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Rawat S, Singh R, Mittal G. Phenotypic characterization and antifungal susceptibility profile of Candida isolates from women with vulvovaginal candidiasis at a community health center linked to a teaching institution in the Sub-Himalayan region of North India. J Family Med Prim Care 2023; 12:3326-3331. [PMID: 38361850 PMCID: PMC10866227 DOI: 10.4103/jfmpc.jfmpc_1082_23] [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: 06/30/2023] [Revised: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 02/17/2024] Open
Abstract
Introduction Vulvovaginal candidiasis (VVC) is considered a common gynecological problem among females of reproductive age group. 70-75% of women report having had candidal vulvovaginitis at some point in their lifetimes and 40-50% suffer recurrent candidal vulvovaginitis. Objectives This study aims to identify the Candida species involved in VVC and to determine their antifungal susceptibility pattern. Materials and Methods The present study was a cross-sectional study conducted on 257 females (18-55 yr) with complaints of abnormal vaginal discharge. For detection of Candida, the swab samples were subjected to Gram stain, 10% KOH mount, and culture on Sabouraud dextrose agar (SDA). Candida species identification was done by subculturing Candida isolates onto CHROMagar, corn meal agar (Himedia), and further confirmation was done by MALDI-TOF MS. Antifungal testing was done using the disk diffusion method. Results A total of 257 females with complaints of abnormal discharge were enrolled in this study. Out of 257, C. albicans 37 (58.7%) and 26 (41.3%) isolates were identified as non-albicans Candida. Out of 63 positive cases, a maximum number of study subject belongs to the age group 26-35 years (50.8%). Along with vaginal discharge, itching (65.37%) is the most common complaint. VVC was found to be most predominant in patients with prolonged antibiotic therapy (38.1%), and in pregnant females (15.9%). Conclusion Understanding the emerging fungal pathogens and their drug susceptibility patterns is essential for the effective management of infections. Drug resistance can lead to treatment failure and highlights the need for alternative treatment options or strategies.
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Affiliation(s)
- Sangeeta Rawat
- Department of Microbiology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Jolly Grant, Dehradun, Uttarakhand, India
| | - Rajender Singh
- Department of Microbiology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Jolly Grant, Dehradun, Uttarakhand, India
| | - Garima Mittal
- Department of Microbiology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Jolly Grant, Dehradun, Uttarakhand, India
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Jabeen G, Naz SA, Rangel DEN, Jabeen N, Shafique M, Yasmeen K. In-vitro evaluation of virulence markers and antifungal resistance of clinical Candida albicans strains isolated from Karachi, Pakistan. Fungal Biol 2023; 127:1241-1249. [PMID: 37495314 DOI: 10.1016/j.funbio.2023.04.003] [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: 11/21/2022] [Revised: 04/09/2023] [Accepted: 04/11/2023] [Indexed: 07/28/2023]
Abstract
Candidiasis is a significant fungal infection with high mortality and morbidity rates worldwide. Candida albicans is the most dominant species responsible for causing different manifestations of candidiasis. Certain virulence traits as well as its resistance to antifungal drugs contribute to the pathogenesis of this yeast. This study was designed to determine the production of some virulence factors, such as biofilm formation and extracellular hydrolytic enzymes (esterase, coagulase, gelatinase, and catalase) by this fungus, as well as its antifungal resistance profile. A total of 304 clinical C. albicans isolates obtained from different clinical specimens were identified by a conventional diagnostic protocol. The antifungal susceptibility of C. albicans strains was determined by disk diffusion technique against commercially available antifungal disks, such as nystatin 50 μg, amphotericin B 100 unit, fluconazole 25 μg, itraconazole 10 μg, ketoconazole 10 μg, and voriconazole 1 μg. The assessment of biofilm formation was determined by the tube staining assay and spectrophotometry. Gelatinase, coagulase, catalase, and esterase enzyme production was also detected using standard techniques. A total of 66.1% (201/304) and 28.9% (88/304) of C. albicans strains were susceptible-dose dependent (SDD) to nystatin and itraconazole, respectively. Among the antifungal drugs, C. albicans strains showed high resistance to ketoconazole 24.7% (75/304); however, no statistically significant relationship between the clinical origin of C. albicans isolates and antifungal drug resistance pattern was detected. For virulence factors, the majority of the C. albicans strains actively produced biofilm and all hydrolytic enzymes. Biofilm formation was demonstrated by 88% (267/304) of the strains with a quantitative mean value 0.1762 (SD ± 0.08293). However, 100% (304/304) of isolates produced catalase enzyme, 69% (211/304) produced coagulase, 66% (197/304) produced gelatinase, and 52% (157/304) produced esterase enzyme. A significant relationship between the source of specimens and biofilm formation by C. albicans was observed; nevertheless, there was no significant relationship between different sources of C. albicans strains and the production of different enzymatic virulence factors. The study found that C. albicans strains have excellent potential to produce virulence markers and resistance to antifungals, which necessitates surveillance of these opportunistic pathogens to minimize the chances of severe invasive infections.
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Affiliation(s)
- Gul Jabeen
- Lab of Applied Microbiology and Clinical Mycology, Department of Microbiology, Federal Urdu University of Arts, Science and Technology, Gulshan Iqbal, Karachi, 75300, Pakistan; Department of Microbiology, University of Karachi, Karachi, Pakistan
| | - Sehar Afshan Naz
- Lab of Applied Microbiology and Clinical Mycology, Department of Microbiology, Federal Urdu University of Arts, Science and Technology, Gulshan Iqbal, Karachi, 75300, Pakistan.
| | - Drauzio E N Rangel
- Universidade Tecnológica Federal do Paraná, Dois Vizinhos, Paraná, 85660-000, Brazil
| | - Nusrat Jabeen
- Department of Microbiology, University of Karachi, Karachi, Pakistan
| | - Maryam Shafique
- Lab of Applied Microbiology and Clinical Mycology, Department of Microbiology, Federal Urdu University of Arts, Science and Technology, Gulshan Iqbal, Karachi, 75300, Pakistan
| | - Kousar Yasmeen
- Department of Chemistry, Federal Urdu University of Arts, Science and Technology, Gulshan, Iqbal, Karachi, 75300, Pakistan
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Elzahaby DA, Farrag HA, Haikal RR, Alkordi MH, Abdeltawab NF, Ramadan MA. Inhibition of Adherence and Biofilm Formation of Pseudomonas aeruginosa by Immobilized ZnO Nanoparticles on Silicone Urinary Catheter Grafted by Gamma Irradiation. Microorganisms 2023; 11:microorganisms11040913. [PMID: 37110336 PMCID: PMC10142706 DOI: 10.3390/microorganisms11040913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 03/28/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023] Open
Abstract
Nosocomial infections caused by microbial biofilm formation on biomaterial surfaces such as urinary catheters are complicated by antibiotic resistance, representing a common problem in hospitalized patients. Therefore, we aimed to modify silicone catheters to resist microbial adherence and biofilm formation by the tested microorganisms. This study used a simple direct method to graft poly-acrylic acid onto silicone rubber films using gamma irradiation to endow the silicone surface with hydrophilic carboxylic acid functional groups. This modification allowed the silicone to immobilize ZnO nanoparticles (ZnO NPs) as an anti-biofilm. The modified silicone films were characterized by FT-IR, SEM, and TGA. The anti-adherence ability of the modified silicone films was evidenced by the inhibition of biofilm formation by otherwise strong biofilm-producing Gram-positive, Gram-negative, and yeast clinical isolates. The modified ZnO NPs grafted silicone showed good cytocompatibility with the human epithelial cell line. Moreover, studying the molecular basis of the inhibitory effect of the modified silicone surface on biofilm-associated genes in a selected Pseudomonas aeruginosa isolate showed that anti-adherence activity might be due to the significant downregulation of the expression of lasR, lasI, and lecB genes by 2, 2, and 3.3-fold, respectively. In conclusion, the modified silicone catheters were low-cost, offering broad-spectrum anti-biofilm activity with possible future applications in hospital settings.
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Zare-Bidaki M, Maleki A, Ghanbarzadeh N, Nikoomanesh F. Expression pattern of drug-resistance genes ERG11 and TAC1 in Candida albicans Clinical isolates. Mol Biol Rep 2022; 49:11625-11633. [PMID: 36169896 DOI: 10.1007/s11033-022-07878-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 08/10/2022] [Accepted: 08/16/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Candida albicans (C. albicans) is an opportunistic fungus and the most common cause of vulvovaginal candidiasis (VVC). In recent years, the use of antifungal drugs has led to the incidence of drug-resistant C. albicans strains. The purpose of this study is twofold: to determine the pattern of drug susceptibility and the relationship between demographic factors and the incidence of drug resistance among C. albicans isolates and to investigate the expression pattern of drug-resistance genes ERG11 and TAC1 in C. albicans isolates. METHODS AND RESULTS This descriptive cross-sectional study was conducted on 50 C. albicans isolates from women with VVC. Antifungal susceptibility of the isolates was tested by M27-A3/S4 broth micro dilution method following the Clinical and Laboratory Standards Institute (CLSI) guidelines. High susceptibility rates were recorded for itraconazole and voriconazole (68%), followed by ketoconazole (46%). Fluconazole had the lowest susceptibility to C. albicans with susceptibility of 36%. The change in ERG11 and TAC1 genes expression was determined by qPCR. The mean ∆Ct values of ERG11 and TAC1genes were significantly different between fluconazole-resistant and susceptible groups (p < 0.001). Interestingly, we found that 77% of fluconazole-susceptible isolates had significantly upregulated ERG11 gene (2.9-99.0 fold). In addition, the expression of TAC1 was upregulated in 44% of fluconazole-susceptible isolates (3.86-89.8 fold). CONCLUSION Our finding revealed that incidence of drug resistance in C. albicans is not simply controlled by genes but is a multi-factorial phenomenon, where several factors and mechanisms are involved in the process of drug resistance.
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Affiliation(s)
- Majid Zare-Bidaki
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Anis Maleki
- Student Research committee, Birjand University of Medical University, Birjand, Iran
| | - Nahid Ghanbarzadeh
- Department of Gynecology and Obstetrics, Birjand University of Medical University, Birjand, Iran
| | - Fatemeh Nikoomanesh
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran.
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Medeiros CIS, Sousa MNAD, Filho GGA, Freitas FOR, Uchoa DPL, Nobre MSC, Bezerra ALD, Rolim LADMM, Morais AMB, Nogueira TBSS, Nogueira RBSS, Filho AAO, Lima EO. Antifungal activity of linalool against fluconazole-resistant clinical strains of vulvovaginal Candida albicans and its predictive mechanism of action. Braz J Med Biol Res 2022; 55:e11831. [PMID: 35976268 PMCID: PMC9377531 DOI: 10.1590/1414-431x2022e11831] [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: 01/08/2022] [Accepted: 06/29/2022] [Indexed: 12/01/2022] Open
Abstract
Candida albicans is the most frequently isolated opportunistic
pathogen in the female genital tract, with 92.3% of cases in Brazil associated
with vulvovaginal candidiasis (VVC). Linalool is a monoterpene compound from
plants of the genera Cinnamomum, Coriandrum,
Lavandula, and Citrus that has demonstrated a
fungicidal effect on strains of Candida spp., but its mechanism
of action is still unknown. For this purpose, broth microdilution techniques
were applied, as well as molecular docking in a predictive manner for this
mechanism. The main results of this study indicated that the C.
albicans strains analyzed were resistant to fluconazole and
sensitive to linalool at a dose of 256 µg/mL. Furthermore, the increase in the
minimum inhibitory concentration (MIC) of linalool in the presence of sorbitol
and ergosterol indicated that this molecule possibly affects the cell wall and
plasma membrane integrity of C. albicans. Molecular docking of
linalool with proteins that are key in the biosynthesis and maintenance of the
cell wall and the fungal plasma membrane integrity demonstrated the possibility
of linalool interacting with three important enzymes: 1,3-β-glucan synthase,
lanosterol 14α-demethylase, and Δ 14-sterol reductase. In
silico analysis showed that this monoterpene has theoretical but
significant oral bioavailability, low toxic potential, and high similarity to
pharmaceuticals. Therefore, the findings of this study indicated that linalool
probably causes damage to the cell wall and plasma membrane of C.
albicans, possibly by interaction with important enzymes involved
in the biosynthesis of these fungal structures, in addition to presenting low
in silico toxic potential.
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Affiliation(s)
- C I S Medeiros
- Departamento de Ciências Farmacêuticas, Universidade Federal da Paraíba, João Pessoa, PB, Brasil.,Curso de Medicina, Centro Universitário UniFIP, Patos, PB, Brasil
| | - M N A de Sousa
- Curso de Medicina, Centro Universitário UniFIP, Patos, PB, Brasil
| | - G G A Filho
- Curso de Medicina, Centro Universitário UniFIP, Patos, PB, Brasil
| | - F O R Freitas
- Curso de Medicina, Centro Universitário UniFIP, Patos, PB, Brasil
| | - D P L Uchoa
- Curso de Medicina, Centro Universitário UniFIP, Patos, PB, Brasil
| | - M S C Nobre
- Curso de Medicina, Centro Universitário UniFIP, Patos, PB, Brasil
| | - A L D Bezerra
- Curso de Medicina, Centro Universitário UniFIP, Patos, PB, Brasil
| | - L A D M M Rolim
- Curso de Medicina, Centro Universitário UniFIP, Patos, PB, Brasil
| | - A M B Morais
- Curso de Medicina, Centro Universitário UniFIP, Patos, PB, Brasil
| | - T B S S Nogueira
- Curso de Medicina, Centro Universitário UniFIP, Patos, PB, Brasil
| | - R B S S Nogueira
- Curso de Medicina, Centro Universitário UniFIP, Patos, PB, Brasil
| | - A A O Filho
- Unidade Acadêmica de Ciências Biológicas (UACB), Universidade Federal de Campina Grande, Patos, PB, Brasil
| | - E O Lima
- Departamento de Ciências Farmacêuticas, Universidade Federal da Paraíba, João Pessoa, PB, Brasil
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Dunaiski CM, Kock MM, Jung H, Peters RPH. Importance of Candida infection and fluconazole resistance in women with vaginal discharge syndrome in Namibia. Antimicrob Resist Infect Control 2022; 11:104. [PMID: 35971143 PMCID: PMC9377096 DOI: 10.1186/s13756-022-01143-6] [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: 03/31/2022] [Accepted: 07/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background Vaginal discharge syndrome (VDS) is a common condition. Clinical management targets sexually transmitted infections (STIs) and bacterial vaginosis (BV); there is limited focus on Candida infection as cause of VDS. Lack of Candida treatment coverage and, if present, antifungal resistance may result in VDS treatment failure. This study aimed to determine the prevalence of Candida infection, antifungal resistance, and coinfections in Namibian women with VDS. Methods A cross-sectional study was performed using 253 vaginal swabs from women with VDS in Namibia. Demographic data was collected, and phenotypic and molecular detection of Candida species was performed followed by fluconazole susceptibility testing of Candida isolates. BV was diagnosed using Nugent score microscopy; molecular detection of Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis was performed. Results Candida species was detected in 110/253 women (43%). Ninety women (36%) had Candida albicans and 24 (9.5%) had non-albicans Candida species. The non-albicans species detected were 19 (17%) Candida glabrata, 4.0 (3.5%) Candida krusei, and 1.0 (0.9%) Candida parapsilosis. Candida albicans were more frequently isolated in younger (p = 0.004) and pregnant women (p = 0.04) compared to non-albicans Candida species. Almost all (98%) Candida albicans isolates were susceptible to fluconazole while all non-albicans Candida species were fluconazole resistant. STIs were diagnosed in 92 women (36%): 30 (12%) with C. trachomatis, 11 (4.3%) N. gonorrhoeae, and 70 (28%) T. vaginalis; 98 (39%) women had BV. Candida infection alone was diagnosed in 30 women (12%), combined with STIs in 42 women (17%) and was concurrent with BV in 38 women (15%). Candida infection was more often detected in swabs from women without C. trachomatis detected (6.4% vs. 16%; OR 0.30; 95% CI 0.10–0.77, p = 0.006). Conclusions The high prevalence of Candida infection, especially those due to non-albicans Candida species that are resistant to fluconazole, is a great concern in our setting and may lead to poor treatment outcomes. Access to microbiological testing for Candida species in the context of syndromic management is warranted.
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Fanou BA, Klotoe JR, Dougnon V, Monteiro A, Koudokpon CH, Loko F. [Prevalence and factors associated with vulvovaginal candidiasis in women admitted to the Zone Hospital of Mènontin (Bénin)]. Pan Afr Med J 2022; 42:215. [PMID: 36845234 PMCID: PMC9949275 DOI: 10.11604/pamj.2022.42.215.28984] [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: 03/21/2021] [Accepted: 06/07/2022] [Indexed: 11/11/2022] Open
Abstract
Introduction vulvovaginal candidiasis (VVC) are cosmopolitan affections, very frequent and recurrent, condition due to disruption in vaginal balance and local immunity system. The purpose of this study is to determine the prevalence and factors associated with VVCs in women admitted to the Mènontin Hospital. Methods we conducted a cross-sectional, descriptive and analytical study in the Department of Obstetrics and Gynaecology over the period March - August 2020. Sociodemographic, medical and gynecological data were collected from the medical records of 1336 subjects. Candida species were identified by conventional microbiological tests. Results the prevalence of candidiasis was 56.25% in women with leucorrhea. It was not associated with sociodemographic factors such as age, marital status and BMI. Gestational age; the colour of the cervix and the amount and consistency of leucorrhoea were related to the occurrence of candidiasis. The most common species included Candida dubliniensis (36.11%) and Candida albicans (29.17%). Conclusion eight species of candida are responsible for VVC in southern Benin. Knowing the associated factors allows for the implementation of appropriate control strategies.
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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, 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, Cotonou, Bénin,,Ecole Normale Supérieure de Natitingou, Université Nationale des Sciences, Technologie, Ingénierie et Mathématiques, Natitingou, Bénin,,Corresponding author: 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, 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, 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, Cotonou, Bénin
| | - 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, Cotonou, Bénin
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Fanou BA, Klotoe JR, Dougnon V, Assogba P, Agbodjento E, Koudokpon CH, Fah L, Sintondji K, Kpoze R, Loko F. Efficacy of Extracts of Cyanthillium Cinereum, Khaya senegalensis and Lippia multiflora on Candida Strains Isolated From Urine Samples in Benin (West Africa). FRONTIERS IN TROPICAL DISEASES 2022. [DOI: 10.3389/fitd.2022.890296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The search for new bioactive molecules with antifungal properties to combat resistance to classical antifungals represents a great challenge. This study aimed to explore the virulence factors and resistance profile of Candida species isolated from urine samples in Benin and the in vitro efficacy of organic extracts of Cyanthillium cinereum (L.) H.Rob., Lippia multiflora Moldenke and Khaya senegalensis (Desv.) A.Juss. on the growth of these Candida spp. The study focused on Candida strains isolated from urine samples collected from patients admitted to the bacteriological analysis laboratories of hospitals in Southern Benin. The sensitivity of these strains to classical antifungal agents was determined by the simple diffusion method. Their pathogenicity was investigated via several virulence factors (gelatinase, hemolysin, hydrophobicity, adhesin, biofilm and lecithinase). The in vitro efficacy of the aqueous, ethanolic and hydro-ethanolic extracts of the plants on Candida albicans ATCC 90028 and on six clinical strains was evaluated by the method of determination of the inhibition diameters. The results obtained showed that 51 different Candida strains were isolated from the collected urine samples with a respective predominance of Candida albicans (52.94%) and Candida glabrata (17.64%) species. All identified species were sensitive to amphotericin B and nystatin but 20% are resistant to fluconazole and present 15 different resistance profiles. Six different virulence factors were identified with a high frequency of hydrophobicity (96.08%) and adhesin (94.12%). Antifungal tests revealed that at 100 mg/mL the plant extracts were active on the tested strains with better activity for Cyanthilium cinereum and Khaya senegalensis. Cyanthilium cinereum, Khaya senegalensis and Lippia multiflora showed antifungal activity on virulent Candida strains suggesting the possibility to explore them further for the discovery of new antifungal molecules.
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Azole Antifungal Resistance in Candida albicans and Candida glabrata Isolated from Vulvovaginal Candidiasis Patients. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2021. [DOI: 10.5812/archcid.106360] [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]
Abstract
Background: Vulvovaginal candidiasis (VVC) is the most frequent fungal disorder in healthy and normal women. Objectives: The aim of this study was to evaluate the in vitro antifungal susceptibility of clinical isolates Candida albicans and Candida glabrata, the two most common candida species in Iranian patients with VVC. Methods: One hundred and eight clinical isolates of candida, including; C. albicans (n = 77) and C. glabrata: (n = 31) were isolated from the 108 patients with VVC. The in vitro activity of caspofungin (CAS), amphotericin B (AMB), voriconazole (VRC), itraconazole (ITC), fluconazole (FLC), and nystatin (NYS) were determined according to the CLSI M27-A3 and CLSI M27-S4. Results: Our results were shown 8 (25.8 %) and 6 (7.8 %) C. glabrata and C. albicans isolates resistance to FLU, respectively. Furthermore, resistance to VRC and ITC were observed in 8.4%, and 3.7% of all isolates, and six isolates (5.6%) had intermediate MIC to CAS. Conclusions: We reported 8 (25.8 %) and 6 (7.8 %) C. glabrata and C. albicans isolates resistance to FLU, respectively. Furthermore, resistance to VRC and ITC were observed in 8.4% and 3.7% of all isolates, respectively.
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Anh DN, Hung DN, Tien TV, Dinh VN, Son VT, Luong NV, Van NT, Quynh NTN, Van Tuan N, Tuan LQ, Bac ND, Luc NK, Anh LT, Trung DM. Prevalence, species distribution and antifungal susceptibility of Candida albicans causing vaginal discharge among symptomatic non-pregnant women of reproductive age at a tertiary care hospital, Vietnam. BMC Infect Dis 2021; 21:523. [PMID: 34082699 PMCID: PMC8176683 DOI: 10.1186/s12879-021-06192-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/13/2021] [Indexed: 12/13/2022] Open
Abstract
Background Vaginal candidiasis is frequent in women of reproductive age. Accurate identification Candida provides helpful information for successful therapy and epidemiology study; however, there are very limited data from the Vietnam have been reported. This study was performed to determine the prevalence, species distribution of yeast causing vaginal discharge and antifungal susceptibility patterns of Candida albicans among symptomatic non-pregnant women of reproductive age. Methods Vaginal discharge samples were collected from 462 women of reproductive age in Hanoi, Vietnam between Sep 2019 and Oct 2020. Vaginal swabs from these patients were examined by direct microscopic examination (10% KOH). CHROMagar™ Candida medium and Sabouraud dextrose agar supplemented with chloramphenicol (0.5 g/l) were used to isolate yeast, and species identification was performed using morphological tests and molecular tools (PCR and sequencing). Antifungal susceptibility testing was determined according to the Clinical and Laboratory Standards Institute guidelines (M27-A3 and M27-S4). Results The prevalence of vaginal yeast colonization in non-pregnant women was 51.3% of 462 participants. Nine different yeast species were identified. Among these isolates, C. albicans (51.37%) was the most frequent, followed by C. parapsilosis (25.88%), C. glabrata (11.37%), C. tropicalis (4.31%), C. krusei (3.92%), C. africana (1.57%), Saccharomyces cerevisiae (0.78%), C. nivariensis (1 isolates, 0.39%), and C. lusitaniae (1 isolates, 0.39%), respectively. Among C. albicans, all 46 isolates were 100% susceptible to micafungin, caspofungin, and miconazole. The susceptibility rates to amphotericine B, 5-flucytosine, fluconazole, itraconazole and voriconazole were 95.65, 91.30, 91.30, 82.61 and 86.95%, respectively. Conclusions The prevalence of VVC among symptomatic non-pregnant women of reproductive age in Vietnam was higher than many parts of the world. The high frequency of non-albicans Candida species, which were often more resistant to antifungal agents, was a notable feature. Resistance rates of vaginal C. albicans isolates to antifungal agents was low. Our findings suggest that continued surveillance of changes in species distribution and susceptibility to antifungals should be routinely screened and treated. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06192-7.
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Affiliation(s)
- Do Ngoc Anh
- Department of Medical Parasitology, Vietnam Military Medical University, Hanoi, Vietnam. .,Laboratory of Parasitology and Medical Mycology, 103 Military Hospital, Hanoi, Vietnam.
| | - Dao Nguyen Hung
- 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Tran Viet Tien
- 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Vu Nhat Dinh
- 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Vu Tung Son
- Department of Epidemiology, Vietnam Military Medical University, Hanoi, Vietnam
| | | | - Nguyen Thi Van
- Laboratory of Parasitology and Medical Mycology, 103 Military Hospital, Hanoi, Vietnam
| | - Nguyen Thi Nhu Quynh
- Department of Medical Parasitology, Vietnam Military Medical University, Hanoi, Vietnam
| | - Nguyen Van Tuan
- Department of Medical Parasitology, Vietnam Military Medical University, Hanoi, Vietnam
| | - Le Quoc Tuan
- Department of Medical Parasitology, Vietnam Military Medical University, Hanoi, Vietnam.,Laboratory of Parasitology and Medical Mycology, 103 Military Hospital, Hanoi, Vietnam
| | - Nguyen Duy Bac
- Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, Hanoi, Vietnam
| | - Nguyen Khac Luc
- Department of Medical Parasitology, Vietnam Military Medical University, Hanoi, Vietnam.,Laboratory of Parasitology and Medical Mycology, 103 Military Hospital, Hanoi, Vietnam
| | - Le Tran Anh
- Department of Medical Parasitology, Vietnam Military Medical University, Hanoi, Vietnam.,Laboratory of Parasitology and Medical Mycology, 103 Military Hospital, Hanoi, Vietnam
| | - Do Minh Trung
- Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, Hanoi, Vietnam.
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11
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Kombade SP, Abhishek KS, Mittal P, Sharma C, Singh P, Nag VL. Antifungal profile of vulvovaginal candidiasis in sexually active females from a tertiary care hospital of Western Rajasthan. J Family Med Prim Care 2021; 10:398-402. [PMID: 34017760 PMCID: PMC8132794 DOI: 10.4103/jfmpc.jfmpc_1124_20] [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: 06/08/2020] [Revised: 09/09/2020] [Accepted: 10/08/2020] [Indexed: 11/04/2022] Open
Abstract
Introduction: Vulvovaginal candidiasis (VVC) is the commonest form of sexually transmitted infection especially in sexually active females. Various species of Candida i.e., Candida albicans and non-albicans Candida are associated with VVC. More than 75% of women experiences vulvovaginal candidiasis at least once in their lifetime and 10% of it can lead to recurrent VVC. So, this study was planned to evaluate the clinico-mycological profile and antifungal profile of VVC in sexually active female attending tertiary care hospital. Materials and Methods: The present two months study was conducted in sexually active females attending Obstetrics –gynecology OPD with VVC in tertiary care hospital. Two high vaginal swabs were taken and fungal culture was done on SDA agar by standard methods. Identification and antifungal susceptibility testing of candidial isolates were done by standard mycological methods. Results: Most of the patients belonged to younger age group between 18 and 29 years (55%). Lower abdominal pain was the most common symptom after vaginal discharge followed by burning sensation and pruritis. Candida glabrata (15) with 58% of all the isolates was the most common Candida species associated with VVC in this study, followed by Candida albicans (5, 19%). Highest antifungal resistance was observed to itraconazole (81%) followed by amphotericin B (35%) and fluconazole (31%). 81% resistance to itraconazole among Candida glabrata and Candida albicans. Voriconazole was maximum susceptible to all Candida species. Conclusion: This study highlights the incidence of VVC among sexually active females of reproductive age group as its recurrence may result into obstetric complications and even infertility and also enlightens the common Candida species and their antifungal profile, which would help the treating clinicians to formulate local antifungal treatment policy for VVC.
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Affiliation(s)
- Sarika P Kombade
- Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
| | - Kumar S Abhishek
- Department of Microbiology, Institute of Medical Sciences (IMS), BHU, Varanasi, Uttar Pradesh, India
| | - Payal Mittal
- MBBS Student, Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
| | - Charu Sharma
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
| | - Pratibha Singh
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
| | - Vijaya L Nag
- Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
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12
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Rolo J, Faria-Gonçalves P, Barata T, Oliveira AS, Gaspar C, Ferreira SS, Palmeira-de-Oliveira R, Martinez-de-Oliveira J, Costa-de-Oliveira S, Palmeira-de-Oliveira A. Species Distribution and Antifungal Susceptibility Profiles of Isolates from Women with Nonrecurrent and Recurrent Vulvovaginal Candidiasis. Microb Drug Resist 2021; 27:1087-1095. [PMID: 33646045 DOI: 10.1089/mdr.2020.0139] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Recurrent vulvovaginal candidiasis (RVVC) is caused by Candida spp., a vaginal colonizer. Despite the clinical importance of RVVC, little is known regarding the characteristics of the disease in Portugal. Thirty-six clinical cases were analyzed, comprising 93 yeast vulvovaginal isolates obtained from women attending a gynecologic consultation at a private clinic. Of these, 18 women were diagnosed with RVVC, while other 18 women had a sporadic episode of infection (nonrecurrent vulvovaginal candidiasis [NR-VVC]). Species identification was performed with CHROMagar chromogenic medium and by analysis of biochemical profiles. In addition, antifungal susceptibility testing for two azole compounds was performed by broth microdilution. We found that Candida albicans was isolated from both NR-VVC and RVVC cases, being highly predominant; C. glabrata and C. tropicalis were also isolated. Resistance to at least one antifungal was detected in up to 65% of the isolates, and resistance to both antifungals reached a frequency of 25%. Moreover, azole-resistant isolates were distributed among all species identified. We conclude that in the studied group of patients, C. albicans is in fact the major player both in NR-VVC and in RVVC, C. glabrata being more frequently associated with recurrence (p < 0.05). In addition, we found a high proportion of azole-resistant strains.
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Affiliation(s)
- Joana Rolo
- CICS-UBI-Health Sciences Research Center, University of Beira Interior, Covilhã, Portugal
| | - Paula Faria-Gonçalves
- CICS-UBI-Health Sciences Research Center, University of Beira Interior, Covilhã, Portugal.,Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal.,FMUMN-Faculty of Medicine, University of Mandume ya Ndemufayo, Lubango, Angola
| | - Tiago Barata
- CICS-UBI-Health Sciences Research Center, University of Beira Interior, Covilhã, Portugal.,Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
| | - Ana Sofia Oliveira
- CICS-UBI-Health Sciences Research Center, University of Beira Interior, Covilhã, Portugal.,Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
| | - Carlos Gaspar
- CICS-UBI-Health Sciences Research Center, University of Beira Interior, Covilhã, Portugal.,Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal.,Labfit-HPRD-Health Products Research and Development Lda, Covilhã, Portugal
| | - Sandra Saraiva Ferreira
- Department of Mathematics and Center of Mathematics and Applications, University of Beira Interior, Covilhã, Portugal
| | - Rita Palmeira-de-Oliveira
- CICS-UBI-Health Sciences Research Center, University of Beira Interior, Covilhã, Portugal.,FMUMN-Faculty of Medicine, University of Mandume ya Ndemufayo, Lubango, Angola.,CNC-Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
| | | | - Sofia Costa-de-Oliveira
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal.,Center for Research in Health Technologies and Information Systems (CINTESIS), Porto, Portugal
| | - Ana Palmeira-de-Oliveira
- CICS-UBI-Health Sciences Research Center, University of Beira Interior, Covilhã, Portugal.,Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal.,Labfit-HPRD-Health Products Research and Development Lda, Covilhã, Portugal
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13
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Vulvovaginal Candidiasis: Epidemiology and Risk Factors, Pathogenesis, Resistance, and New Therapeutic Options. CURRENT FUNGAL INFECTION REPORTS 2021. [DOI: 10.1007/s12281-021-00415-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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14
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Molecular Characterization and Antifungal Susceptibility of Candida Species Isolated From Vulvovaginitis in Jahrom City, South of Iran. Jundishapur J Microbiol 2020. [DOI: 10.5812/jjm.106825] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Vulvovaginal candidiasis (VVC) is a significant health issue due to Candida spp. Although Candida albicans is considered a major causative agent of vaginal candidiasis, non-albicans species have increased during previous decades. Objectives: This research aimed at molecular identification and assessing antifungal susceptibility of VVC isolated Candida spp. Methods: A professional physician examined two hundred and ninety-five suspected females with vaginitis. The specimens were collected by sterile cotton swabs. Swabs were inoculated on Sabouraud dextrose agar plates and then incubated for 48 - 72 hours at 35°C. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to detect all Candida species. Broth microdilution, according to the M27-A3 and M27-S4 CLSI documents, were employed for determining the antifungal susceptibility tests of caspofungin (CAS), voriconazole (VRC), itraconazole (ITC), fluconazole (FLU), clotrimazole (CLO), ketoconazole (KTO), amphotericin B (AMB), and nystatin (NYS). Results: A total of 295 females suspected of vulvovaginal candidiasis were examined. The culture results were positive in 50.5% (149 of 295) of specimens. According to molecular identification techniques, C. albicans 133/149 (89.2%), C. glabrata 8/149 (5.4%), and C. kefyr 2/149 (1.4%) were the main species. A mixed infection of C. albicans and C. glabrata 6/149 (4 %) was detected. The geometric mean values to all Candida strains were in increasing order as the following: CAS, 0.075 µg/mL; VRC, 0.091 µg/mL; ITC, 0.15 µg/mL; AMB, 0.22 µg/mL; CLO, 0.23 µg/mL; KTO, 0.28 µg/mL; NYS, 0.88 µg/mL; FLU, 1.48 µg/mL. Further, the MIC ranges of all Candida isolates to the tested antifungal agents were in increasing order as follows: CAS: 0.031 - 0.25 µg/mL, KTO and ITC: 0.031 - 2 µg/mL, VRC: 0.031 - 4 µg/mL, CLO and AMB: 0.031 - 8 µg/mL, NYS: 0.06 - 4 µg/mL, and FLU: 0.12 - 128 µg/mL. Conclusions: We reported 1 (7.2 %) C. glabrata isolate resistance to FLU and 2 (14.3%) C. glabrata isolates susceptible-dose-dependent (SDD) to CAS. We also reported 6 (4.5%), 5 (3.8%), and 2 (1.5%) C. albicans resistance to ITC, FLU, and AMB, respectively, but 100% C. albicans susceptible to CAS and VRC.
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Varnasiri M, Salmanzadeh S, Mahmoudabadi AZ, Halvaeezadeh M, Taghipour S, Molavi S, Alavi SM, Nezhad KH, Choghakabodi PM. The occurrence of vulvovaginal Candida species and their antifungal susceptibility pattern in HIV seropositive women in Ahvaz, Southwest Iran. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2020.02.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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16
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Ghaddar N, Anastasiadis E, Halimeh R, Ghaddar A, Dhar R, AlFouzan W, Yusef H, El Chaar M. Prevalence and antifungal susceptibility of Candida albicans causing vaginal discharge among pregnant women in Lebanon. BMC Infect Dis 2020; 20:32. [PMID: 31931738 PMCID: PMC6958632 DOI: 10.1186/s12879-019-4736-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 12/24/2019] [Indexed: 01/11/2023] Open
Abstract
Background Vaginal candidiasis is frequent in pregnant women and is associated with sepsis and adverse neonatal outcomes. This study determined the prevalence of candida species in symptomatic pregnant women and evaluated the antifungal susceptibility profile of the isolated Candida strains. It also aimed to explore whether Candida species predicts gestational complications and adverse neonatal outcomes. Methods A total of 258 pregnant women with vaginal discharge at 35 to 37 week of gestation participated in this study. Vaginal swabs from these patients were collected at various obstetrics and gynecology clinics in Lebanon for a period of 14 months. Candida isolates were identified at species level and antifungal susceptibility of Candida albicans to fluconazole (FCZ), amphotericin B (AMB), itraconazole (ICZ) and voriconazole (VCZ) was determined by the agar-based E-test method. Results Among 258 women tested, 100 (39%) were positive for Candida species. C. albicans, C. glabrata and C. krusei were isolated from 42, 41 and 17% of the women, respectively. C. albicans was significantly associated only with gestational diabetes while C. krusei or C. glabrata had significant positive associations with other gestational complications. The antifungal susceptibility tests of C. albicans isolates revealed 97.5, 90, 87.5 and 97.5% susceptibility to AMB, FCZ, ICZ and VCZ, respectively. Conclusion The current study revealed high incidence of both C. albicans and non-C. albicans Candida strains causing vulvovaginitis among pregnant women in Beirut, Lebanon. Candida screening as antenatal follow up is advised to minimize the risk of adverse neonatal outcome or gestational complications.
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Affiliation(s)
- Nahed Ghaddar
- Faculty of Science, Biological Sciences Department, Beirut Arab University, Beirut, Lebanon
| | - Elie Anastasiadis
- Department of Obstetrics and Gynecology, Saint George Hospital, Beirut, Lebanon.,Faculty of Medicine, University of Balamand, Beirut, Lebanon
| | - Rawad Halimeh
- Department of Obstetrics and Gynecology, Saint George Hospital, Beirut, Lebanon
| | - Ali Ghaddar
- Department of Biomedical Sciences, Lebanese International University, Beirut, Lebanon
| | - Rita Dhar
- Faculty of Health Sciences, University of Balamand, P.O.Box 166378 Ashrafieh, Beirut, 1100-2807, Lebanon
| | - Wadha AlFouzan
- Microbiology Unit, Department of Laboratories, Farwania Hospital, Sabah Al Nasser, Kuwait.,Faculty of Health Sciences, University of Balamand, P.O.Box 166378 Ashrafieh, Beirut, 1100-2807, Lebanon
| | - Hoda Yusef
- Faculty of Science, Biological Sciences Department, Beirut Arab University, Beirut, Lebanon
| | - Mira El Chaar
- Department of Microbiology, Health Sciences Center, Kuwait University, Jabriya, Kuwait.
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17
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Yassin MT, Mostafa AA, Al-Askar AA, Bdeer R. In vitro antifungal resistance profile of Candida strains isolated from Saudi women suffering from vulvovaginitis. Eur J Med Res 2020; 25:1. [PMID: 31901238 PMCID: PMC6942276 DOI: 10.1186/s40001-019-0399-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 12/09/2019] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Vulvovaginal candidiasis (VVC) represents a universal health hazard that contributes to significant morbidity in women. Resistance of Candida to antifungal therapy has been reported as a public health problem. So, the objective of our current study is to detect resistance profile of different candidal strains. METHODS In this study, isolated Candida strains were identified by conventional methods, confirmed by internal transcribed spacer (ITS) sequencing, and phylogenetically analyzed with reference strains in GenBank. Also, sensitivity of different Candida strains to common antifungal agents was evaluated by disc diffusion method. RESULTS Candida albicans was identified as the most frequent strain (63%) followed by non-albicans strains, such as C. glabrata (20%), C. tropicalis (13%), and C. krusei (4%). Sensitivity of Candida strains (C. albicans, C. tropicalis and C. glabrata) to commonly used antifungal agents was evaluated through the disc diffusion method. C. glabrata was the most resistant strain and considered to be a multidrug-resistant pathogen, while both, C. albicans and C. tropicalis showed high susceptibility to terbinafine. In contrast, C. albicans showed resistance to fluconazole, clotrimazole, and nystatin, while C. tropicalis, considered as the most sensitive strain, was susceptible to all the antifungal agents tested except nystatin. Terbinafine was the most effective antifungal agent against both C. tropicalis and C. albicans, and hence its minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) for C. albicans and C. tropicalis were evaluated. MICs of terbinafine against C. albicans and C. tropicalis were 5 μg/ml and 2.5 μg/ml, while their MFCs were 10 μg/ml and 5 μg/ml, respectively. CONCLUSION The emergence of resistant Candida strains necessitates conduction of the antifungal susceptibility test prior to deciding the medication regime.
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Affiliation(s)
- Mohamed T Yassin
- Botany and Microbiology Dept., College of Science, King Saud University, P.O. 2455, Riyadh, 11451, Saudi Arabia.
| | - Ashraf A Mostafa
- Botany and Microbiology Dept., College of Science, King Saud University, P.O. 2455, Riyadh, 11451, Saudi Arabia
| | - Abdulaziz A Al-Askar
- Botany and Microbiology Dept., College of Science, King Saud University, P.O. 2455, Riyadh, 11451, Saudi Arabia
| | - Rashad Bdeer
- Microbiology Department, Regional Laboratory at King Saud Medical City, P.O. 2897, Riyadh, 11196, Saudi Arabia
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18
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Bonifácio BV, Vila TVM, Masiero IF, da Silva PB, da Silva IC, de Oliveira Lopes É, Dos Santos Ramos MA, de Souza LP, Vilegas W, Pavan FR, Chorilli M, Lopez-Ribot JL, Bauab TM. Antifungal Activity of a Hydroethanolic Extract From Astronium urundeuva Leaves Against Candida albicans and Candida glabrata. Front Microbiol 2019; 10:2642. [PMID: 31803166 PMCID: PMC6873212 DOI: 10.3389/fmicb.2019.02642] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 10/30/2019] [Indexed: 12/31/2022] Open
Abstract
We have previously reported on the activity of different extracts from Astronium sp. against Candida albicans, with the hydroethanolic extract prepared from leaves of A. urundeuva, an arboreal species widely distributed in arid environments of South America and often used in folk medicine, displaying the highest in vitro activity. Here we have further evaluated the antifungal activity of this extract against strains of C. albicans and C. glabrata, the two most common etiological agents of candidiasis. The extract was tested alone and loaded into a nanostructured lipid system (10% oil phase, 10% surfactant and 80% aqueous phase, 0.5% Poloxamer 407®). In vitro susceptibility assays demonstrated the antifungal activity of the free extract and the microemulsion against both Candida species, with increased activity against C. glabrata, including collection strains and clinical isolates displaying different levels of resistance against the most common clinically used antifungal drugs. Checkerboard results showed synergism when the free extract was combined with amphotericin B against C. albicans. Serial passage experiments confirmed development of resistance to fluconazole but not to the free extract upon prolonged exposure. Although preformed biofilms were intrinsically resistant to treatment with the extract, it was able to inhibit biofilm formation by C. albicans at concentrations comparable to those inhibiting planktonic growth. Cytotoxicity assays in different cell lines as well as an alternative model using Artemia salina L. confirmed a good safety profile of the both free and loaded extracts, and an in vivo assay demonstrated the efficacy of the free and loaded extracts when used topically in a rat model of vaginal candidiasis. Overall, these results reveal the promise of the A. urundeuva leaves extract to be further investigated and developed as an antifungal.
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Affiliation(s)
- Bruna Vidal Bonifácio
- School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara, Brazil.,Department of Biology and South Texas Center for Emerging Infectious Diseases, The University of Texas at San Antonio (UTSA), San Antonio, TX, United States
| | - Taissa Vieira Machado Vila
- Department of Biology and South Texas Center for Emerging Infectious Diseases, The University of Texas at San Antonio (UTSA), San Antonio, TX, United States
| | | | | | | | | | | | | | - Wagner Vilegas
- Institute of Biosciences, São Paulo State University (UNESP), São Vicente, Brazil
| | - Fernando Rogério Pavan
- School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara, Brazil
| | - Marlus Chorilli
- School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara, Brazil
| | - José Luis Lopez-Ribot
- Department of Biology and South Texas Center for Emerging Infectious Diseases, The University of Texas at San Antonio (UTSA), San Antonio, TX, United States
| | - Taís Maria Bauab
- School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara, Brazil
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Anti-candidal and anti-virulence efficiency of selected seaweeds against azole resistance Candida albicans. BIOCATALYSIS AND AGRICULTURAL BIOTECHNOLOGY 2019. [DOI: 10.1016/j.bcab.2019.101195] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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20
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Arumugam G, Rajendran R. Anti-candidal activity and synergetic interaction of antifungal drugs with differential extract of brown algae Stocheospermum marginatum. BIOCATALYSIS AND AGRICULTURAL BIOTECHNOLOGY 2019. [DOI: 10.1016/j.bcab.2019.101145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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21
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Starishko OM, Voronkova YS, Ostanina TH, Voronkova OS. Vaginal candidiasis among women of reproductive age in Dnipro city (Ukraine): Species spectrum of Candida and their susceptibility to antimycotics. REGULATORY MECHANISMS IN BIOSYSTEMS 2019. [DOI: 10.15421/021925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Candidiasis is one of the most common pathological processes, especially among women of reproductive age, especially pregnant. It can be expressed as Candida carriage and as an active form of infection. Although candidiasis is caused by opportunistic microorganisms, its effects can be quite significant, so it is necessary to treat it with the use of antimycotic drugs. In view of the spread among these microorganisms of resistance to antimicrobial drugs, the determining factor for the success of therapeutic measures, it is important to make a preliminary assessment of the susceptibility to antimycotics of strains isolated from persons with Candida carriage or active candidiasis. The aim of the research was to study the species range of fungi of the genus Candida isolated from the reproductive tract in women with dysbiosis and to study their susceptibility to antimycotics. Total of 227 samples of biological material from women aged 16 to 56 years have been investigated. Microscopic and cultural methods of detecting of fungi in the primary material were used for research. For the identification of species of Candida fungi, a polymerase chain reaction method in real-time was used. It was determined that the frequency of detection of Candida fungi in the composition of vaginal microbiome during inflammatory pathological processes was 76.7%. It was shown that the incidence of Candida carriage – 51.7% – slightly exceeded the frequency of detection of the active form of infection – 48.3%. The species spectrum of pathogens included: C. albicans (57.1%), C. krusei (12.6%), C. glabrata (19.5%) and Candida spp. (16.1%). In the case of active form of infection, C. albicans was prevalent – 64 (76.2%) cases. In the case of Candida carriage, other species were prevalent – 58 (64.4%) cases. The most effective drug against all isolates was amphotericin B – more than 87% of isolates were susceptible. The least effective drug was nystatin: less than 60% of isolates were susceptible. There is a rather high level of resistance to certain antimycotic drugs among the Candida species, which requires a prior preliminary study of the susceptibility of isolated strains to antimycotics for the purpose of choosing a rational and effective treatment scheme.
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Emergence of Resistance to Fluconazole in Candida albicans Isolated From Vaginal Discharge. CURRENT FUNGAL INFECTION REPORTS 2018. [DOI: 10.1007/s12281-018-0329-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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