Antifungal Clinical Trials and Guidelines: What We Know and Do Not Know

Pappas, Peter G.

doi:10.1101/cshperspect.a019745

Cited by 12 publications

(8 citation statements)

References 98 publications

(97 reference statements)

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“…The high morbidity and mortality associated with fungal infections is compounded by the limited therapeutic options and the emergence of drug-resistant fungi [13][14][15][16][17]. Timely and adequate interventions are necessary to maximize favorable outcomes, culminating in a successful treatment.…”

Section: Editorialmentioning

confidence: 99%

“…Timely and adequate interventions are necessary to maximize favorable outcomes, culminating in a successful treatment. Improved antifungal strategies are therefore urgently required [13][14][15][16][17]. In this context, the anti-virulence strategy is in vogue and is a light at the end of the tunnel considering the limited antifungal armamentarium [18][19][20].…”

Section: Editorialmentioning

confidence: 99%

“…The dispersion of cells from a mature biofilm is another important step in the fungal biofilm development cycle, which can induce devastating consequences for the patient, including either bloodstream or invasive fungal infections, with high risks of mortality [14][15][16]19,26,[30][31][32][33][40][41][42]. For instance, the biofilm-detached C. albicans cells were more cytotoxic than their planktonic free-living cells and significantly more virulent in a murine model of infection [50].…”

Section: Host Immune Statusmentioning

confidence: 99%

See 2 more Smart Citations

Biofilm: A Robust and Efficient Barrier to Antifungal Chemotherapy

AL¹,

TP²

2015

J Antimicro

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Section: Editorialmentioning

confidence: 99%

Section: Editorialmentioning

confidence: 99%

Section: Host Immune Statusmentioning

confidence: 99%

See 1 more Smart Citation

Biofilm: A Robust and Efficient Barrier to Antifungal Chemotherapy

AL¹,

TP²

2015

J Antimicro

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“…For some decades, systemic and local antifungal agents such as fluconazole, nystatin, and amphotericin B have been successfully used as therapeutic and prophylactic agents to obviate colonization, as well as invasive fungal infections (Ericson and Benjamin 2014;Pappas 2014). However, their efficacy is compromised due to an alarming increase in the emergence of drug resistant Candida strains worldwide (Sanguinetti et al 2015).…”

Section: Introductionmentioning

confidence: 99%

Probiotic lactobacilli inhibit early stages of Candida albicans biofilm development by reducing their growth, cell adhesion, and filamentation

Matsubara

Wang

Bandara

et al. 2016

Appl Microbiol Biotechnol

159

131

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We evaluated the inhibitory effects of the probiotic Lactobacillus species on different phases of Candida albicans biofilm development. Quantification of biofilm growth and ultrastructural analyses were performed on C. albicans biofilms treated with Lactobacillus rhamnosus, Lactobacillus casei, and Lactobacillus acidophilus planktonic cell suspensions as well as their supernatants. Planktonic lactobacilli induced a significant reduction (p < 0.05) in the number of biofilm cells (25.5-61.8 %) depending on the probiotic strain and the biofilm phase. L. rhamnosus supernatants had no significant effect on the mature biofilm (p > 0.05), but significantly reduced the early stages of Candida biofilm formation (p < 0.01). Microscopic analyses revealed that L. rhamnosus suspensions reduced Candida hyphal differentiation, leading to a predominance of budding growth. All lactobacilli negatively impacted C. albicans yeast-to-hyphae differentiation and biofilm formation. The inhibitory effects of the probiotic Lactobacillus on C. albicans entailed both cell-cell interactions and secretion of exometabolites that may impact on pathogenic attributes associated with C. albicans colonization on host surfaces and yeast filamentation. This study clarifies, for the first time, the mechanics of how Lactobacillus species may antagonize C. albicans host colonization. Our data elucidate the inhibitory mechanisms that define the probiotic candicidal activity of lactobacilli, thus supporting their utility as an adjunctive therapeutic mode against mucosal candidal infections.

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“…The most common species to form normal microbiota and potentially cause invasive infections are C. albicans, C. glabrata, C. krusei, C. tropicalis , and C. parapsilosis . These five species are responsible for more than 90% of invasive infections [ 16 , 30 , 31 , 32 , 33 ]. Other Candida spp.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and Treatment of Invasive Candidiasis

Barantsevich

2022

Antibiotics

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Candida species, belonging to commensal microbial communities in humans, cause opportunistic infections in individuals with impaired immunity. Pathogens encountered in more than 90% cases of invasive candidiasis include C. albicans, C. glabrata, C. krusei, C. tropicalis, and C. parapsilosis. The most frequently diagnosed invasive infection is candidemia. About 50% of candidemia cases result in deep-seated infection due to hematogenous spread. The sensitivity of blood cultures in autopsy-proven invasive candidiasis ranges from 21% to 71%. Non-cultural methods (beta-D-glucan, T2Candida assays), especially beta-D-glucan in combination with procalcitonin, appear promising in the exclusion of invasive candidiasis with high sensitivity (98%) and negative predictive value (95%). There is currently a clear deficiency in approved sensitive and precise diagnostic techniques. Omics technologies seem promising, though require further development and study. Therapeutic options for invasive candidiasis are generally limited to four classes of systemic antifungals (polyenes, antimetabolite 5-fluorocytosine, azoles, echinocandins) with the two latter being highly effective and well-tolerated and hence the most widely used. Principles and methods of treatment are discussed in this review. The emergence of pan-drug-resistant C. auris strains indicates an insufficient choice of available medications. Further surveillance, alongside the development of diagnostic and therapeutic methods, is essential.

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Antifungal Clinical Trials and Guidelines: What We Know and Do Not Know

Cited by 12 publications

References 98 publications

Biofilm: A Robust and Efficient Barrier to Antifungal Chemotherapy

Biofilm: A Robust and Efficient Barrier to Antifungal Chemotherapy

Probiotic lactobacilli inhibit early stages of Candida albicans biofilm development by reducing their growth, cell adhesion, and filamentation

Diagnosis and Treatment of Invasive Candidiasis

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