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Abstract The biggest challenge in root canal treatment is the elimination of microorganisms; there- fore, new techniques are continually sought to achieve success. The agar diffusion method was used to determine the antibacterial and antifungal effect of ozonated Sacha Inchi essential oil, calcium hydroxide paste, and the combination of both. Brain heart infusion and sabouraud agar were the culture media for Enterococcus faecalis and Candida albicans respectively. The antibacterial and antifungal effects were determined using the inhibition halos that formed around the wells containing the drugs at 24 hours and 48 hours. From the study, the antibacterial and antifungal effects of the ozonized oil was greater after 6 hours, proportional to the higher concentration of peroxide. This study showed that the antibacterial effect of ozonated Sacha Inchi oil is superior to that of calcium hydroxide and the combination of both substances.

Resumen El desafío más grande en el tratamiento de conductos es la eliminación de los microorganismos; por lo que se busca continuamente nuevas técnicas para alcanzar éxito en el tratamiento. Se determinó el efecto antibacteriano y antifúngico del aceite esencial ozonizado de sacha inchi, hidróxido de calcio en pasta y la combinación de ambas; se utilizó el método de difusión en agar, siendo el medio de cultivo para los Enterococcus faecalis infusión cerebro corazón y para la Candida albicans agar sabouraud, para determinar el efecto antibacteriano y antifúngico se midieron y se registraron los halos de inhibición que se formaron alrededor de los pocillos que contenían los medicamentos a las 24 horas y 48 horas. Obteniendo como resultado que el efecto antibacteriano y antifúngico del aceite ozonizado es mayor a las 6 horas proporcional a la mayor concentración de peróxido. El presente estudio mostró el efecto antibacterial del aceite ozonizado de sacha inchi que es superior frente al hidróxido de calcio y la combinación de ambas sustancias.

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Vaginal candidiasis, primarily caused by microorganisms belonging to the Candida genus, is a common fungal infection prevalent among millions of women worldwide and can lead to significant morbidity. The treatment of Candida infections has often relied on antifungal drugs such as azoles and echinocandins. However, the emergence of resistance among Candida species to these drugs poses a significant challenge to effective treatment. This study was, thus, aimed at evaluating the in vitro antifungal activity of ethanol extracts of some selected medicinal plants against Candida species isolated from high vaginal swabs of some women attending a hospital in Enugu State, Nigeria. Six (6) isolates resistant to three or more commercial antifungal drugs were selected for this study. These isolates include Candida tropicalis (2), Candida albicans (2), Candida Parapsilosis (1) and Candida krusei (1). The plants used were Moringa oleifera leaves, Vernonia amygdalina and Ocimum gratissimum. The leaves were dried, pulverized and 300g of each was extracted using ethanol in a Soxhlet extractor at 70°C for 6hrs. The concentrated extract of each plant was reconstituted in Dimethyl sulfoxide and different concentrations of 400 mg/ml, 200 mg/ml, 100 mg/ml, 50 mg/ml, 25 mg/ml and 12.25 mg/ml were obtained using double fold serial dilution. The susceptibility of the Candida species to the ethanol plant extracts was carried out using the agar well diffusion method. The results showed that the Extract of Moringa oleifera had the highest inhibition zone diameter (19 mm) at 200 mg/ml against resistant Candida albicans1, followed by the extract of Vernonia amygdalina and Ocimum gratissimum with inhibition zone diameters of 18.67 mm and 18 mm at 100 mg/ml and 200 mg/ml respectively. Candida tropicalis1 was sensitive to all the plant extracts at all concentrations, while Candida parapsilosis was resistant to the extract of Ocimum gratissimum at all concentrations. The activity of the extracts of Moringa oleifera and Ocimum gratissimum against Candida tropicalis1 was concentration dependent. This study also revealed that Candida krusei was resistant to all the extracts of the plants at the highest concentration of 200 mg/ml. The antifungal activities of these plant extracts implies these plants have great therapeutic potential that can be harnessed. This study, thus, recommends that these plants be investigated further for possible use in the formulation of antifungal drugs especially, against those diseases caused by Candida species that have developed resistance to the commonly used antifungal drugs.

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Candida albicans and Staphylococcus aureus can coexist to form a biofilm, leading to infections associated with biofilms. Actinomycetes produce secondary metabolites known as antibiotics, antifungals, antibiofilm, anticancer, and antimalarials. This study was aimed to explore the antibiofilm activity of secondary metabolites of Actinomycetes InaCC A758 extracts (InaCC A758) against dual-species biofilms, i.e., C. albicans and S. aureus. Ethyl acetate and chloroform were used as solvents in a maceration extraction technique to isolate the compound designated InaCC A758. The fractionation of the InaCC A758 extracts was carried out using semi-preparative HPLC. Identification of the compounds from the InaCC A758 extracts was performed using gas chromatography-mass spectrometry analysis. Antimicrobial and antibiofilm testing of the InaCC A758 extracts was done utilizing the micro broth dilution method. The morphology of the biofilms following treatment with the InaCC A758 extracts was visualized using scanning electron microscopy (SEM). The minimum inhibitory concentration of InaCC A758 against dual-species biofilms was 400 ?g/ml. The concentrations of InaCC A758 required to inhibit 50% and 80% of dual-species biofilm formation (BIC50 and BIC80) ranged from 3.57–6.66 and 29.25–30.50 ?g/ml, respectively. The concentrations needed to reduce formed dual-species biofilms by 50% and 80% (BRC50 and BRC80) ranged from 100.62–131.85 and 596.4–849.6 ?g/ml, respectively. SEM observation showed a reduced number of cells and disruption of the cell membranes when exposed to the InaCC A758 extracts. The InaCC A758 contains seven compounds, i.e., dodecanoic acid 3-hydroxy-; 1,3,5-pentanetriol,3-methyl-; 1,3-dioxolane-4-methanol, 2-ethyl-; 2-cyclopropylcarbonyloxytridecane; 2-hepten-1- ol,(E); methyl 6-methyl heptanoate; and 11-octadecenoic acid, methyl ester. The InaCC A758 extract altered cell morphology and exhibited potential as an anti-biofilm agent, particularly against dual-species biofilms.

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Background: Fungal infections pose a significant public health concern due to the extended duration of treatment needed and the frequent reoccurrence of the disease. Objectives: This study was aimed to enhance the permeability of luliconazole with sustain release for prolonged period for the effective treatment of fungal infection by incorporating it into lipid based nanocarrier system. Methods: Luliconazole loaded leciplex were prepared by one step fabrication method using phospholipid, Dimethyldidodecyl ammonium bromide and transcutol P. The prepared leciplex were optimized by using Box Behnken statistical design. Furthermore, luliconazole loaded leciplex were incorporated into carbopol gel system and evaluated for various parameters. Results: The luliconazole loaded leciplex showed high entrapment efficiency (98.8% ± 1.2) and size were recorded around 428.11 nm with a polydispersity index value of 0.35 ± 0.12, along with zeta potential of +26.30 mV. The Transmission Electron Microscopy studies revealed the spherical morphology of the leciplex. The developed leciplex gel was evaluated for its pH, viscosity, spreadability, hardness and adhesiveness. Furthermore, in vitro and ex vivo release kinetics demonstrated the sustained drug release pattern. Moreover, histopathology studies conducted on the rat skin revealed that the prepared formulation was non - irritant and non – toxic. The antifungal assay of developed formulations (containing only 0.3 % w/v luliconazole) showed significantly greater antifungal activity against Candida albicans as compared to marketed formulation (containing 1 % w/v luliconazole). Conclusion: By taking all the results in to account it can be concluded that luliconazole loaded leciplex formulation is simple to prepare and showed excellent activity in against Candida albicans.

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The incidence of Candida utilis septicaemia is on the rise, particularly among immunocompromised neonates in neonatal intensive care units (NICUs). This case series presents three neonates admitted to the NICU, each with distinct clinical presentations. Methodologically, blood samples underwent comprehensive analysis, combining conventional microbiological techniques with automated systems for identi?cation and antifungal susceptibility testing. Results revealed Candida utilis as the causative agent, sensitive to multiple antifungal agents. Discussion highlights the signi?cance of accurate species identi?cation for effective treatment, particularly in the face of emerging antifungal resistance. The discussion also underscores the importance of surveillance for uncommon fungal pathogens to enhance management strategies and improve outcomes in NICU settings. This case series underscores the necessity of vigilant monitoring and targeted management to combat non-albicans candidiasis in vulnerable neonatal populations.

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Aim: Calendula officinalis and Lavendula angustifolia are traditional medicinal plants that have antifungal activity. A combination of these two plants has not been known for its activity against fungus. The present study deals with the formulation and evaluation of herbal topical Antifungal gel containing essential oils of both plants. Study Design: Proto type research design. Place and Duration of Study: Smt. R. D. Gardi Pharmacy College, Nyara- Rajkot. January 2024 to April 2024. Methodology: As 90% of skin infections are caused by Candida albicans, the antifungal activity of topical gel against this species was assessed. In this investigation, we created an antifungal herbal gel by combining carbopol 940 and other excipients with the essential oils of Calendula officinalis and Lavendula angustifolia in varying concentrations. For compatibility study, FTIR study would be done. Evaluation of Antifungal gel performed by using different tests likes, pH, Stability, Extrudability, Spreadability, Viscosity, Antifungal activity against Candida albicance, and in-vitro drug diffusion study. Results: As a result, the formulation's physiochemical characteristics, in vitro antifungal efficacy, and stability analysis (stable even after 30 days) were assessed. Every herbal gel formulation with a pH of 5–7 had favorable outcomes for physiochemical measures. Out of all the formulations, batch no 4 exhibited superior release characteristics (98 %) and zone of inhibition in comparison to the other formulated batches. The drug release profile of batch 4 showed great results. Conclusion: This is the first study on the scientific evaluation of Calendula officinalis and Lavendula angustifolia essential oil as a gel for antifungal activity. Thus this study reveals both good antifungals and in-vitro drug release; their essential oil may be formulated as Topical Gel Antifungal with satisfactory physicochemical parameters.

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Background: Candida-associated bloodstream infections (BSI) are one of the major causes of nosocomial mortality. The changing spectrum of candidemia with respect to increased isolation of non-albicans Candida (NAC) along with the susceptibility pattern underlines the necessity of rapid and appropriate diagnosis of pathogenic Candida along with antifungal susceptibility to institute prompt and appropriate antifungal therapy. Aims and Objectives: The aim of the present study is to determine the prevalence of Candida isolates causing BSI along with the changing trend of its species- specific aetiology and susceptibility pattern in a tertiary care hospital in Kolkata. Materials and Methods: Candida species isolated from positive blood cultures were speciated conventionally as per standard laboratory protocol. Virulence factors were determined phenotypically on sabouraud dextrose agar with blood, egg yolk agar, and tween 80 agar. Adherence and biofilm production were also detected. Antifungal susceptibility was performed by the disk diffusion method as per clinical and laboratory standards institute guidelines. Results: Out of a total of 3987 blood samples collected during a period of 1 year, 73 (1.83%) showed growth of Candida, among which the majority was NAC (61.64%). Out of them, Candida tropicalis (23.28%) was the predominant species, followed by Candida guilliermondii (19.18%). Males (61.64%) outnumbered females. Age groups <10 years were most affected. Major risk factors were prolonged intensive care unit stays, diabetes, and the presence of a central venous catheter. 93.15% of Candida produced hemolysin, 83.56% phospholipase, and 68.49% esterase. 79.45% of species showed adherence, and 52.05% produced biofilm. Antifungal susceptibility showed lower resistance to amphotericin B, where a higher incidence of azole resistance among NAC species was observed. Conclusion: The detection of Candida species along with their antifungal susceptibility will help in better comprehension of the changing patterns of Candida for better management and prognosis of patients.

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Abstract Objectives: Fungal infections (FI) pose a public health concern and significantly increase mortality rates, especially within Neonatal Intensive Care Units (NICU). Thus, this study aimed to investigate epidemiological indicators, risk factors, and lethality predictors associated with FI in a NICU. Methods: This study included 1,510 neonates admitted to the NICU of a reference hospital in Brazil between 2015 and 2022. Demographic data, such as sex, birth weight, gestational age, and use of invasive devices were analyzed. Results: Thirty neonates developed invasive FI, totaling 33 episodes and an incidence of 1.2 per 1,000 patient days. Candida albicans was the most frequent species (52.9 %), the bloodstream was the most affected site (78.9 %), and 72.7 % of infections occurred between 2015 and 2018. The lethality rate associated with FI was 33.3 %, and 90 % of deaths occurred within 30 days of diagnosis of infection. Weight < 750 g, prolonged hospital stay, use of parenteral nutrition, and broad-spectrum antimicrobials were independent risk factors for infection occurrence, especially glycopeptides and 4th generation cephalosporins, having a considerable role in the increase in fungal infections. Weight < 750 g was considered a significant predictor of lethality, and C. albicans had the highest lethality rate (40 %). Conclusion: These findings highlight the elevated lethality rate associated with these infections, reinforcing the importance of developing strategies to control FI within NICU.

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Background: Candida is opportunistic microorganisms in oral cavity, causes oral candidiasis. The presence of candida and subspecies in oral premalignant lesions may intensify the infection and transform pre malignant lesions into cancer. Objective: To isolate various types of candida species, among Oral submucous fibrosis (OSMF) and Oral lichen Planus (OLP) patients. Methodology: Total 60 individuals included and grouped as; OSMF (n=20) group A, Lichen Planus (n=10); group B and Controls (n=30) group C. Results: The higher candida carriage revealed in OSMF+ OLP groups (23.3%) as compared to controls (10%). The species level findings showed 13.3% of candida albicans in OSMF+ OLP and 6.7% in controls, candida krusei 6.7% in OSMF+ OLP and 3.3% in controls and non candida albicans were 10% in OSMF+ OLP and 6.7% in control group respectively. Conclusion: This basic understanding of candida species and their association with potentially malignant disorders will help in better interventions, so as to restrict the lesion before it transform in to malignancy.

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Abstract: Introduction: In hospitalized patients, candidemia accounts for considerable morbidity and mortality. Knowledge of local species epidemiology and antifungal susceptibility is important when considering therapy. This study was performed to speciate Candida isolates from inpatients admitted with blood stream infections in our hospital and to assess their risk factors. Materials and Methods: This present study of 2 years' duration was performed from April 2022 to March 2024. BacT/Alert aerobic culture bottle (bioMérieux, France) was used for all routine blood cultures and incubated for 5 days at 37°C. Any blood culture growing yeast was identified by Gram stain and MALDI-TOF MS (Bruker Daltonics). Disk diffusion method was used for antifungal susceptibility testing and test was performed according to clinical laboratory standard institute (CLSI) guidelines. Results: About 132 Candida isolates from blood were isolated in 2 years. Predominance of males (59%) was noted with the median age of 52 years. Majority were nonalbicans Candida (81.06 %) with C. tropicalis (31.81%) and C. auris (13.63%). Susceptibility to fluconazole and voriconazole was 100% for both C. albicans and C. tropicalis isolates. Fluconazole resistance of 11.77% and 100% was observed in C. parapsilosis and C. auris isolates respectively. Conclusion: The predominance of non-albicans Candida with increasing fluconazole resistance and isolation of C. auris as the third most common non-albicans Candida species in this study is of concern. Accurate identification of non-albicans Candida specially C. auris and strict infection control policies should be in place to combat the spread of C. auris in the hospital.

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In Côte d'Ivoire, as elsewhere in Africa, Solanum anguivi Lam is widely used in traditional medicine to treat bacterial and fungal infections. Given the importance of this plant, the extracts 70%, 80% and 100% from fresh and dried fruits was evaluated for the in vitro growth of two isolates of pathogenic fungi (Candida albicans and Trichophyton rubrum), as well as its anti-free radical activity. Antifungal tests were carried out by plating 1000 cells of each isolate on Sabouraud agar medium using the double dilution method in inclined tubes. Both extracts were active on the different strains tested, according to a dose-response relationship based on the principle of the method used. However, extracts from fresh fruit showed good activity on C. albicans, while the dried fresh fruit extracts were highly active on T. rubrum.

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Background: Vaginal miroflora plays an important role in maintaining healthy microenvironment. Lactobacilli are the dominant flora responsible for this. Any disturbance in balance of normal and abnormal flora leads to different types of vaginal infections like, vulvo-vaginal candidiasis, and bacterial vaginosis. Most common organisms causing vaginitis is Gardnerella vaginalis which causes bacterial vaginosis. Other organisms responsible for infections are, candida, trichomonas, and viruses. Abnormal growth of pathogenic bacteria during pregnancy can lead to various adverse pregnancy outcomes.Methods: This is an observational study conducted in a tertiary care hospital over a period of 6 months (January 2023 to June 2023). Overall, out of 135 women, sample of 120 women were taken and treated accordingly.Results: Among 120 women, 52 (43.3%) women had no growth on culture, while 20 patients (16.6%) showed growth of Klebsiella and 20 (16.6%) patient shows Candida and rest shows growth of other pathogen.Conclusions: In our study, half of the women were found to be with positive culture report, who shown improvement after treatment.

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Antifungal resistance remains a critical health challenge within dermatology and pharmaceutical research. This study aimed to enhance antifungal creams by investigating the effectiveness of fluconazole (FLZ) and fluconazole combined with silver metal colloid (FLZ-AgMC). Employing a 3² factorial design, systematic exploration was conducted to assess the influence of metal colloid concentration and stearic acid content on crucial cream attributes: viscosity, spreadability, and zone of inhibition ratio. Viscosity ranged from 56132 to 58700 cP, spreadability from 28.7 to 27.8 gm.cm/sec, and the zone of inhibition increased with metal colloid concentration. Optimized cream formulations were identified using Stat-Ease Design Expert version 7. Various FLZ and AgMC concentrations were evaluated for antifungal activity against Candida albicans, with FLZ-AgMC exhibiting significantly enhanced efficacy, as indicated by a larger inhibition zone compared to FLZ alone. The inhibitory zone ratio demonstrated a 35 to 40% improvement, indicating enhanced fungal growth inhibition. Skin permeation and ex-vivo studies confirmed that the optimized Fluconazole formulation followed the Higuchi Model (R2 = 0.9847). Silver metal colloid-containing formulations demonstrated superior antifungal efficacy against C. albicans. The impact of silver metal colloid and stearic acid on viscosity and spreadability was established, revealing key factors influencing the cream’s physical properties. This optimization approach highlights the potential for innovative antifungal formulations, contributing to improved patient care, user acceptability, and clinical application.

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Background: Candida is the most common cause of fungal oral lesion. Only few decades back, role of Candida in the process of infection was considered as passive and only host's organic weakness was the known mechanism. However, this concept is revamped recently and it is now stated that Candida can actively participate in the process of disease establishment and progression by aggression known as virulence factors. Bio?lm is one of the important virulence factors of Candida spp. The present study was conducted with an aim to evaluate bio?lm forming ability among Candida species isolated from various types of oral and maxillofacial lesions. Candida spp. isolated fromoral lesionswereMethodology: identi?ed upto species level by standard mycological protocol. Bio?lm formation was studied by Confocal Scanning Laser Microscope. Results: A total of 104 Candida spp. were isolated from patients with oral lesions. Leukoplakia, tobacco pouch keratosis and pseudomembranous whitish lesion were the common oral lesions. C. albicans were isolated from 83 (79.8%) patients with oral lesions whereas non-albicansCandida (NAC) spp. were isolated from 21 (20.2%) cases.A total of 80 (76.9%) Candida isolates from oral lesions showed bio?lm formation. As compared to other Candida spp., C. tropicalis showed high ability to form bio?lm. Candida isolates from oral lesions like leukoplakia and pseudomembranous whitish lesions showed maximum bio?lm formation Study of virulence factors like bio?lm formation will aid in better. Conclusion: understanding of association between oral lesions and Candida spp. It may be also facilitate to explore new therapeutic modalities in future.

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Background: The curry leaf is an Indonesian plant commonly utilized as a spice. Curry leaves are abundant in secondary metabolites, which endow this plant with numerous advantages, including antibacterial and antifungal properties, as well as the ability to reduce blood sugar levels and blood pressure. The objective of this study is to assess the efficacy of an ethanol extract derived from curry leaves in suppressing the proliferation of Pityrosporum ovale and Candida albicans fungus. Methods: The symbiotic properties and phytochemical composition of curry leaf simplisia were examined. The antifungal efficacy of the ethanol extract derived from curry leaves was evaluated against Pityrosporum ovale and Candida albicans using the disc diffusion method. Calculate the precise values of the minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC). Results: The simplisia of curry leaf fulfills the criteria for simplisia characterization. Curry leaves possess a variety of secondary metabolite chemicals, including alkaloids, flavonoids, tannins, saponins, glycosides, steroids, and triterpenoids. The activity against the inhibition of fungal growth of Pityrosporum ovale and Candida albicans can suppress fungal growth with inhibition zone diameters measuring 6.93±0.15 mm and 7.27±0.47 mm, respectively. The minimum lethal concentration of leaf ethanol extract for Pityrosporum ovale fungi is 8.75%, resulting in a decrease of 98.25%. For Candida albicans fungi, the minimum lethal concentration is 12.5%, resulting in a reduction of 98.37%. Conclusions: The ethanol extract derived from curry leaves has the ability to hinder the proliferation of Pityrosporum ovale and Candida albicans fungus.

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Resistance of antifungal therapeutics has been reported, for instance, azole antifungal against Candida and Aspergillus. The discovery of new antifungal agent is thus warranted. Lagerstreomia speciosa is a notable Asian medicinal plant with profound antidiabetic activity. We previously demonstrated that the plant extract and one of the active substances, corosolic acid, have potential inhibitory effects against methicillin-resistant Staphylococcus aureus and can potentiate cefotaxime. The current study investigated the antifungal activity of bark and leaf extracts against three clinical fungal isolates. Well diffusion and broth microdilution methods were employed to assess the antifungal activity of L. speciosa leaf and bark extracts against Candida albicans, Aspergillus fumigatus, and Aspergillus flavus isolated from patients in Jakarta. Candida albicans was susceptible to the leaf and bark extracts as evidenced by the inhibitory zone ? 20 mm and minimum inhibitory concentration (MIC) of the leaf extract was categorized as susceptible-dose dependent. Aspergillus fumigatus and A. flavus were also relatively susceptible to the leaf extract, while the MIC of the bark extract categorized as susceptible-dose-dependent against both fungus. Lagerstreomia speciosa is a potential antifungal agent with comparable activity to fluconazole; therefore, further bioassay-guided fractionation of both extracts is warranted to identify the antifungal compound.

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Background: Oil pulling is a traditional ayurvedic practice which uses edible oils for dental plaque control. Coconut oil is found to have anti-plaque and antimicrobial effects in oral cavity. Majority of the studies have used refined coconut oil. Very few studies have evaluated the wet processed virgin coconut oil which has the beneficial phytochemicals in an un-altered form for their anti-plaque and antimicrobial effects. Objective: To study the anti-plaque and anti- microbial effects of wet processed virgin coconut oil after 30 days of oil pulling. Methodology: A prospective interventional study was done on with 15 subjects. Plaque index, Streptococcus mutants and Candida albicans colony counts were done before and after 30 days of oil pulling using wet processed virgin coconut oil. Results: There was a statistically significant reduction in the plaque index (p=0.001), Streptococcus mutants colony counts (p=0.003) and Candida albicans colony counts (p=0.05) after 30 days of oil pulling using wet processed virgin coconut oil. Conclusion: The study demonstrated antiplaque and antimicrobial actions of wet processed virgin coconut oil when used in oil pulling. This can be due to the unique medium chain fatty acids present in coconut oil. This study demonstrates that oil pulling using wet processed virgin coconut oil can be an effective organic plaque control measure

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Background:Vulvovaginal candidiasis (VVC), one of the commonest fungal infections in women of reproductive age group, can become recurrent if not managed appropriately. Recently, production of biofilm, which reduces the susceptibility to anti-fungal agents, has also been implicated in its pathogenesis. Hence, thestudy was planned to determine the prevalence of VVC in cases of vulvovaginitis, identify the pre-dominant candida species,and find out their antifungal susceptibility pattern and to detect biofilm production in the candida isolates. Material And Methods:In this cross-sectional study, all isolates were identified and confirmed by various basic microbiological methods followed by the VITEK-2 system.Biofilm formation was detected by Congo red agar method and Tube method. Descriptive statistical methods were used to evaluate the data collected. Result:Out of total 25 patients, 7 were positive with VVC out of which 2 cases were caused by C.albicans and 5 by Candida Non Albicans (3 by C.glabrata and 2 by C.tropicalis). As compared to NAC, C. albicans is still partially sensitive to fluconazole. Fortunately, both C. albicans and C. tropicalis are still 100% sensitive to voriconazole although resistance has developed partially in C. glabrata. Biofilm production was observed in 3 cases. Conclusion:Majority of cases of VVC were due to NAC predominantly C. glabrata which has grave therapeutic implications as they show decreased susceptibility to all antifungals. Voriconazole is still effective but needs to be used rationally to avoid developing resistance to it also. The evidence of biofilm production could be an important contributor towards increased incidence ofantifungal drug resistance.

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Candida is one of the most common problems faced these days which require timely medical attention. We have aimed to identify the Candida albicans and non-albicans species of upper aerodigestive fungal infections and their antifungal drug’s susceptibility using various antifungal. Swab samples were collected from the upper aerodigestive area and by use of Sabouraud dextrose agar to identify Candida fungal growth. Albicans and non-albicans Candida species were identified by the use of candida differential agar media. Disk-diffusion method is used to evaluate antifungal susceptibility. Two hundred and fifty-two samples were identified with candidiasis. This study found that Candida albicans species are more in comparison to non-albicans species with a female predilection in upper aerodigestive candidiasis. All Candida isolates species showed the least resistant to itraconazole and amphotericin B whereas 60% maximum resistant to fluconazole by Candida tropicalis than 54% resistance to clotrimazole shown by Candida glabrata, resistance to nystatin 50% by Candida krusei, and resistance to ketoconazole 24% by C. tropicalis. Candida parapsilosis showed 100% susceptibility to miconazole, itraconazole, and amphotericin B. So, suggesting that empirical use of antifungal can be harmful to the patient and can lead to the growth of further development of more resistant strains of Candida and this study revealed that in Itraconazole and Amphotericin B is the most effective antifungals for upper aerodigestive candidiasis in comparison to fluconazole.

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Objective To study the antifungal effect of demethylzelamaldehyde in vitro. Methods The minimum inhibitory concentrations （MIC） of demethylzeylasteral and fluconazole against 23 fungal strains were determined by micro liquid dilution method. The synergistic index （FICI） of the two drugs was determined using a checkerboard micro liquid dilution method. The synergistic effect of the combination of the two drugs was visually verified by paper diffusion experiments. Finally, the cytotoxicity of demethylzelamaldehyde was determined by CCK-8 method. Results Demethylzelamaldehyde showed a broad spectrum of antifungal activity when used alone, with MICs ranging from 4 g/L to 32 g/L. When combined with fluconazole, the effective concentration of fluconazole could be reduced from over 64 g/L to 0.25 g/L, with FICI values ranging from 0.129 to 0.254, indicating the synergistic effect of the two drugs. The CCK-8 results showed that demethylzeylasteral exhibited cytotoxicity only at concentrations four times higher than the MIC value. Conclusion Demethylzelamaldehyde exhibited good antifungal effect and synergistic effect with fluconazole, and its toxicity was low.