics (Basel) 2023; 12:1675. [PMID: 38136708 PMCID: PMC10741164 DOI: 10.3390/antibiotics12121675] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/20/2023] [Accepted: 11/25/2023] [Indexed: 12/24/2023] Open
Abstract
Candida albicans filamentation plays a significant role in developing both mucosal and invasive candidiasis, making it a crucial virulence factor. Consequently, exploring and identifying inhibitors that impede fungal hyphal formation presents an intriguing approach toward antifungal strategies. In line with this anti-filamentation strategy, we conducted a comprehensive screening of a library of FDA-approved drugs to identify compounds that possess inhibitory properties against hyphal growth. The compound octenidine dihydrochloride (OCT) exhibits potent inhibition of hyphal growth in C. albicans across different hyphae-inducing media at concentrations below or equal to 3.125 μM. This remarkable inhibitory effect extends to biofilm formation and the disruption of mature biofilm. The mechanism underlying OCT's inhibition of hyphal growth is likely attributed to its capacity to impede ergosterol biosynthesis and induce the generation of reactive oxygen species (ROS), compromising the integrity of the cell membrane. Furthermore, it has been observed that OCT demonstrates protective attributes against invasive candidiasis in Galleria mellonella larvae through its proficient eradication of C. albicans colonization in infected G. mellonella larvae by impeding hyphal formation. Although additional investigation is required to mitigate the toxicity of OCT in mammals, it possesses considerable promise as a potent filamentation inhibitor against invasive candidiasis.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Hui Lu
- Department of Pharmacy, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai 200072, China
| | - Yuanying Jiang
- Department of Pharmacy, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai 200072, China
| |
Collapse
|
12
|
Bhattacharya R, Sourirajan A, Sharma P, Kumar A, Upadhyay NK, Shukla RK, Dev K, Krishnakumar B, Singh M, Bose D. Bioenhancer potential of Aegle marmelos (L.) Corrêa essential oil with antifungal drugs and its mode of action against Candida albicans. BIOCATALYSIS AND AGRICULTURAL BIOTECHNOLOGY 2023. [DOI: 10.1016/j.bcab.2023.102647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
|
13
|
Vejzovic D, Iftic A, Ön A, Semeraro EF, Malanovic N. Octenidine's Efficacy: A Matter of Interpretation or the Influence of Experimental Setups? Antibiotics (Basel) 2022; 11:1665. [PMID: 36421309 PMCID: PMC9686575 DOI: 10.3390/antibiotics11111665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 07/30/2023] Open
Abstract
With its broad antimicrobial spectrum and non-specific mode of action via membrane disruption, any resistance to octenidine (OCT) seems unlikely and has not been observed in clinical settings so far. In this study, we aimed to investigate the efficacy of OCT against Escherichia coli and mutants lacking specific lipid head groups which, due to altered membrane properties, might be the root cause for resistance development of membrane-active compounds. Furthermore, we aimed to test its efficacy under different experimental conditions including different solvents for OCT, bacterial concentration and methods for analysis. Our primary goal was to estimate how many OCT molecules are needed to kill one bacterium. We performed susceptibility assays by observing bacterial growth behavior, using a Bioscreen in an analogous manner for every condition. The growth curves were recorded for 20 h at 420-580 nm in presence of different OCT concentrations and were used to assess the inhibitory concentrations (IC100%) for OCT. Bacterial concentrations given in cell numbers were determined, followed by Bioscreen measurement by manual colony counting on agar plates and QUANTOMTM cell staining. This indicated a significant variance between both methods, which influenced IC100% of OCT, especially when used at low doses. The binding capacity of OCT to E. coli was investigated by measuring UV-absorbance of OCT exposed to bacteria and a common thermodynamic framework based on Bioscreen measurements. Results showed that OCT's antimicrobial activity in E. coli is not affected by changes at the membrane level but strongly dependent on experimental settings in respect to solvents and applied bacterial counts. More OCT was required when the active was dissolved in phosphate or Hepes buffers instead of water and when higher bacterial concentration was used. Furthermore, binding studies revealed that 107-108 OCT molecules bind to bacteria, which is necessary for the saturation of the bacterial surface to initiate the killing cascade. Our results clearly demonstrate that in vitro data, depending on the applied materials and the methods for determination of IC100%, can easily be misinterpreted as reduced bacterial susceptibility towards OCT.
Collapse
Affiliation(s)
- Djenana Vejzovic
- Institute of Molecular Biosciences, University of Graz, 8010 Graz, Austria
| | - Azra Iftic
- Institute of Molecular Biosciences, University of Graz, 8010 Graz, Austria
| | - Ayse Ön
- Institute of Molecular Biosciences, University of Graz, 8010 Graz, Austria
| | - Enrico F. Semeraro
- Institute of Molecular Biosciences, University of Graz, 8010 Graz, Austria
- Field of Excellence BioHealth, University of Graz, 8010 Graz, Austria
- Bio TechMed Graz, 8010 Graz, Austria
| | - Nermina Malanovic
- Institute of Molecular Biosciences, University of Graz, 8010 Graz, Austria
- Field of Excellence BioHealth, University of Graz, 8010 Graz, Austria
- Bio TechMed Graz, 8010 Graz, Austria
| |
Collapse
|
14
|
The Impact of Antiseptic-Loaded Bacterial Nanocellulose on Different Biofilms-An Effective Treatment for Chronic Wounds? J Clin Med 2022; 11:jcm11226634. [PMID: 36431111 PMCID: PMC9692265 DOI: 10.3390/jcm11226634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 10/31/2022] [Accepted: 11/03/2022] [Indexed: 11/10/2022] Open
Abstract
Introduction: Pathogenic biofilms are an important factor for impaired wound healing, subsequently leading to chronic wounds. Nonsurgical treatment of chronic wound infections is limited to the use of conventional systemic antibiotics and antiseptics. Wound dressings based on bacterial nanocellulose (BNC) are considered a promising approach as an effective carrier for antiseptics. The aim of the present study was to investigate the antimicrobial activity of antiseptic-loaded BNC against in vitro biofilms. Materials and Methods: BNC was loaded with the commercially available antiseptics Prontosan® and Octenisept®. The silver-based dressing Aquacel®Ag Extra was used as a positive control. The biofilm efficacy of the loaded BNC sheets was tested against an in vitro 24-hour biofilm of Staphylococcus aureus and Candida albicans and a 48-hour biofilm of Pseudomonas aeruginosa. In vivo tests using a porcine excisional wound model was used to analyze the effect of a prolonged treatment with the antiseptics on the healing process. Results: We observed complete eradication of S. aureus biofilm in BNC loaded with Octenisept® and C. albicans biofilm for BNC loaded with Octenisept® or Prontosan®. Treatment with unloaded BNC also resulted in a statistically significant reduction in bacterial cell density of S. aureus compared to untreated biofilm. No difference on the wound healing outcome was observed for the wounds treated for seven days using BNC alone in comparison to BNC combined with Prontosan® or with Octenisept®. Conclusions: Based on these results, antiseptic-loaded BNC represents a promising and effective approach for the treatment of biofilms. Additionally, the prolonged exposure to the antiseptics does not affect the healing outcome. Prevention and treatment of chronic wound infections may be feasible with this novel approach and may even be superior to existing modalities.
Collapse
|
15
|
Paruch K, Biernasiuk A, Khylyuk D, Paduch R, Wujec M, Popiołek Ł. Synthesis, Biological Activity and Molecular Docking Studies of Novel Nicotinic Acid Derivatives. Int J Mol Sci 2022; 23:2823. [PMID: 35269966 PMCID: PMC8911400 DOI: 10.3390/ijms23052823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 02/23/2022] [Accepted: 02/24/2022] [Indexed: 11/16/2022] Open
Abstract
In our research, we used nicotinic acid as a starting compound, which was subjected to a series of condensation reactions with appropriate aldehydes. As a result of these reactions, we were able to obtain a series of twelve acylhydrazones, two of which showed promising activity against Gram-positive bacteria (MIC = 1.95-15.62 µg/mL), especially against Staphylococcus epidermidis ATCC 12228 (MIC = 1.95 µg/mL). Moreover, the activity of compound 13 against the Staphylococcus aureus ATCC 43300 strain, i.e., the MRSA strain, was MIC = 7.81 µg/mL. Then, we subjected the entire series of acylhydrazones to a cyclization reaction in the acetic anhydride, thanks to which we were able to obtain twelve new 3-acetyl-2,5-disubstituted-1,3,4-oxadiazoline derivatives. Obtained 1,3,4-oxadiazolines were also tested for antimicrobial activity. The results showed high activity of compound 25 with a 5-nitrofuran substituent, which was active against all tested strains. The most promising activity of this compound was found against Gram-positive bacteria, in particular against Bacillus subtilis ATCC 6633 and Staphylococcus aureus ATCC 6538 (MIC = 7.81 µg/mL) and ATCC 43300 MRSA strains (MIC = 15.62 µg/mL). Importantly, the best performing compounds did not show cytotoxicity against normal cell lines. It seems practical to use some of these compounds or their derivatives in the future in the prevention and treatment of infections caused by some pathogenic or opportunistic microorganisms.
Collapse
Affiliation(s)
- Kinga Paruch
- Chair and Department of Organic Chemistry, Faculty of Pharmacy, Medical University of Lublin, 4A Chodźki Street, 20-093 Lublin, Poland; (D.K.); (M.W.); (Ł.P.)
| | - Anna Biernasiuk
- Chair and Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Medical University of Lublin, 1 Chodźki Street, 20-093 Lublin, Poland;
| | - Dmytro Khylyuk
- Chair and Department of Organic Chemistry, Faculty of Pharmacy, Medical University of Lublin, 4A Chodźki Street, 20-093 Lublin, Poland; (D.K.); (M.W.); (Ł.P.)
| | - Roman Paduch
- Department of Virology and Immunology, Institute of Biological Sciences, Faculty of Biology and Biotechnology, Maria Curie-Skłodowska University, 19 Akademicka Street, 20-033 Lublin, Poland;
| | - Monika Wujec
- Chair and Department of Organic Chemistry, Faculty of Pharmacy, Medical University of Lublin, 4A Chodźki Street, 20-093 Lublin, Poland; (D.K.); (M.W.); (Ł.P.)
| | - Łukasz Popiołek
- Chair and Department of Organic Chemistry, Faculty of Pharmacy, Medical University of Lublin, 4A Chodźki Street, 20-093 Lublin, Poland; (D.K.); (M.W.); (Ł.P.)
| |
Collapse
|