Candida auris is a pathogenic yeast causing outbreaks in intensive care units with high mortality rates. The treatment of C. auris colonization is challenging due to high resistance rates. A potential alternative antifungal treatment is medical-grade honey. In this study the susceptibility of C. auris and other Candida species to the medical-grade honey-based formulation L-Mesitran® Soft was investigated. The medical-grade honey formulation reduced the growth of C. auris and other Candida species in a dose-dependent manner. This inhibition was not only due to the honey component, as treatment with an identical concentration of this component only was less effective and even stimulated the growth of C. albicans and C. glabrata, supporting the interpretation that supplements in the medical-grade honey formulation enhanced the antimicrobial activity. Increasing the concentration of the honey component to 40%, as is also present in an undiluted medical-grade honey formulation, lead to a 1- to 4-log inhibition of all Candida species. Unprocessed local honey reduced the growth of nearly all Candida species more strongly than medical-grade honey. C. auris’ susceptibility to the medical-grade honey formulation did not depend on geographic origin or resistance profile, although the multiresistant isolates tended to be more susceptible. Altogether, medical-grade honey formulation has a strong antifungal activity against C. auris and other Candida species. Future studies should demonstrate whether the treatment of open wounds or skin colonized with C. auris is feasible and effective in the clinical setting.
We have assessed matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) identification (Bruker) of nontuberculous mycobacteria from newly positive liquid cultures of respiratory samples. Twelve (22%) of 54 isolates were identified directly from liquid medium. After subculture and with manual laser operation, this rose to 49/54 isolates (91%). MALDI-TOF MS is less promising than previously suggested. N ontuberculous mycobacteria (NTM) are increasingly recognized as mostly opportunistic pathogens of humans. The most frequent disease manifestation is a chronic pulmonary infection (1). Since NTM are environmental microorganisms, their presence in pulmonary samples need not indicate disease per se. The clinical relevance of NTM isolation differs strongly by species (2). Hence, correct identification is of paramount importance (3).Identification of NTM is done mostly by using molecular tools. While accurate, these require a good laboratory infrastructure and trained personnel and are costly. Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) has revolutionized identification in general bacteriology and has also been tried for NTM (3). Most studies of MALDI-TOF MS identification of NTM have applied it to pure cultures from strain collections (4) rather than new positive cultures from clinical samples from nonsterile sites.We assessed MALDI-TOF MS identification of NTM directly from new positive liquid cultures of respiratory samples in a mycobacterial disease reference clinic.Primary cultures of respiratory samples were performed with the Mycobacterium Growth Indicator Tube (MGIT) system (BD Bioscience, Erembodegem, Belgium), as well as on Löwenstein-Jensen slants, both at 37°C, after decontamination by the 1% Nacetyl-L-cysteine-sodium hydroxide method (3).All of the positive cultures that we obtained during the MarchApril 2014 and January-February 2015 periods that tested negative in the TBc-ID immunochromatography assay (BD Bioscience) were studied.We performed MALDI-TOF MS identification with the MALDI Biotyper (Bruker Daltonics, Bremen, Germany) platform. Protein extraction from liquid MGIT medium for MALDI-TOF MS analysis was performed by the manufacturer's MycoEx protocol. In short, we collected biomass by aspirating 1.2 ml of liquid medium from the bottom of the MGIT tube and transferring it to a reaction tube, which was then centrifuged for 2 min at 13,000 rpm (8,124 ϫ g; 43-mm rotor radius); the supernatant was pipetted off, the pellet was resuspended in 300 l of high-performance liquid chromatography grade water, and cells were then inactivated by boiling for 30 min. A 900-l volume of pure cold ethanol was then added, and the tube was vortexed and centrifuged for 2 min at 13,000 rpm. The supernatant was pipetted off. The last two steps were repeated once. The pellet was dried at room temperature before the addition of zirconium beads and 10 to 50 l of pure acetonitrile, depending on the pellet size. After 1 min of vortexing, we adde...
The susceptibilities of 24 molecularly identified dimorphic fungi belonging to the genera, , and within the family were tested against 8 standard antifungal agents using CLSI document M38-A2. Amphotericin B and posaconazole had the lowest geometric mean MICs (<0.05 μg/ml) followed by itraconazole (<0.07 μg/ml), voriconazole (<0.15 μg/ml), and isavuconazole (<0.42 μg/ml) while fluconazole was not active. Micafungin demonstrated good antifungal activity against (geometric mean minimum effective concentration [GM MEC] 0.1 μg/ml) and (GM MEC<0.017 μg/ml).
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