In vitro interactions between anidulafungin and nonsteroidal anti-inflammatory drugs on biofilms of Candida spp.

Candida spp. are responsible for many biomaterial-related infections; they give rise to infective pathologies typically associated with biofilm formation. We recently reported that the echinocandin anidulafungin (ANF) showed a strong in vitro activity against both planktonic and biofilms cells. Herein, we report the antifungal activities of ANF alone and in association with some non-steroidal anti-inflammatory drugs (NSAIDs) against nine Candida strain biofilms: four Candida albicans, two Candida glabrata and three Candida guilliermondii. The activity of ANF was assessed using an in vitro microbiological model relevant for clinical practice. ANF proved oneself to be active against biofilms cells, and a clear-cut synergism was found against Candida species biofilms when ANF was used in combination with three NSAIDs: aspirin, diclofenac, ibuprofen. The positive synergism against Candida spp. of ANF in association with aspirin or the other NSAIDs proved to be a very effective antifungal treatment (FICI <0.5). These results may provide the starting point for new combination therapies of ANF with NSAIDs against Candida biofilm pathologies.     

Activity of anidulafungin against Candida biofilms

Currently, no standardized method to study the in vitro activity of antifungal agents on biofilms is available, thus, the comparison among different authors is difficult. The studies discussed in this review use the XTT reduction to measure the activity of antifungals on biofilms of 24 h of maturation. To date, biofilm anidulafungin MICs of 47 isolates of Candida spp. (25 Candida albicans, 16 Candida tropicalis, 5 Candida dubliniensis and 1 Candida parapsilosis) have been published. The geometric mean MIC of anidulafungin on biofilms of Candida spp. is of 1.18 microg/ml. Against isolates of species with great capacity of biofilm formation, the geometric mean MIC is 0.325 (C. albicans), 2 (C. parapsilosis) and 0.5 microg/ml (C. dubliniensis). No echinocandin has activity on C. tropicalis biofilms. In addition, anidulafungin can be used for lock therapy of catheters since it is the echinocandin with the least in vitro paradoxical effect.     

穿心莲内酯体外抗白念珠菌生物膜作用的初步研究

目的研究穿心莲内酯对体外白念珠菌生物膜的影响。方法采用XTT减低法评价穿心莲内酯对白念珠菌生物膜及其黏附性的影响;镜下观察该药对白念珠菌生物膜的形态学影响;细胞毒性试验检测该药的毒副作用。结果穿心莲内酯对白念珠菌生物膜的SMIC50、SMIC80分别是250、1000μg/ml;1000μg/ml及100μg/ml时对白念珠菌的早期黏附及菌丝生长有抑制作用;对人细胞毒性较弱。结论穿心莲内酯对体外白念珠菌生物膜有显著的抑制作用。     

大蒜素体外抗白念珠菌生物膜作用的初步研究

目的研究大蒜素对体外白念珠菌生物膜的影响。方法 MTT法评价大蒜素对白念珠菌生物膜形成及细胞黏附的影响;血清芽管计数法评价大蒜素对白念珠菌芽管形成的影响。结果低浓度(4μg/mL)和高浓度(64μg/mL)大蒜素对白念珠菌生物膜形成的抑制率分别为(23.0±1.1)%和(95.6±0.3)%;32μg/mL大蒜素对早期(0h)、中期(12h)及成熟期(48h)生物膜的抑制率分别为(88.5±0.5)%、(63.3±0.8)%和(52.3±1.1)%;与空白对照组相比,不同浓度大蒜素(4～32μg/mL)对培养30min、60min、90min、120min的白念珠菌细胞黏附均有显著抑制作用(P0.05);空白对照组芽管形成率为(91.2±1.6)%,64μg/mL大蒜素组为(2.2±1.2)%。结论大蒜素对体外白念珠菌生物膜有较明显的抑制作用。     

胡桃楸提取物对体外白念珠菌生物膜形成的影响

目的研究胡桃楸提取物对白念珠菌生物膜形成的影响。方法采用甲基四氮盐（XTT）还原法评价胡桃楸提取物对白念珠菌的生物膜形成及黏附性的影响。镜下观察胡桃楸提取物对白念珠菌生物膜的形态学影响。结果胡桃楸提取物抑制白念珠菌生物膜50％及90％的最小抑制药物浓度（SMIC50、SMIC90）分别为15．2μg、23．4μg。胡桃楸提取物作用浓度大于20μg时对该菌细胞黏附有抑制作用。30μg胡桃楸提取物可完全抑制白念珠菌生物膜的形成。结论胡桃楸提取物对体外白念珠菌生物的膜形成有较强的抑制作用。     

In vitro activity of amphotericin B cochleates against Leishmania chagasi

Cochleate delivery vehicles are a novel lipid-based system with potential for delivery of amphotericin B (AmB). In this study, the efficacy of cochleates was evaluated by examining the in vitro activity of AmB cochleates (CAMB) against Leishmania chagasi in a macrophage model of infection. We demonstrate that CAMB is nontoxic to macrophages at concentrations as high as 2.5 μg/mL, whereas the conventional formulation, AmB deoxycholate, showed high toxicity at this concentration. The in vitro activity of CAMB against L. chagasi was found to be similar to that of the reference drug AmB deoxycholate, with ED50s of 0.017 μg/mL and 0.021 μg/mL, respectively. Considering that L. chagasi affects organs amenable to cochleate-mediated delivery of AmB, we hypothesize that CAMB will be an effective lipid system for the treatment of visceral leishmaniasis.     

In vitro synergistic activity of diketopiperazines alone and in combination with amphotericin B or clotrimazole against Candida albicans

The synergistic anticandidal activity of three diketopiperazines [cyclo-(l-Pro-l-Leu) (1), cyclo-(d-Pro-l-Leu) (2), and cyclo-(d-Pro-l-Tyr) (3)] purified from a Bacillus sp. N strain associated with entomopathogenic nematode Rhabditis (Oscheius) in combination with amphotericin B and clotrimazole was investigated using the macrodilution method. The minimum inhibitory concentration and minimum fungicidal concentration of the diketopiperazines was compared with that of the standard antibiotics. The synergistic anticandidal activities of diketopiperazines with amphotericin B or clotrimazole were assessed using the checkerboard and time-kill methods. The results of the present study showed that the combined effects of diketopiperazines with amphotericin B or clotrimazole predominantly recorded synergistic (<0.5). Time-kill study showed that the growth of the Candida was completely attenuated after 12–24 h of treatment with 50:50 ratios of diketopiperazines and antibiotics. These results suggest that diketopiperazines combined with antibiotics may be microbiologically beneficial and not antagonistic. These findings have potential implications in delaying the development of resistance as the anticandidal effect is achieved with lower concentrations of both drugs (diketopiperazines and antibiotics). The cytotoxicity of diketopiperazines was also tested against two normal human cell lines (L231 lung epithelial and FS normal fibroblast) and no cytotoxicity was recorded for diketopiperazines up to 200 μg/mL. The in vitro synergistic activity of diketopiperazines with antibiotics against Candida albicans is reported here for the first time.     

两性霉素B和伏立康唑对临床真菌的体外抗菌活性分析

目的比较两性霉素B和伏立康唑对临床真菌的体外抗菌活性。方法用两性霉素B和伏立康唑的E-test条对分离自临床标本的116株真菌进行体外药敏试验,其中热带念珠菌15株,光滑念珠菌14株,近平滑念珠菌11株,克柔念珠菌6株,新生隐球菌8株,阿萨希毛孢子菌9株,烟曲霉29株,黄曲霉15株,黑曲霉1株,镰刀菌属7株,根霉属1株,以ATCC22019光滑念珠菌为质控菌株。结果两性霉素B对阿萨希毛孢子菌、镰刀菌、黄曲霉的MIC90均为64μg/ml,对其余受试菌株的MIC90均≤1μg/ml,伏立康唑对镰刀菌的MIC90为64μg/ml,对大部分受试菌株的MIC90均≤2μg/ml。结论除对某些真菌可能无效外,两性霉素B和伏立康唑可能适用于治疗大多数的真菌感染。     

In vitro activity of fluconazole and amphotericin B against Candida inconspicua clinical isolates as determined by the time-kill method

Candida inconspicua is an emerging pathogen in immunocompromised patients possessing inherently decreased susceptibility to fluconazole. We determined the MICs and killing activity of fluconazole and amphotericin B against C. inconspicua clinical isolates as well as reference strain C. inconspicua ATCC 16783 for comparison. MICs were determined using the standard broth microdilution method. Killing rates were determined using time-kill methodology at 0.5-16 x MIC fluconazole and amphotericin B concentrations. Fluconazole and amphotericin B MIC values varied between 16-128 mg/l and 0.5-1 mg/l, respectively. In time kill-assays fluconazole showed fungistatic effect at 1-16 x MIC concentrations against all tested strains after 24 h-incubation, but became fungicidal after 48 h at 4-16 x MIC concentrations. The time necessary to achieve fungicidal endpoint at 1 mg/l amphotericin B concentration ranged from 2 to 24 h. Our in vitro results confirm the data that fluconazole is ineffective against C. inconspicua at the fluconazole serum concentration attainable in humans. Amphotericin B due to its rapid killing activity seems to be a good alternative for the treatment of infections caused by C. inconspicua.     

米卡芬净对分离自中国的念珠菌和曲霉临床株体外抑菌活性的研究

目的了解新型抗真菌药物米卡芬净(micafungin,MFG)对分离自中国的念珠菌和曲霉临床株的体外抑菌活性。方法参照CLSI(Clinical and Laboratory Standards Institute,以前为NCCLS)制定的M27-A2和M38-A方案测定86株念珠菌和35株曲霉的最低抑菌浓度(MIC)或最低有效浓度(MEC)。结果MFG对大多数念珠菌属和曲霉属均有较好的抑菌作用。对念珠菌属的MIC90从高到低依次为:氟康唑(FLC)敏感的白念珠菌、热带念珠菌、光滑念珠菌为0.125μg/ml,FLC耐药和剂量依赖敏感株为0.25μg/ml,克柔念珠菌为0.5μg/ml,近平滑念珠菌8μg/ml,季也蒙念珠菌>16μg/ml。MFG对烟曲霉的MEC90为≤0.03μg/ml,对非烟曲霉的曲霉属MEC90为0.06μg/ml。MFG与唑类药物、两性霉素B(AMB)不存在交叉耐药,对FLC耐药的念珠菌、伊曲康唑耐药的曲霉、AMB不敏感的曲霉均有好的抑菌活性。结论MFG对多数念珠菌属和曲霉属(包括对唑类耐药和AMB不敏感的菌株)有较好的体外抑菌作用。     

In vitro antifungal activity of anidulafungin

Anidulafungin is a new and very useful pharmacological tool for the treatment of invasive mycoses. The antifungal spectrum of anidulafungin reaches the most common pathogenic fungi. Anidulafungin is especially active against the genera Candida and Aspergillus. Its antifungal mechanism is based on the inhibition of the beta-1,3-D-glucan synthesis, an essential molecule for the cell wall architecture, with different consequences for Candida and Aspergillus, being anidulafungin fungicide for the former and fungistatic for the latter. This review describes the in vitro antifungal spectrum of anidulafungin based in the scientific and medical literature of recent years. We can underline that most than 99% of Candida isolates are susceptible to < or = 2 microg/ml of anidulafungin. MIC are very low (< or =0.125 microg/ml) for most clinical isolates of the species Candida albicans, Candida glabrata, Candida tropicalis and Candida krusei while Candida parapsilosis and Candida guilliermondii isolates are susceptible to anidulafungin concentrations < or = 2 microg/ml. An excellent activity of anidulafungin has been also described against Aspergillus, Pneumocystis and other fungi. However, its activity is very low against Cryptococcus and the Zygomycetes. The excellent activity of anidulafungin has made this antifungal a first line therapeutic indication for candidemia and invasive candidiasis in non-neutropenic patients.     

In vitro activity of xanthorrhizol against Streptococcus mutans biofilms

AIMS: We determined the effect of xanthorrhizol (XTZ) purified from the rhizome of Curcuma xanthorrhiza Roxb. on the Streptococcus mutans biofilms in vitro. METHODS AND RESULTS: The biofilms of S. mutans at different phases of growth were exposed to XTZ at different concentrations (5, 10 and 50 micromol l(-1)) and for different time exposures (1, 10, 30 and 60 min). The results demonstrated that the activity of XTZ in removing S. mutans biofilm was dependent on the concentration, exposure time and the phase growth of biofilm. A concentration of 5 micromol l(-1) of XTZ completely inhibited biofilm formation by S. mutans at adherent phases of growth, whereas 50 micromol l(-1) of XTZ removed 76% of biofilm at plateau accumulated phase when exposed to S. mutans biofilm for 60 min. CONCLUSIONS: Xanthorrhizol isolated from an edible plant (C. xanthorrhiza Roxb.) shows promise as an antibacterial agent for inhibiting and removing S. mutans biofilms in vitro. SIGNIFICANCE AND IMPACT OF THE STUDY: XTZ could be used as a potential antibacterial agent against biofilm formation by S. mutans.     

In vitro activities of voriconazole, fluconazole, itraconazole and amphotericin B against non Candida albicans yeast isolates

Antifungal susceptibility testing was performed on 197 yeast isolates from the BCCM/IHEM biomedical fungi and yeasts collection (Belgian Co-ordinated Collections of Micro-organisms / IPH-Mycology) to study the in vitro activity of voriconazole against fluconazole, itraconazole and amphotericin B. MICs of the four antifungal agents were determined by an adapted NCCLS M27-A microdilution reference method. MIC readings were visually and spectrophotometrically determined. Optical density data were used for calculation of the MIC endpoints. For amphotericin B, the MIC endpoint was defined as the minimal antifungal concentration that exerts 90% inhibition, compared to the control growth. The azoles endpoints were determined at 50% inhibition of growth. The MIC distribution of voriconazole susceptibilities showed that 193 isolates had a MIC < or = 2 microg/ml and 185 a MIC < or = 1 microg/ml. Cross-tabulation of voriconazole, fluconazole, and itraconazole MICs indicated that voriconazole MICs raised with fluconazole and itraconazole MICs. The in vitro data obtained in this study suggest that voriconazole may also be effective treating yeast infection in patients infected with fluconazole or itraconazole resistant isolates.     

大黄酚体外抗白念珠菌生物膜作用的研究

目的研究大黄酚对体外白念珠菌生物膜的影响。方法采用XTT减低法评价大黄酚对白念珠菌的生物膜及黏附性的影响;镜下观察该药对白念珠菌生物膜的形态学影响;细胞毒试验检测该药的毒副作用。结果大黄酚对白念珠菌生物膜的SMIC50、SMIC80分别为125、1000μg/ml;100μg／ml及1000μg/ml含量浓度的大黄酚对自念珠菌的早期黏附及菌丝生长有抑制作用;大黄酚对人细胞毒性较弱。结论大黄酚对体外白念珠菌生物膜有较强的抑制作用。     

壳聚糖体外抗白念珠菌生物膜作用的初步研究

目的观察壳聚糖对白念珠菌生物膜形成的影响,探讨其可能的作用机制。方法 XTT减低法评价壳聚糖对白念珠菌生物膜形成及黏附的影响,镜下观察壳聚糖对白念珠菌生物膜形态的影响;实时定量RT-PCR法观察壳聚糖对白念珠菌的Ras信号通路因子CDC35、PDE2、EFG1和HWP1的基因表达的影响。结果低浓度(0.02 mg/mL)和高浓度(0.32mg/mL)壳聚糖对白念珠菌生物膜形成的抑制率分别为(19.6±1.2)%和(96.96±0.6)%,0.16 mg/mL浓度下壳聚糖对早期(0 h)、中期(12 h)和成熟期(48 h)的生物膜抑制率分别为(78.6±0.5)%、(54.4±0.9)%和(41.1±1.1)%,不同浓度的壳聚糖对各黏附阶段的白念珠菌细胞黏附均有抑制作用,壳聚糖可剂量依赖性地下调白念珠菌生物膜Ras信号通路基因CDC35、EFG1和HWP1的表达水平,上调Ras信号通路抑制剂PDE2的基因表达水平(P<0.05)。结论壳聚糖可能通过影响Ras信号通路及抑制细胞黏附而对白念珠菌生物膜的形成具有抑制作用。     

In vitro activity of essential oils extracted from plants used as spices against fluconazole-resistant and fluconazole-susceptible Candida spp

In the present study, the antifungal activity of selected essential oils obtained from plants used as spices was evaluated against both fluconazole-resistant and fluconazole-susceptible Candida spp. The Candida species studied were Candida albicans, Candida dubliniensis, Candida tropicalis, Candida glabrata, and Candida krusei. For comparison purposes, they were arranged in groups as C. albicans, C. dubliniensis, and Candida non-albicans. The essential oils were obtained from Cinnamomum zeylanicum Breyn, Lippia graveolens HBK, Ocimum basilicum L., Origanum vulgare L., Rosmarinus officinalis L., Salvia officinalis L., Thymus vulgaris L., and Zingiber officinale. The susceptibility tests were based on the M27-A2 methodology. The chemical composition of the essential oils was obtained by gas chromatography-mass spectroscopy and by retention indices. The results showed that cinnamon, Mexican oregano, oregano, thyme, and ginger essential oils have different levels of antifungal activity. Oregano and ginger essential oils were found to be the most and the least efficient, respectively. The main finding was that the susceptibilities of fluconazole-resistant C. albicans, C. dubliniensis, and Candida non-albicans to Mexican oregano, oregano, thyme, and ginger essential oils were higher than those of the fluconazole-susceptible yeasts (P<0.05). In contrast, fluconazole-resistant C. albicans and Candida non-albicans were less susceptible to cinnamon essential oil than their fluconazole-susceptible counterparts (P<0.05). A relationship between the yeasts' susceptibilities and the chemical composition of the essential oils studied was apparent when these 2 parameters were compared. Finally, basil, rosemary, and sage essential oils did not show antifungal activity against Candida isolates at the tested concentrations.     

土槿乙酸对白假丝酵母菌生物膜的抑制作用

目的 探讨土槿乙酸（pseudolaric acid B,PAB）对体外白假丝酵母菌生物膜的影响。方法 甲基四氮盐（XTT）法检测不同浓度PAB和AMB（两性霉素B）对白假丝酵母菌生物膜的抑制作用。血清芽管试验检测不同浓度PAB对芽管生成的影响。结果 PAB对白假丝酵母菌生物膜的SMIC50（抑制生物膜50%的药物浓度）为256~512 μg/mL;1024和512 μg/mL PAB对早期2 h生物膜的抑制率分别为（99.5±0.28）%和（97.1±0.38）%;512 μg/mL PAB对早期（2 h）、中期（8 h）及成熟期（24 h）生物膜的抑制率分别为（97.1±0.38）%、（90.4±0.32）%和（80.1±0.67）%;不同浓度PAB的血清芽管试验显示,64 μg/mL PAB可以完全抑制白假丝酵母菌的出芽生长,16 μg/mL PAB可以抑制83.5%的白假丝酵母菌出芽生长。结论 PAB对体外白假丝酵母菌生物膜有抑制作用,对白假丝酵母菌的出芽生长过程抑制作用显著。     

棘白菌素对氟康唑耐药的念珠菌体外药物敏感性的研究

目的评价3种棘白菌素类药物（卡泊芬净、米卡芬净、阿尼多芬净）体外对氟康唑耐药念珠菌的药物敏感性。方法采用微量液体稀释法和琼脂稀释法测定最小抑制浓度（MIC）。结果微量液体稀释法：59株耐药白念珠菌3种药物MIC50均为0.06μg/mL,米卡芬净、阿尼多芬净的MIC范围均为0.015～0.125μg/mL,卡泊芬净为0.015～0.25μg/mL;8株耐药光滑念珠菌MIC值均为0.063μg/mL。琼脂稀释法：59株耐药白念珠菌和8株耐药光滑念珠菌3种药物MIC值均为0.063μg/mL。结论3种棘白菌素类药物可能具有治疗氟康唑耐药的念珠菌感染的临床价值。