Induction of oxidative stress as a possible mechanism of the antifungal action of three phenylpropanoids

The increasing incidence of hospital-acquired infections caused by drug-resistant pathogens, host toxicity, the poor efficacy of drugs and high treatment costs has drawn attention to the potential of natural products as antifungals in mucocutaneous infections and combinational therapies. Moreover, cellular and subcellular targets for these compounds may provide better options for the development of novel antifungal therapies. Eugenol, methyl eugenol and estragole are phenylpropanoids found in essential oil. They are known to possess pharmacological properties including antimicrobial activity. Induction of oxidative stress characterized by elevated levels of free radicals and an impaired antioxidant defence system is implicated as a possible mechanism of cell death. An insight into the mechanism of action was gained by propidium iodide cell sorting and oxidative stress response to test compounds in Candida albicans. The extent of lipid peroxidation (LPO) of cytoplasmic membranes was estimated to confirm a state of oxidative stress. Activity levels of primary defence enzymes and glutathione were thus further determined. Whereas these compounds cause fungal cell death by disrupting membrane integrity at minimum inhibitory concentrations (MIC), sub-MIC doses of these compounds significantly impair the defence system in C. albicans. The study has implications for understanding microbial cell death caused by essential oil components eliciting oxidative stress in Candida. The formation of membrane lesions by these phenylpropanoids thus appears to be the result of free radical cascade-mediated LPO.     

<Emphasis Type="Italic">Rhizopus homothallicus</Emphasis> Causing Invasive Infections: Series of Three Cases from a Single Centre in North India

Mucormycoses are opportunistic fungal infections with a high mortality rate. Rhizopus oryzae is the most common agent implicated in human infections. Although R. homothallicus has been previously reported to be a cause of pulmonary mucormycosis, it is the first time that we are reporting as a causative agent of rhino-orbital and cutaneous mucormycosis.     

A novel antimicrobial peptide derived from modified N-terminal domain of bovine lactoferrin: Design,synthesis, activity against multidrug-resistant bacteria and Candida

Lactoferrin (LF) is believed to contribute to the host's defense against microbial infections. This work focuses on the antibacterial and antifungal activities of a designed peptide, L10 (WFRKQLKW) by modifying the first eight N-terminal residues of bovine LF by selective homologous substitution of amino acids on the basis of hydrophobicity, L10 has shown potent antibacterial and antifungal properties against clinically isolated extended spectrum beta lactamases (ESBL), producing gram-negative bacteria as well as Candida strains with minimal inhibitory concentrations (MIC) ranging from 1 to 8 μg/mL and 6.5 μg/mL, respectively. The peptide was found to be least hemolytic at a concentration of 800 μg/mL. Interaction with lipopolysaccharide (LPS) and lipid A (LA) suggests that the peptide targets the membrane of gram-negative bacteria. The membrane interactive nature of the peptide, both antibacterial and antifungal, was further confirmed by visual observations employing electron microscopy. Further analyses, by means of propidium iodide based flow cytometry, also supported the membrane permeabilization of Candida cells. The peptide was also found to possess anti-inflammatory properties, by virtue of its ability to inhibit cyclooxygenase-2 (COX-2). L10 therefore emerges as a potential therapeutic remedial solution for infections caused by ESBL positive, gram-negative bacteria and multidrug-resistant (MDR) fungal strains, on account of its multifunctional activities. This study may open up new approach to develop and design novel antimicrobials.     

Isolation and characterization of novel protein with anti-fungal and anti-inflammatory properties from Aloe vera leaf gel

The Aloe protein of 14 kDa from the Aloe vera leaf gel was isolated by an ion exchange chromatography using DEAE-cellulose and CM-cellulose column. The purified Aloe protein exhibited a potent anti-fungal activity against Candida paraprilosis, Candida krusei and Candida albicans. In addition, the purified Aloe protein also showed an anti-inflammatory property against pure lipoxygenase and cyclooxygenase-2 with 84% and 73% inhibition, respectively, and was verified by binding with these proteins by real time method by the phenomenon of surface plasmon resonance. This Aloe protein is a novel protein possessing antifungal and anti-inflammatory properties and thus sets a platform to be used as a medicinal plant product.     

Isolation and Characterization of Senescent Cryptococcus neoformans and Implications for Phenotypic Switching and Pathogenesis in Chronic Cryptococcosis

Although several virulence factors and associated genes have been identified, the mechanisms that allow Cryptococcus neoformans to adapt during chronic infection and to persist in immunocompromised hosts remain poorly understood. Characterization of senescent cells of C. neoformans demonstrated that these cells exhibit a significantly enlarged cell body and capsule but still cross the blood-brain barrier. C. neoformans cells with advanced generational age are also more resistant to phagocytosis and killing by antifungals, which could promote their selection during chronic disease in humans. Senescent cells of RC-2, a C. neoformans strain that undergoes phenotypic switching, manifest switching rates up to 11-fold higher than those of younger cells. Infection experiments with labeled cells suggest that senescent yeast cells can potentially accumulate in vivo. Mathematical modeling incorporating different switching rates demonstrates how increased switching rates promote the emergence of hypervirulent mucoid variants during chronic infection. Our findings introduce the intriguing concept that senescence in eukaryotic pathogens could be a mechanism of microevolution that may promote pathoadaptation and facilitate evasion of an evolving immune response.Cryptococcus neoformans is an encapsulated yeast that causes chronic meningoencephalitis predominantly in patients with advanced human immunodeficiency virus infection. Worldwide, this disease is estimated to cause more than 600,000 deaths per year (22). This high death rate may result in part from the fact that this chronic infection is notoriously difficult to eradicate, despite effective antifungal therapy. Even in successfully treated patients with access to antiretroviral therapy, the organism persists and can cause relapse both before and after the start of highly active antiretroviral treatment.In murine infection models, C. neoformans strain RC-2 can augment virulence by undergoing phenotypic switching from a smooth (SM) parent colony to a more virulent mucoid (MC) colony variant (6). Phenotypic switching occurs in both species and varieties of this fungus (6, 8, 11). Although differentially regulated genes associated with switching have been described (10), the precise molecular mechanism that controls phenotypic switching in C. neoformans is unknown. In vitro investigations have demonstrated that phenotypic switching occurs at a stable rate and MC switch variants spontaneously arise at a rate of 1 in about 20,000 plated SM colonies. Environmental signals that induce or alter this process have not been identified to date. Phenotypic switching occurs during chronic murine infection and alters the outcome (6), but it is noteworthy that MC switch variants consistently emerge late in the course of infection (after 6 weeks), although the fungal burden is highest on day 14 after intratracheal (i.t.) infection. This could reflect altering selection pressure by an evolving host response or, alternatively, a change in the microbe''s propensity to undergo phenotypic switching over time. In Candida albicans, the process of phenotypic switching is controlled by pathways that are involved in silencing and maintenance of genomic stability (14, 20, 34, 35). Furthermore, in the context of research on aging in Saccharomyces cerevisiae, it has become evident that senescent yeast cells (old cells with advanced generational age) exhibit less genomic stability (17, 18). C. neoformans is also a unicellular haploid yeast that replicates clonally in vivo. Consequently, we reasoned that it was conceivable that replicative aging of C. neoformans during chronic infection could alter genomic stability and its propensity to undergo phenotypic switching. We therefore investigated the effect of generational aging on phenotypic switching in C. neoformans and also compared it to C. albicans.     

Staged Reimplantation of a Total Hip Prosthesis After Co-infection with <Emphasis Type="Italic">Candida tropicalis</Emphasis> and <Emphasis Type="Italic">Staphylococcus haemolyticus</Emphasis>: A Case Report

Fungal prosthetic joint infection is a rare complication in total joint arthroplasty. There are no established guidelines for management of these infections. We present a case of a 53-year-old male with a hip joint prosthesis co-infected with Candida tropicalis and Staphylococcus haemolyticus. A two-stage exchange arthroplasty was performed. The patient underwent implant removal, debridement, irrigation with saline solution and application of cement spacer impregnated with vancomycin followed by aggressive antimicrobial treatment in first stage. Complete eradication of infection was demonstrated by negative culture of sonicated cement spacer fluid and negative 16S rRNA and 18S rRNA gene PCR of sonicate fluid, synovial fluid and periprosthetic tissue samples. He underwent second-stage revision hip arthroplasty after 9 months of the first stage. At the latest follow-up, there was no evidence of recurrence of infection. This case illustrates the utility of sonication of biomaterials and molecular techniques for microbiological confirmation of absence of infection in staged surgeries which is required for a successful outcome.     

DS6: anticandidal,antibiofilm peptide against Candida tropicalis and exhibit synergy with commercial drug

Antifungal peptides have gained interest as therapeutic agents in recent years because of increased multidrug resistance against present antifungal drugs. This study designed, synthesized and characterized antifungal activity of a small peptide analogue, DS6. This peptide was designed using the template from the N‐terminal part of the antifungal protein, Aspergillus giganteous. DS6 inhibited Candida tropicalis (ATCC 13803), as well as its clinical isolates. DS6 was found to be a fungicidal, killing the fungus very rapidly. DS6 is also non‐toxic to human cells. Synergistic interactions of DS6 with amphotericin B and fluconazole were also evident. DS6 is membrane lytic and exhibits antibiofilm activity against C. tropicalis. In conclusion, DS6 may have utility as an alternative antifungal therapy for C. tropicalis. Copyright © 2017 European Peptide Society and John Wiley & Sons, Ltd.     

Comparative Analysis of the Vitek 2 Antifungal Susceptibility System and E-test with the CLSI M27-A3 Broth Microdilution Method for Susceptibility Testing of Indian Clinical Isolates of Cryptococcus neoformans

The emergence of antifungal resistance among Cryptococcus neoformans isolates is a matter of great concern. The Clinical and Laboratory Standards Institute (CLSI) broth microdilution reference method (BMD) for antifungal susceptibility testing of C. neoformans is tedious and time-consuming. Consequently, there is a greater need for a reproducible in vitro susceptibility testing method for use in clinical microbiology laboratories. By random amplified polymorphic DNA analysis, the 62 Indian clinical isolates were characterized as Cryptococcus neoformans var. grubii. We evaluated the susceptibilities of these isolates for amphotericin B (AMB) and fluconazole (FLC) by two commercial techniques, i.e., Vitek 2 and E-test against the CLSI M27-A3 BMD. The essential agreement (EA) between the Vitek 2 and E-test with the reference procedure for FLC was similar (82.2%). For AMB, EA of 92 and 76% was obtained with E-test and Vitek 2. Excellent categorical agreement (CA) (98.3% and 100% by Vitek 2 and E-test, respectively) was obtained for AMB. The CA for FLC was 81 and 77.4% by Vitek 2 and E-test. We conclude that both E-test and Vitek 2 system have acceptable levels of accuracy for susceptibility testing of both the drugs. Both of them could identify fluconazole-resistant strains. Vitek 2 could be used for testing susceptibility of voriconazole and 5-flucytosine also at the same time.     

Multilocus Sequence Typing of Clinical Isolates of Cryptococcus from India

Mycopathologia - Cryptococcosis is a life-threatening infection caused by Cryptococcus neoformans and C. gattii species complex. In the present study, to understand the molecular epidemiology of...