Synergistic Antifungal Effect of Fluconazole Combined with ZnO Nanoparticles against Candida albicans Strains from Vaginal Candidiasis

Abstract

Background and Objective: The prevalence of the infections caused by Candida species has led to a significant increase in their resistance to antifungal compounds. The aim of this study was to i) investigate drug resistance ii) evaluate the incidence of Candida albicans drug resistance pattern in the vaginal samples of women referring to health centers of Qom province, and iii) examine the effect of Zn nanoparticles combined with fluconazole against C. albicans isolates. Methods: This experimental, descriptive study was performed on 120 patients of candidiasis. In order to identify Candida albicans, direct experiments, differential culture, Germ tube test and sugar assimilation test (API20C kit) were conducted. The effect of different antifungal drugs and zinc nanoparticles and the synergistic effect of fluconazole with zinc nanoparticles were investigated by disk diffusion method. Minimum Inhibitory Concentration (MICs) of all cases was further specified. Results: Of the 120 samples, 50 (41.6%) were identified as Candida albicans. These strains were resistant to certain antifungal drugs while others were semi-sensitive and sensitive. The lowest and the highest mean diameter of inhibition zone in all Candida albicans isolates belonged to ketoconazole (15.64 mm) and fluconazole nano-ZnO (26.76mm), respectively. The lowest and the highest MICs were observed in fluconazole-nano-ZnO and nano-ZnO, respectively. Conclusion: The synergistic effect of Zn nanoparticles with fluconazole can be conducive to the treatment of vaginal candidiasis.

Striking Back against Fungal Infections: The Utilization of Nanosystems for Antifungal Strategies

“…Zinc oxide nanoparticles are considered the most promising of these for drug release and low toxicity [ 141 , 142 , 143 ]. As with silver nanoparticles, zinc nanoparticles show significant anti-candida effects both as a monotherapy [ 144 , 145 ] and in combination with antifungal drugs such as fluconazole [ 146 ]. Thus far, the in vitro antifungal activities of zinc nanoparticles have been evaluated with various strains of C. albicans, C. krusei, C. aprapsilosis, and C. tropicalis [ 116 , 144 , 147 ].…”

Recent advances in the synthesis, characterization and biomedical applications of zinc oxide nanoparticles

“…Second is the release of zinc ions in medium with effects on active transport as well as on the amino acid metabolism [ 129 ]. Hajar et al [ 130 ] showed the synergistic effect of ZnONPs with fluconazole against C. albicans, and Xue et al [ 131 ] demonstrated the synergistic inhibition of Phytophthora growth by 0.25 g/L ZnONPs with 0.01 g/L thiram.…”

Anti-fungal therapy via incorporation of nanostructures: A systematic review for new dimensions

“…Recently synthesized nanostructures of zinc, manganese, and thioacetamide have been found to possess antifungal activity against pathogenic fungal species [42]. In recent studies, ZnO nanoparticles were synthesized that exhibited antifungal activity [43][44][45][46][47]. In low concentrations, silver nanoparticles were less cytotoxic than zinc oxide nanoparticles and represent an alternative antimicrobial compound against A. hydrophila, A. salmonicida and A. invadans [48].…”