Candida species: current epidemiology, pathogenicity, biofilm formation, natural antifungal products and new therapeutic options

Sardi, Janaína de Cássia Orlandi; Scorzoni, Liliana; Bernardi, Thais; Fusco‐Almeida, Ana Marisa; Mendes-Giannini, María José Soares

doi:10.1099/jmm.0.045054-0

Cited by 990 publications

(860 citation statements)

References 169 publications

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“…Other relevant fact associated with virulence is their capacity to form biofilms with other species, which together with the presence of teleomorph forms (sexual phase of fungi in which the same biologic entity could have two different scientific names), difficult the treatment and alter the susceptibility profiles to traditional antifungals agents [3,9,10,13,[19][20][21][22].…”

Section: Dubliniensis C Parapsilosis C Orthopsilosis C Metapsilmentioning

confidence: 99%

Candidiasis: Predisposing Factors, Prevention, Diagnosis and Alternative Treatment

et al. 2014

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SUMMARYCandidiasis is the most common opportunistic yeast infection. Candida species and other microorganisms are involved in this complicated fungal infection, but Candida albicans continues to be the most prevalent. In the past two decades, it has been observed an abnormal overgrowth in the gastrointestinal, urinary and respiratory tracts, not only in immunocompromised patients, but also related to nosocomial infections and even in healthy individuals. There is a widely variety of causal factors that contribute to yeast infection which means that candidiasis is a good example of a multifactorial syndrome. Due to rapid increase in the incidence of these infections, this is the subject of numerous studies. Recently, the focus of attention is the treatment and, above all, the prevention of those complications. The diagnosis of candidiasis could become quite complicated. Prevention is the most effective "treatment", much more than eradication of the yeast with antifungal agents. There are several aspects to consider in the daily routine that can provide a strength protection. However, a therapeutic approach is necessary when the infection is established and, therefore, other alternatives should be explored. This review provides an overview on predisposition factors, prevention and diagnosis of candidiasis, highlighting alternative approaches for candidiasis treatment.

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Section: Dubliniensis C Parapsilosis C Orthopsilosis C Metapsilmentioning

confidence: 99%

Candidiasis: Predisposing Factors, Prevention, Diagnosis and Alternative Treatment

et al. 2014

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“…(Costerton et al ., 1999; Davey and O'Toole G, 2000) . Candida albicans is an opportunistic fungal pathogen and causes systemic infections predominantly by contaminating implant devices such as pacemakers, endotracheal tubes, contact lenses, penile implants, intrauterine devices and catheters (Ramage et al ., 2005; Sardi et al ., 2013). Candida albicans biofilms contain cells in three development stages viz.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of 7‐benzyloxyindole and other halogenated indoles to inhibit Candida albicans biofilm and hyphal formation

Manoharan

Lee

2018

Microbial Biotechnology

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SummaryCertain pathogenic bacteria and yeast form biofilms on biotic and abiotic surfaces including medical devices and implants. Hence, the development of antibiofilm coating materials becomes relevant. The virulence of those colonizing pathogens can be reduced by inhibiting biofilm formation rather than killing pathogens using excessive amounts of antimicrobials, which is touted as one of the main reasons for the development of drug resistance. Candida albicans is an opportunistic fungal pathogen, and the transition of yeast cells to hyphal cells is believed to be a crucial virulence factor. Previous studies have shown that indole and its derivatives possess antivirulence properties against various bacterial pathogens. In this study, we used various indole derivatives to investigate biofilm‐inhibiting activity against C. albicans. Our study revealed that 7‐benzyloxyindole, 4‐fluoroindole and 5‐iodoindole effectively inhibited biofilm formation compared to the antifungal agent fluconazole. Particularly, 7‐benzyloxyindole at 0.02 mM (4.5 μg ml−1) significantly reduced C. albicans biofilm formation, but had no effect on planktonic cells, and this finding was confirmed by a 2,3‐bis‐(2‐methoxy‐4‐nitro‐5‐sulfophenyl)‐2H‐tetrazolium‐5‐carboxanilide (XTT) assay and three‐dimensional confocal laser scanning microscopy. Scanning electron microscopy analyses revealed that 7‐benzyloxyindole effectively inhibited hyphal formation, which explains biofilm inhibition. Transcriptomic analysis showed that 7‐benzyloxyindole downregulated the expressions of several hypha/biofilm‐related genes (ALS3,ECE1,HWP1 and RBT1). A C. albicans‐infected Caenorhabditis elegans model system was used to confirm the antivirulence efficacy of 7‐benzyloxyindole.

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“…Candida glabrata , the most frequently isolated non- C. albicans species, accounts for around 21% of all Candida -related systemic bloodstream infections in North America [3]. The rise in number of C. glabrata infections is particularly concerning, due to the high antifungal resistance of this species.…”

Section: Introductionmentioning

confidence: 99%

Biguanides enhance antifungal activity against Candida glabrata

Feliu

Lord

et al. 2018

Virulence

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Candida spp. are the fourth leading cause of nosocomial blood stream infections in North America. Candida glabrata is the second most frequently isolated species, and rapid development of antifungal resistance has made treatment a challenge. In this study, we investigate the therapeutic potential of metformin, a biguanide with well-established action for diabetes, as an antifungal agent against C. glabrata. Both wild type and antifungal-resistant isolates of C. glabrata were subjected to biguanide and biguanide-antifungal combination treatment. Metformin, as well as other members of the biguanide family, were found to have antifungal activity against C. glabrata, with MIC50 of 9.34 ± 0.16 mg/mL, 2.09 ± 0.04 mg/mL and 1.87 ± 0.05 mg/mL for metformin, phenformin and buformin, respectively. We demonstrate that biguanides enhance the activity of several antifungal drugs, including voriconazole, fluconazole, and amphotericin, but not micafungin. The biguanide-antifungal combinations allowed for additional antifungal effects, with fraction inhibition concentration indexes ranging from 0.5 to 1. Furthermore, metformin was able to lower antifungal MIC50 in voriconazole and fluconazole-resistant clinical isolates of C. glabrata. We also observed growth reduction of C. glabrata with rapamycin and an FIC of 0.84 ± 0.09 when combined with metformin, suggesting biguanide action in C. glabrata may be related to inhibition of the mTOR complex. We conclude that the biguanide class has direct antifungal therapeutic potential and enhances the activity of select antifungals in the treatment of resistant C. glabrata isolates. These data support the further investigation of biguanides in the combination treatment of serious fungal infections.

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Candida species: current epidemiology, pathogenicity, biofilm formation, natural antifungal products and new therapeutic options

Cited by 990 publications

References 169 publications

Candidiasis: Predisposing Factors, Prevention, Diagnosis and Alternative Treatment

Candidiasis: Predisposing Factors, Prevention, Diagnosis and Alternative Treatment

Efficacy of 7‐benzyloxyindole and other halogenated indoles to inhibit Candida albicans biofilm and hyphal formation

Biguanides enhance antifungal activity against Candida glabrata

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