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Phytotherapeutics is widely used nowadays as an alternative to the current antifungal drugs to reduce their side effects. Curcumin, with its wide therapeutic array as antioxidant and anti-inflammatory agent, is one of the natural compounds that ha..s an antifungal effect, especially when being used at nanoscale to increase its bioavailability. Our research aimed to evaluate clinically and microbiologically the effect of using topical nanocurcumin suspension to treat oral candidiasis. After 4 days from induction of oral candidiasis (baseline), we randomly divided 39 female BALB/c mice into three groups of 13 animals; nanocurcumin, nystatin, and sham groups. All animals in nanocurcumin and nystatin groups received topical treatment twice daily for 10 days. Then, we performed clinical and microbiological evaluations at baseline, day 5, and day 10. By the end of treatment, our results revealed that nanocurcumin promoted a significant reduction in the number of candida colonies. There was no statistically significant difference neither clinically nor microbiologically between nanocurcumin and nystatin groups. In conclusion, nanocurcumin has a good antifungal effect as nystatin, however, its therapeutic efficacy takes a longer time to appear than nystatin. The enhanced bioavailability of curcumin at the nanoscale qualifies this nano-herb as a promising alternative therapy for oral candidiasis, evading nystatin-associated morbidity.

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INTRODUCTION:Oral candidiasis is the most common human fungal infection resulting from infection of the oral cavity by yeastlike fungus, candida. Its treatment by available topical or systemic antifungal drugs has several problems including toxicity and the development of drug resistance. Hence recent studies have given much attention to molecules from natural sources. Therefore, curcumin is considered one of the promising natural antifungal drugs. It has antifungal properties, but its poor solubility in aqueous solvents results in poor oral bioavailability. To improve the properties of curcumin, recent trails used nanotechnology. The size of nanoparticles can help them to gain entry into cells increasing its solubility and improving its bioavailability. OBJECTIVES: To evaluate the use of topical application of nanocurcumin in treatment of oral candidiasis and compare it to curcumin and nystatin in a murine model. MATERIALS AND METHODS: Thirty-nine female mice were randomly divided into three groups of 13 animals each after induction of oral candidiasis. Group 1 received nanocurcumin at 64 µg/ml. Group 2 received curcumin at 128 µg/ml. Group 3 received nystatin 100000 U/ml. All animals were received treatment topically twice daily for 10 days. The clinical evaluation and microbiological analysis were at baseline, day 5 and day 10. RESULTS: There was no statistical differences between the three studied groups in the number of cured animals at the end of the treatment period (p=0.358). CONCLUSION: Nanocurcumin has a good antifungal effect but further research is needed to get the maximum benefits of these nanoparticles.

Background: Carbapenemase-producing Enterobacterales are increasingly spreading in healthcare facilities. Identifying the type of carbapenemase can help epidemiologic surveillance and proper selection of antimicrobials. Objective: This study assessed the sensitivity and specificity of carbapenem inactivation method (mCIM with eCIM) for identification of carbapenemase-production. Methodology: The study involved 150 isolates of Enterobacterales. Carbapenem-resistant isolates by Kirby Bauer method were further tested for carbapenemase production phenotypically by mCIM with eCIM, and genotypically by multiplex PCR using specific primers for bla KPC , bla OXA-48 , bla NDM-1 , bla VIM , and bla IMP. Results: Resistance to carbapenem was observed in 53/150 isolates. Phenotypically, 28/53 isolates produced metallo-β-lactamase, 16/53 produced serine carbapenemase, 5/53 isolates gave inconclusive results, and 4/53 were negative by mCIM with eCIM test. Genotypically, 30 isolates carried bla NDM-1 , and 41 isolates carried bla . Both genes co-existed in 18 Metallo-β-lactamase producers. The 9 isolates with negative or inconclusive results carried carbapenemase-encoding genes. For mCIM with eCIM test the sensitivity and specificity of detecting Metallo-β-lactamase production were higher (87% and 91%) than for serine carbapenemase detection (34% and 83%), respectively. Conclusion: It was concluded that the mCIM with eCIM test does not always lead to true conclusions about the existence and the type of carbapenemase produced by Enterobacterales.