Antiproliferative and antimicrobial activities of endophytic fungus isolated from erycibe elliptilimba.

Background: Erycibe elliptilimba Merr.&Chun. is a Thai herb in the family Convolvulaceae that has long been used in traditional medicine to treat various diseases including infections and malignancies. Its methanolic extract has antiproliferative activities against various human cancer cell lines with potential ED50 values. Objective: The antiproliferative activities exhibited from this plant should be investigated to ensure that the effects were from the plant itself. Therefore, the endophytic fungus from this special plant was isolated and evaluated for their antiproliferative and antimicrobial activities. Methods: The isolation of fungal endophytes from the stems of Erycibe elliptilimba Merr.&Chun. was identified by macroscopic and microscopic morphology. Fungal extraction was demonstrated using thin layer chromatography of the crude broth extract. Four human breast cancer cell lines, two human lung cancer cell lines, and one human colon cancer cell line were used to evaluate the antiproliferative activity of the crude broth extract on the cell growth and determine of antibacterial activities. Results: The results revealed that only one species, Trichoderma ovalisporum, was isolated and its cultured broth extract did not provide an antiproliferative effect against any human cancer cell line nor antimicrobial activities. Conclusion: Based on this study, the antiproliferative activities against several human cancer cell lines of Erycibe elliptilimba, Merr&Chun extract, in recent reports may depend upon the active compounds in the plant itself.

Safety and efficacy of a new imidazole fungicide, Sertaconazole, in the treatment of fungal vulvo-vaginitis: a comparative study using Fluconazole and Clotrimazole.

Background: Sertaconazole is a new imidazole fungicide introduced for vulvo-vaginal candidiasis. It has an azole group with benzothiophene that inhibits biosynthesis of ergosterol and brings about a massive leak of cytoplasm with consequent fungal cell death. Objective: Assess the safety and efficacy of Sertaconazole in the treatment of fungal vulvo-vaginitis for comparison with Fluconazole and Clotrimazole. Subjects and methods: One-hundred eighty-eight outpatients with fungal vulvo-vaginitis were recruited at Siriraj Hospital, Thailand between August 31, 2004 and January 30, 2006. The patients were given Sertaconazole, Fluconazole, or Clotrimazole, and received vaginal swab and culture for fungus at seventh and 28th days after treatment. Results: Out of 188 cases, 177 cases were followed-up completely. Sertaconazole group included 66 cases where 35 cure, 20 fail, and 7 recurrent cases. Fluconazole group included 60 cases and had 37 cure, six fail, and 20 recurrence cases. Clotrimazole group included 55 cases and had 32 cure, nine fail and 11 recurrent cases. There were risk factors of fungal vulvo-vaginitis, including frequent micturition and small toilet shower flushing. Conclusion: Sertaconazole had similar effectiveness and less side-effect as compared with Fluconazole and Clotrimazole. It appeared to work well with lowest recurrence.

Surveillance of subtype and genetic variation of the circulating strains of HIV-1 in Thailand.

Two HIV-1 strains, CRF01_AE and subtype B', were reported in Thailand during the early years of the epidemic. Recently, an intersubtype recombination of HIV-1 strain was found in Thailand. Eight-hundred and twenty-eight samples collected during years 1995-2004 from high-risk groups in Bangkok, northern, northeastern, and southern region of Thailand were studied. HIV-1 env nucleotide sequences were used for phylogenetic analysis of the circulating HIV-1 strain. By single HIV-1 region (env) genotyping, CRFO1_AE was found in 97.3% and HIV-1 subtype B was found in 2.7%. A predominance of CRF01_AE was found in all geographic regions. Parallel analysis of the HIV-1 gag and env genes demonstrated that 2.1% and 4.0% of recombinant HIV-1 strains were found using p17 and p24 region sequences, respectively. The recombinant gag gene was also found in one southern isolate. Phylogenetic analysis of HIV-1 isolated from 20 provinces in 2002 suggested the northern and northeastern isolates were more related than the southern isolates which had the lowest genetic diversity of 0.13. The GPGQ V3 loop tip was also present in isolates from all regions. The molecular epidemiological data from this study may be useful for surveillance design as well as targeting prevention efforts. It also provides information regarding new antigenic regions of circulating strains responsible for the HIV-1 epidemic in Thailand.

Antifungal susceptibilities of Cryptococcus neoformans cerebrospinal fluid isolates and clinical outcomes of cryptococcal meningitis in HIV-infected patients with/without fluconazole prophylaxis.

OBJECTIVES: To compare the MICs of FLUconazole (FLU) and amphotericin B against isolates of Cryptococcus neoformans (C. neoformans) obtained from the CerebroSpinal Fluid (CSF); and clinical outcomes of HIV-infected patients diagnosed with cryptococcal meningitis. MATERIAL AND METHOD: There were two groups including those who did not receive FLU (group A) and those who did receive either FLU 400 mg/week for primary prophylaxis cryptococosis or 200 mg/day for secondary prophylaxis cryptococosis (group B). CSF isolates of C. neoformans from group A and group B between January 2003 and October 2004 were retrospectively studied. The MICs were determined by using the standard NCCLS broth microdilution methods (M27-A). The MICs of FLU and amphotericin B, and clinical outcomes after 10 weeks of cryptococcal meningitis treatment were determined. RESULTS: There were 98 isolates; 80 in group A and 18 in group B. The patients in group B had a higher proportion of previous opportunistic infections (p = 0.008). The other baseline characteristics between the two groups were not different. The median (range) MIC of FLU was 8.0 (0.5-32) microg/ml in group A, and 6.0 (0.5-32) microg/ml in group B (p = 0.926). The median (range) MIC of amphotericin B was 0.25 (0.03-1.0) microg/ml in group A, and 0.25 (0.12-1.0) microg/ml in group B (p = 0.384). Sixty patients from group A and 14 from group B received standard treatment and continued to follow-up. After the 10-week treatment, 39/60 (65%) patients in group A and 7/14 (50%) in group B had complete recovery (p = 0.364; RR = 0.538, 95%CI = 0.166-1.742). The overall mortality rate was 14/60 (23.3%) in group A and 7/14 (50.0%) in group B (p = 0.096; RR = 3.286, 95%CI = 0.983-10.979). CONCLUSION: The MICs of FLU and amphotericin B against CSF isolates of C. neoformans and clinical outcomes between HIV-infected patients who receive or did not receive FLU prophylaxis are not different.

Candida species, genotypes and antifungal susceptibility of Candida isolates from blood samples of patients at the largest tertiary care hospital in Thailand during 1999-2002.

From 1999 to 2002, a total of 202 Candida isolates causing candidemia were recovered from 202 individual patients in the largest tertiary hospital in Bangkok, Thailand. C. albicans comprised 44.55 per cent of all isolates. Non-albicans Candida spp. isolates accounted for 55.45 per cent of all candidemia episodes and were primarily due to C. tropicalis (45%) followed by C. parapsilosis (6%), C. glabrata (4%), and C. krusei (0.5%). Non-albicans Candida spp appeared more frequently in children (59%). Regarding etiology, non-albicans Candida spp showed an increase (67%) in the year 2002. The distribution of C. albicans genotypes was as follows: genotype A, 71 per cent; genotype B, 26 per cent and genotype C, 3 per cent, with a similar susceptibility proportion to amphotericin B, fluconazole and itraconazole. All isolates of C. albicans, C. tropicalis, and C. parapsilosis were susceptible to fluconazole in vitro. Only 16.7-19.8 per cent of the isolates were resistant to itraconazole. A high proportion of C. glabrata isolates showed drugs resistance.