Combination of Posaconazole and Amphotericin B in the Treatment of Candida glabrata Biofilms

Rodrigues, Célia Fortuna; Alves, Diana; Henriques, Mariana

doi:10.3390/microorganisms6040123

Cited by 16 publications

(18 citation statements)

References 66 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, this high suffering of drug resistance has been attributed to the no synergy. Rodrigues et al have also tried combining two common antifungal drugs (AMB and posaconazole), and the FICI showed that the combination did not bring a clear advantage for this species [44]. Also, in agreement with our results, other studies notably confirmed the antifungal effects of farnesol against Candida species.…”

Section: Discussionsupporting

confidence: 91%

Combination of Farnesol with Common Antifungal Drugs: Inhibitory Effect against Clinical Isolates of <em>Candida</em> Species

Nikoomanesh¹,

Falahati²,

Santos³

et al. 2023

Preprint

View full text Add to dashboard Cite

Vulvovaginal candidiasis (VVC) is a mucous membrane infection, with an increased rate of antifungal resistance of Candida species. The in vitro efficacy of farnesol alone or in combination with traditional antifungals, against resistant Candida strains recovered from women with VVC was assessed. In this study, 80 Candida isolats were identified by multi-plex PCR. Antifungal sus-ceptibility of amphotericin B (AMB), fluconazole (FLU), itraconazole (ITZ), voriconazole (VOR), clotrimazole (CTZ) and farnesol was tested by M27-A3/S4 broth micro dilution method. The combinations of farnesol with each antifungal were calculated based on the fractional inhibitor concentration index (FICI). C. glabrata was the predominant species (48.75%) isolated from vaginal discharges, followed by C. albicans (43.75%), C. parapsilosis (3.75%), mixed infection of C. albicans and C. glabrata (2.5%), C. albicans and C. parapsilosis (1%). C. albicans and C. glabrata isolates had lower susceptibility to FLU (31.4% and 23.0%, respectively) and CTZ (37.1% and 33.3%, respectively). Importantly, there was ‟synergismˮ between farnesol-FLU and farnesol-ITZ against C. albicans and C. parapsilosis (FICI= 0.5 and 0.35, respectively), reverting the original azole resistant profile. These findings indicate that farnesol is able to revert to the resistance profile of azole by enhancing the activity of FLU and ITZ in resistant isolates, which is a promising result.

show abstract

Section: Discussionsupporting

confidence: 91%

Combination of Farnesol with Common Antifungal Drugs: Inhibitory Effect against Clinical Isolates of <em>Candida</em> Species

Nikoomanesh¹,

Falahati²,

Santos³

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…In the present study, the combinations of fluconazole and amphotericin B mainly showed indifferent interactions in terms of effects against C. tropicalis (70.6%) and C. parapsilosis (50%) isolates, but antagonistic interactions were observed against the two Candida species isolates. Rodrigues and colleagues showed indifference effects for the voriconazole–amphotericin B combination against C. glabrata [36].…”

Section: Discussionmentioning

confidence: 99%

Effect of antifungal agents, lysozyme and human antimicrobial peptide LL-37 on clinical Candida isolates with high biofilm production

Chen

Lee

2021

Journal of Medical Microbiology

View full text Add to dashboard Cite

Introduction. Candida species can form biofilms on tissues and medical devices, making them less susceptible to antifungal agents. Hypothesis/Gap Statement. Antifungal combination may be an effective strategy to fight against Candida biofilm. Aim. In this study, we investigated the in vitro activity of fluconazole, caspofungin and amphotericin B, alone and in combination, against 17 clinical Candida tropicalis and 6 Candida parapsilosis isolates with high biofilm formation. We also tested LL-37 and lysozyme for anti-biofilm activity against a selected C. tropicalis isolate. Methodology. Candida biofilms were prepared using the 96-well plate-based method. The minimum biofilm eradication concentrations were determined for single and combined antifungal drugs. The activity of LL-37 and lysozyme was determined by visual reading for planktonic cells and using the XTT assay for biofilms. Results. Under biofilm conditions, fluconazole plus caspofungin showed synergistic effects against 60.9% (14 of 23) of the tested isolates, including 70.6% of C. tropicalis [fractional inhibitory concentration index (FICI), 0.26–1.03] and 33.3% of C. parapsilosis (FICI, 0.04–2.03) isolates. Using this combination, no antagonism was observed. Amphotericin B plus caspofungin showed no effects against 78.3% (18 of 23) of the tested isolates. Amphotericin B plus fluconazole showed no effects against 65.2% (15 of 23) of the tested isolates and may have led to antagonism against 2 C. tropicalis and 2 C. parapsilosis isolates. LL-37 and lysozyme had no effect on biofilms of the selected C. tropicalis isolate. Conclusions. We found that fluconazole plus caspofungin led to a synergistic effect against C. tropicalis and C. parapsilosis biofilms. The efficacy of the antifungal combination therapies of the proposed schemes against biofilm-associated Candida infections requires careful and constant evaluation.

show abstract

“…To determine the minimal antifungal concentration that decreases at least 2 log of biofilm, 200 µL -1 of PBS (pH 7.5) was first added to each well of the 96-well microplate containing biofilm specimens 16 . The plate was then subjected to sonication using an ultrasonic bath for 5 min at 36 ºC and 40 kHz (Sanders Medical, MG, Brazil), disrupting the biofilm matrix cells through cavitation.…”

Section: Determination Of Minimum Biofilm Eradication Concentration (...mentioning

confidence: 99%

“…After incubation (24 h at 36 °C), the CFU number was determined, and CFU per area unit (Log 10 CFU/cm 2 ) was calculated. A strong reduction in biofilm was considered when > 2log CFU/cm 2 , as previously described 16 .…”

Section: Determination Of Minimum Biofilm Eradication Concentration (...mentioning

confidence: 99%

Saprochaete clavata invasive infection: characterization, antifungal susceptibility, and biofilm evaluation of a rare yeast isolated in Brazil

Kraft

Ribeiro

Petroski

et al. 2023

Rev. Inst. Med. trop. S. Paulo

View full text Add to dashboard Cite

Rare emerging pathogens such as Saprochaete clavata are associated with invasive fungal diseases, high morbidity, mortality, rapidly fatal infections, and outbreaks. However, little is known about S. clavata infections, epidemiology, risk factors, treatment, biofilms, and disease outcomes. The objective of this study was to describe a new case of severe S. clavata infection in a patient diagnosed at a referral children's hospital in Brazil, including antifungal minimal inhibitory concentration, S. clavata biofilm characterization, and molecular characterization. The S. clavata isolated from an immunocompromised 11-year-old male patient was characterized using MALDI-TOF, Gram staining, scanning electron microscopy (SEM), and next generation sequencing (NGS) of genomic DNA. Biofilm production was also evaluated in parallel with determining minimal inhibitory concentration (MIC) and biofilm sensitivity to antifungal treatment. We observed small to medium, whitish, farinose, dry, filamentous margin colonies, yeast-like cells with bacillary features, and biofilm formation. The MALDI-TOF system yielded a score of ≥ 2,000, while NGS confirmed S. clavata presence at the nucleotide level. The MIC values (in mg L -1 ) for tested drugs were as follows: fluconazole = 2, voriconazole ≤ 2, caspofungin ≥ 8, micafungin = 2, amphotericin B = 4, flucytosine ≤ 1, and anidulafungin = 1. Amphotericin B can be active against S. clavata biofilm and the fungus can be susceptible to new azoles. These findings were helpful for understanding the development of novel treatments for S. clavata-induced disease, including combined therapy for biofilm-associated infections.

show abstract

Combination of Posaconazole and Amphotericin B in the Treatment of Candida glabrata Biofilms

Cited by 16 publications

References 66 publications

Combination of Farnesol with Common Antifungal Drugs: Inhibitory Effect against Clinical Isolates of <em>Candida</em> Species

Combination of Farnesol with Common Antifungal Drugs: Inhibitory Effect against Clinical Isolates of <em>Candida</em> Species

Effect of antifungal agents, lysozyme and human antimicrobial peptide LL-37 on clinical Candida isolates with high biofilm production

Saprochaete clavata invasive infection: characterization, antifungal susceptibility, and biofilm evaluation of a rare yeast isolated in Brazil

Contact Info

Product

Resources

About