Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 128
Article in English | WPRIM | ID: wpr-888786


Candida is an intractable life-threatening pathogen. Candida infection is extremely difficult to eradicate, and thus is the major cause of morbidity and mortality in immunocompromised individuals. Morevover, the rapid spread of drug-resistant fungi has led to significant decreases in the therapeutic effects of clinical drugs. New anti-Candida agents are urgently needed to solve the complicated medical problem. Natural products with intricate structures have attracted great attention of researchers who make every endeavor to discover leading compounds for antifungal agents. Their novel mechanisms and diverse modes of action expand the variety of fungistatic agents and reduce the emergence of drug resistance. In recent decades, considerable effort has been devoted to finding unique antifungal agents from nature and revealing their unusual mechanisms, which results in important progress on the development of new antifungals, such as the novel cell wall inhibitors YW3548 and SCY-078 which are being tested in clinical trials. This review will present a brief summary on the landscape of anti-Candida natural products within the last decade. We will also discuss in-depth the research progress on diverse natural fungistatic agents along with their novel mechanisms.

Antifungal Agents/pharmacology , Biological Products/pharmacology , Candida/drug effects , Candidiasis/drug therapy , Humans , Microbial Sensitivity Tests
J. oral res. (Impresa) ; 9(1): 57-62, feb. 28, 2020. graf, tab
Article in English | LILACS | ID: biblio-1151489


The ageing of population is increasing, and a great percentage of these patients wear removable prostheses, and can suffer denture stomatitis, a condition that has been associated with candidiasis. Aims: To evaluate in vitro the effectiveness of Copper Sulfate against Candida albicans in samples of heat-polymerized acrylic resin, compared to nystatin, sodium hypochlorite and chlorhexidine. Materials and Methods: Initially, the minimum inhibitory concentration (MIC) of copper sulfate for Candida albicans was determined by microdilution. Then, 54 resin samples were divided into 6 treatment groups corresponding to Nystatin 100.000 UI, Sodium Hypochlorite 0.5%, chlorhexidine 0.12%, Copper Sulfate 4.7µg/ml, Copper Sulfate 9.4µg/ml and physiological saline solution, in which samples were submerged for 6 hours. Resin samples were then washed and cultured on solid media at 37°C for 72 hours. The number of colony-forming units was determined using a Quebec colony counter. The statistical analysis was performed using the Kruskal-Wallis test and the Mann-Whitney U test. Results: Copper sulfate at a concentration of 9.4µg/ml presented a similar effectiveness as the other control products regarding the reduction in the number of colonies of Candida albicans post-treatment. Conclusion: The effectiveness of copper sulfate against Candida albicans on acrylic resin was similar to that of nystatin, sodium hypochlorite and chlorhexidine.

En las últimas décadas se ha observado un aumento de la población de adultos mayores, de los cuales un gran porcentaje es portador de prótesis removible, y dos tercios pueden sufrir estomatitis subprotésica, enfermedad que es asociada a infecciones como candidiasis. Objetivo: Evaluar la efectividad antimicótica in vitro del sulfato de cobre en placas de resinas acrílicas de termocurado inoculadas con Candida albicans, frente a Nistatina, Hipoclorito de Sodio y Clorhexidina. Material y Métodos: Inicialmente, y mediante microdilución del sulfato de cobre, se determinó la concentración mínima inhibitoria (CMI) para Candida albicans. En la fase experimental, 54 muestras de resina se dividieron en 6 grupos correspondientes a Nistatina 100.000 UI, Hipoclorito 0.5%, Clorhexidina 0.12%, Sulfato de Cu 4.7µg/ml, Sufato de Cu 9.4 µg/ml y suero fisiológico. Las muestras fueron sumergidas en estos agentes por 6 horas, para posteriormente ser lavadas y cultivada en medios solidos a 37°C por 72 horas. Luego se realizó el conteo de unidades formadoras de colonias mediante contador tipo Quebec. El análisis estadístico se realizó mediante la prueba de Kruskal-Wallis y la prueba U de Mann-Whitney. Resultado: El sulfato de cobre a una concentración de 9.4µg/ ml presentó una efectividad similar a los otros productos, en la reducción de colonias de Candida albicans. Conclusión: La efectividad del sulfato de cobre contra Candida albicans fue semejante a la de Nistatina, Hipoclorito y Clorhexidina.

Humans , Acrylic Resins , Candida albicans/drug effects , Copper Sulfate/pharmacology , Sodium Hypochlorite , Stomatitis, Denture , In Vitro Techniques , Candidiasis/drug therapy , Chlorhexidine , Culture Media
Rev. chil. infectol ; 36(6): 767-773, dic. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1058109


Resumen Candida auris es una levadura multi-resistente emergente con rápida diseminación mundial. Desde el primer reporte el 2009, varios aislados a través de los cinco continentes han sido identificados como agentes de infecciones asociadas a la atención en salud. Brotes independientes y simultáneos por C. auris se han vuelto prioridad para la comunidad hospitalaria y científica. Además, los errores en identificación y los perfiles de multi-resistencia, raramente observados para otras especies de Candida, resultan en una difícil erradicación y fallas terapéuticas frecuentes en infecciones por C. auris. Presentamos el primer aislamiento de una cepa de C. auris en un hospital en Santiago, en un paciente proveniente de la India, que fue admitido para tratamiento de su pie diabético. La cepa fue recuperada de un cultivo de tejido e identificada por VITEK® 2 Compact. La identificación de C. auris fue confirmada por MALDI-TOF MS y secuenciación. El aislado fue resistente a fluconazol y susceptible a anfotericina y caspofungina, según puntos de corte recomendados por el CDC. La emergencia de C. auris es alarmante debido a que el modo de transmisión dentro del ambiente hospitalario no es claro y probablemente es multifactorial.

Candida auris is an emerging multi-drug-resistant fungus that is rapidly spreading worldwide. Since the first reports in 2009, many isolates across five continents have been identified as agents of hospital-associated infections. Independent and simultaneous outbreaks of C. auris are becoming a major concern for healthcare and scientific community. Moreover, laboratory misidentification and multi-drug-resistant profiles, rarely observed for other non-albicans Candida species, result in difficult eradication and frequent therapeutic failures of C. auris infections. In this article we present the first case of isolation of a strain of C. auris at a hospital in Santiago, in a patient coming from India, who was admitted for treatment of diabetic foot complications. The strain was recovered from a tissue culture and identified by VITEK® 2 Compact. The accurate identification of C. auris was confirmed by means of MALDI-TOF MS and DNA sequence analysis. The isolate was resistant to fluconazole, retaining only susceptibility to amphotericin and caspofungin with MIC breakpoints recommended by CDC. The emergence of C. auris is alarming because the mode of transmission within the healthcare environment is not clear and is likely to be multifactorial.

Humans , Candida/genetics , Candidiasis/drug therapy , Microbial Sensitivity Tests , Chile , Antifungal Agents/therapeutic use , Antifungal Agents/pharmacology
Braz. j. microbiol ; 49(2): 212-219, Apr.-June 2018. tab
Article in English | LILACS | ID: biblio-889241


Abstract The evolution of microorganisms resistant to many medicines has become a major challenge for the scientific community around the world. Motivated by the gravity of such a situation, the World Health Organization released a report in 2014 with the aim of providing updated information on this critical scenario. Among the most worrying microorganisms, species from the genus Candida have exhibited a high rate of resistance to antifungal drugs. Therefore, the objective of this review is to show that the use of natural products (extracts or isolated biomolecules), along with conventional antifungal therapy, can be a very promising strategy to overcome microbial multiresistance. Some promising alternatives are essential oils of Melaleuca alternifolia (mainly composed of terpinen-4-ol, a type of monoterpene), lactoferrin (a peptide isolated from milk) and chitosan (a copolymer from chitin). Such products have great potential to increase antifungal therapy efficacy, mitigate side effects and provide a wide range of action in antifungal therapy.

Anti-Infective Agents/pharmacology , Biological Products/pharmacology , Candida/drug effects , Chitosan/pharmacology , Lactoferrin/pharmacology , Melaleuca/chemistry , Anti-Infective Agents/isolation & purification , Biological Products/isolation & purification , Candidiasis/drug therapy , Chitosan/isolation & purification , Lactoferrin/isolation & purification
Braz. j. infect. dis ; 22(1): 11-15, Jan.-feb. 2018. tab, graf
Article in English | LILACS | ID: biblio-951617


ABSTRACT Fluconazole is extensively used for the treatment of candidiasis and cryptococcosis. Among other factors, successful treatment is related to appropriate fluconazole levels in blood and cerebrospinal fluid. In the present study, fluconazole levels were determined in 15 patients, 14 of whom had AIDS and 13 had neurocryptococcosis. The only selection criterion was treatment with fluconazole, which was performed with a generic or similar form of the drug. Fluconazole level was determined by high performance liquid chromatography and the susceptibility profile of Cryptococcus spp. isolated from the patients was assessed by broth microdilution. Blood and cerebrospinal fluid fluconazole levels were found to be related to the fluconazole daily dose, and exceeded the minimum inhibitory concentration of this antifungal for the Cryptococcus spp. isolates. A good correlation was observed between serum and cerebrospinal fluid drug concentration. In conclusion, treatment with non-original fluconazole under usual medical practice conditions results in appropriate blood and cerebrospinal fluid levels of the drug for inhibiting Cryptococcus spp. susceptible to this antifungal drug. The relatively common failures of neurocryptococcosis treatment appear not to be due to insufficient fluconazole levels in the cerebrospinal fluid, especially with the use of daily doses of 400-800 mg.

Humans , Adult , Middle Aged , Fluconazole/cerebrospinal fluid , Fluconazole/blood , Cryptococcosis/drug therapy , Antifungal Agents/cerebrospinal fluid , Antifungal Agents/blood , Reference Values , Candidiasis/cerebrospinal fluid , Candidiasis/drug therapy , Candidiasis/blood , Microbial Sensitivity Tests , Fluconazole/administration & dosage , Chromatography, High Pressure Liquid , Treatment Outcome , AIDS-Related Opportunistic Infections/drug therapy , Statistics, Nonparametric , Cryptococcosis/cerebrospinal fluid , Cryptococcosis/blood , Cryptococcus/isolation & purification , Cryptococcus/drug effects , Dose-Response Relationship, Drug , Histoplasmosis/cerebrospinal fluid , Histoplasmosis/drug therapy , Histoplasmosis/blood , Antifungal Agents/administration & dosage
Arch. argent. pediatr ; 115(5): 307-310, oct. 2017. ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-887383


Las nuevas opciones de tratamiento prolongan la hospitalización y aumentan las infecciones intrahospitalarias bacterianas y fúngicas, pero también mejoran la sobrevida de los recién nacidos hospitalizados en la unidad de cuidados intensivos neonatales. Las infecciones fúngicas invasivas en neonatos están asociadas con una morbimortalidad significativa. También pueden diseminarse a órganos específicos y causar endocarditis, endoftalmitis, artritis séptica, nefropatía obstructiva y meningitis. En el caso de la endocarditis, se recomiendan tratamientos antimicóticos sistémicos agresivos y, en algunos casos, la intervención quirúrgica del neonato. Informamos el caso de un lactante prematuro, de bajo peso al nacer, con vegetación intracardíaca. Esta es una complicación rara y potencialmente mortal de infecciones fúngicas invasivas. El paciente recibió tratamiento con caspofungina y un activador tisular del plasminógeno recombinante, en vez de una intervención quirúrgica.

Developing treatment options have resulted in prolonged admission and increased bacterial and fungal nosocomial infections as well as improved survival in neonatal intensive care unit. Invasive fungal infections in newborns are associated with significant morbidity and mortality and can cause endorgan dissemination such as endocarditis, endophthalmitis, septic arthritis, obstructive nephropathy and meningitis. Endocarditis requires aggressive systemic antifungal therapy and sometimes surgical intervention in neonates. We report a low birth weight premature infant with intracardiac vegetation that is rare and a life-threatening complication of invasive fungal infections. He was treated with caspofungin and recombinant tissue plasminogen activator in stead of surgical intervention.

Humans , Male , Infant, Newborn , Candidiasis/drug therapy , Tissue Plasminogen Activator , Endocarditis/microbiology , Endocarditis/drug therapy , Echinocandins/therapeutic use , Lipopeptides/therapeutic use , Candida parapsilosis , Antifungal Agents/therapeutic use , Recombinant Proteins/therapeutic use , Infant, Very Low Birth Weight
Braz. j. infect. dis ; 21(1): 79-87, Jan.-Feb. 2017. tab, graf
Article in English | LILACS | ID: biblio-839188


Abstract The current increment of invasive fungal infections and the availability of new broad-spectrum antifungal agents has increased the use of these agents by non-expert practitioners, without an impact on mortality. To improve efficacy while minimizing prescription errors and to reduce the high monetary cost to the health systems, the principles of pharmacokinetics (PK) and pharmacodynamics (PD) are necessary. A systematic review of the PD of antifungals agents was performed aiming at the practicing physician without expertise in this field. The initial section of this review focuses on the general concepts of antimicrobial PD. In vitro studies, fungal susceptibility and antifungal serum concentrations are related with different doses and dosing schedules, determining the PD indices and the magnitude required to obtain a specific outcome. Herein the PD of the most used antifungal drug classes in Latin America (polyenes, azoles, and echinocandins) is discussed.

Humans , Antifungal Agents/pharmacokinetics , Polyenes/therapeutic use , Polyenes/pharmacokinetics , Aspergillosis/metabolism , Aspergillosis/drug therapy , Azoles/therapeutic use , Azoles/pharmacokinetics , Triazoles/therapeutic use , Triazoles/pharmacokinetics , Candidiasis/metabolism , Candidiasis/drug therapy , Microbial Sensitivity Tests , Area Under Curve , Dose-Response Relationship, Drug , Echinocandins/therapeutic use , Echinocandins/pharmacokinetics , Latin America , Antifungal Agents/therapeutic use
Clin. biomed. res ; 37(3): 247-254, 2017. tab
Article in English | LILACS | ID: biblio-859840


Candida auris is a multidrug-resistant emerging yeast, which was responsible for healthcare-associated infection outbreaks, and was cataloged as a new species in 2009, after being isolated from a patient's ear canal secretion in Japan. Since the notification of this first occurrence, numerous cases have been reported throughout the world, including Brazil. C. auris affects mainly inpatients, patients in intensive care units, exposed to broad-spectrum antifungal medications and who make use of vascular catheters. Currently, this yeast is one of the main responsible for invasive infections in hospitals and has been cause of concern by authorities and organs due to its rapid dissemination and difficult treatment caused by its low susceptibility to antifungal agents traditionally used in clinical practice. As a contributor to the severity of infections associated with C. auris, the transmission mechanism is still unknown, which implies in a lack of control of the microorganism and high mortality rates. Thus, this literature review presents relevant information in order to alert the importance of C. auris as an etiological agent of systemic infections, as well as its epidemiology and the real challenges of the treatment (AU)

Humans , Candida/pathogenicity , Candidiasis/epidemiology , Anti-Infective Agents/therapeutic use , Antifungal Agents/therapeutic use , Candida/drug effects , Candida/isolation & purification , Candidiasis/diagnosis , Candidiasis/drug therapy , Candidiasis/microbiology , Drug Resistance, Multiple, Fungal
Salud pública Méx ; 58(4): 446-452, jul.-ago. 2016. tab, graf
Article in Spanish | LILACS | ID: lil-795411


Resumen: Objetivo: Describir los patrones de resistencia bacteriana en cultivos de orina de pacientes de un hospital oncológico en la Ciudad de México, de 2004 a 2013. Material y métodos: Se obtuvo el porcentaje de susceptibilidad para diferentes antibióticos, describiendo por separado las bacterias multidrogorresistentes (MDR). Se analizaron por separado las cepas obtenidas de pacientes hospitalizados de las de la comunidad. Resultados: Se realizaron 51 202 cultivos, de los cuales se identificaron 14 480 bacterias (28.3%). De éstas, se reportaron 11 427 Gram negativos (78.9%); 2 080 Gram positivos (14.4%); y 973 (6.6%) levaduras. Escherichia coli fue el principal microorganismo aislado (56.1%); 24% de las cepas de la comunidad y 66% de las nosocomiales fueron productoras de beta-lactamasas de espectro extendido (BLEE). Klebsiella pneumoniae se identificó en 705 cultivos (4.8%), 115 de los cuales fueron BLEE (16%): 13.1% de la comunidad y 29.8% nosocomiales. Pseudomonas aeruginosa se identificó en 593 cultivos (4.1%): 9% de la comunidad y 51% nosocomiales. Conclusiones: Las cepas MDR son mucho más frecuentes en muestras de origen nosocomial. Es prioritario intensificar el uso racional de antibióticos en la comunidad y el programa de desescalamiento de antimicrobianos en el hospital.

Abstract: Objective: To describe the incidence and patterns of bacterial resistance in urine samples from a tertiary care oncology hospital in Mexico, from 2004 to 2013. Materials and methods: We included the strains obtained from urine cultures, describing separately multidrug-resistant (MDR) bacteria. We analyzed the susceptibility to different antibiotics. Results: 51 202 urine cultures were processed during the study; 14 480 (28.3%) cultures were positive. In 11 427 samples Gram negative (79%) were isolated, 2 080 Gram positive (14.4%), and 973 yeasts (6.6%). Escherichia coli was the most frequent bacteria identified (56.1%); 24% of the community strains and 65.7% of the nosocomial were extended-spectrum beta-lactamase producers (ESBL). Klebsiella pneumoniae was isolated in 705 samples (4.8%); 115 were ESBL (16%), 13.1% from community and 29.8% from nosocomial source. Pseudomonas aeruginosa was identified in 593 cultures (4.1%): 9% from community and 51% nosocomial. Conclusions: MDR bacteria were more frequent in nosocomial isolates. It should be a priority to intensify the rational use of antimicrobials in the community and antibiotic stewardship in the hospital.

Humans , Adult , Bacteriuria/microbiology , Urinary Tract Infections/microbiology , Urine/microbiology , Drug Resistance, Multiple, Bacterial , Neoplasms/epidemiology , Bacteriuria/epidemiology , Urinary Tract Infections/drug therapy , Urinary Tract Infections/epidemiology , Cancer Care Facilities , Candidiasis/drug therapy , Comorbidity , Cross Infection/drug therapy , Follow-Up Studies , Community-Acquired Infections/microbiology , Community-Acquired Infections/drug therapy , Tertiary Care Centers , Anti-Bacterial Agents/therapeutic use
Rev. cuba. plantas med ; 21(2): 168-180, abr.-jun. 2016. tab
Article in Portuguese | LILACS | ID: lil-788934


Introdução: espécies do gênero Piper são encontradas nas regiões tropicais do globo e possuem inúmeras indicações terapêuticas. Objetivos: avaliar a atividade antimicrobiana de extratos e frações de quatro espécies de Piper, além de dois flavonoides isolados de Piper montealegreanum e determinar a concentração inibitória mínima dos produtos ativos. Métodos: o material vegetal foi coletado em diferentes regiões do estado da Paraíba e na cidade de Belém (Pará) submetido à extração com etanol e partição com solventes em grau crescente de polaridade. Os flavonoides foram isolados por meio de técnicas cromatográficas. A avaliação da atividade antimicrobiana foi realizada pelo método de disco-difusão frente a três espécies bacterianas: Staphylococcus aureus ATCC 25923, Escherichia coli ATCC 25922, Pseudomonas aeruginosa ATCC 27853 e três espécies fúngicas: Candida albicans ATCC 76645, Candida tropicalis ATCC 13803 e Candida glabrata ATCC 15545. Resultados: quase metade dos produtos testados foi capaz de inibir o crescimento de S. aureus com halos de inibição variando entre 8-16 mm. O extrato etanólico bruto e as frações hexânica e CHCl3 das folhas de P. mollicomum mostraram atividade antibacteriana frente as três linhagens testadas. As frações hexânicas de P. arboreum, de P. caldense e de P. mollicomum apresentaram atividade antifúngica, enfatizando a formação do halo de inibição de 28 mm para a fração de P. mollicomum. Os dois flavonoides isolados de P. montealegreanum não apresentaram atividade antimicrobiana. Conclusões: os resultados preliminares deste estudo sugerem que alguns dos produtos obtidos das espécies de Piper são uma fonte promissora de compostos com atividade antimicrobiana(AU)

Introducción: el género Piper se encuentra en las regiones tropicales del mundo y numerosas indicaciones terapéuticas. Objetivos: evaluar la actividad antimicrobiana de extractos y fracciones de cuatro especies de Piper, además de dos flavonoides aislados de Piper montealegreanum y determinar la concentración inhibitoria mínima de los productos activos. Métodos: el material vegetal fue recolectado en diferentes regiones del estado de Paraíba y en Belém (Pará) y sometido a extracción con etanol y partición com disolventes en grado creciente de polaridad. Los flavonoides fueron aislados por medio de técnicas cromatográficas. La evaluación de la actividad antimicrobiana se realizó por el método de difusión en disco frente a tres especies bacterianas:Staphylococcus aureus ATCC 25923, Escherichia coli ATCC 25922, Pseudomonas aeruginosa ATCC 27853 y três especies de hongos: Candida albicans ATCC 76645, Candida tropicalis ATCC 13803 y Candida glabrata ATCC 15545. Resultados: casi la mitad de los productos ensayados fueron capaces de inhibir el crecimiento de S. aureus con zonas de inhibición entre 8-16 mm. Los extractos etanolicos crudo y fracciones hexano y CHCl3 de las hojas de P. mollicomum mostraron actividad antibacteriana contra todas las cepas probadas. Las fracciones hexano de P. arboreum, P. caldense y P. mollicomum mostraron actividad antifúngica, con énfasis en la zona de inhibición de 28 mm para la fracción de P. mollicomum. Los dos flavonoides aislados de P. montealegreanum no mostraron actividad antimicrobiana. Conclusiones: los resultados preliminares de este estudio sugieren que algunos de los productos obtenidos de especies de Piper son una fuente prometedora de compuestos con actividad antimicrobiana(AU)

Introduction: The species of the genus Piper are widely found in the tropical regions of the globe and have numerous therapeutic indications. Objective: To evaluate the antimicrobial activity of extracts and fractions of four species of Piper and two flavonoids isolated from Piper montealegreanum and determine the minimum inhibitory concentration of the active products. Methods: The plant material was collected in different regions of the state of Paraíba and in Belém (Pará) and subjected to extraction with ethanol and partition with solvents in increasing degree of polarity. Flavonoids were isolated through chromatographic techniques. The evaluation of antimicrobial activity was performed by disk diffusion method front the three bacterial species: Staphylococcus aureus ATCC 25923, Escherichia coli ATCC 25922, Pseudomonas aeruginosa ATCC 27853 and three fungi species: Candida albicans ATCC 76645, Candida tropicalis ATCC 13803 and Candida glabrata ATCC 15545. Results: Almost half of the products tested were able to inhibit the growth of S. aureus with inhibition zones between 8-16 mm. The crude ethanolic extract and hexane fractions and CHCl3 of P. mollicomum leaves showed antibacterial activity against all the tested strains. The hexane fractions of P. arboreum, P. caldense and P. mollicomum showed antifungal activity, emphasizing the formation of 28 mm inhibition zone for the fraction of P. mollicomum. The two flavonoids isolated from P. montealegreanum showed no antimicrobial activity. Conclusions: preliminary results suggest that some the products obtained from Piper species are a promising source of compounds with antimicrobial activity(AU)

Humans , Pseudomonas Infections/drug therapy , Staphylococcal Infections/drug therapy , Candidiasis/drug therapy , Piper/chemistry , Escherichia coli Infections/drug therapy , Anti-Infective Agents/therapeutic use
Rev. cuba. farm ; 49(4)oct.-dic. 2015. ilus
Article in Portuguese | LILACS, CUMED | ID: lil-780749


Introdução: o estudo com plantas medicinais tem sido usado para assistência médica e farmacêutica, mais principalmente utilizadas como forma alternativa ou complementar ao tratamento terapêutico. Objetivo: este trabalho teve como objetivo elucidar os principais metabólitos secundários e atividade antioxidante, bem como avaliar a atividade antifúngica e moduladora do extrato etanólico de folhas de Anadenanthera macrocarpa frente às linhagens do gênero Candida. Métodos: na elucidação dos constituintes químicos foi utilizado o método de Cromatografia Líquida de Alta Eficiência, sendo que a verificação da atividade antioxidante foi realizada por método de FRAP. A atividade antifúngica do extrato foi mensurada através da determinação da Concentração Inibitória Mínima, sendo a modulação realizada por ensaio de microdiluição, realizado para verificar as interações entre o produto natural e o antifúngico utilizando a amostra em uma concentração subinibitória. Resultados: demonstrou-se pela análise do Cromatografia Líquida de Alta Eficiência a presença de metabólitos secundários, como a: quercitrina, quercetina, isoquercitrina, apigenina, ácido gálico e ácido caféico. No ensaio FRAP, a redução ocorreu em uma equivalência de 2,72 mg de FeSO4 por g de extrato. Na avaliação da concentração inibitória mínima foram obtidos resultados ≥512 µg/mL e na avaliação dos ensaios para efeito modulador, o extrato etanólico não potencializou o efeito do antifúngico, não havendo nem sinergismo nem antagonismo. Conclusão: através dos resultados podemos concluir que o presente extrato pode ser uma alternativa terapêutica uma vez que possui constituintes químicos com reconhecidas atividades biológicas e antioxidantes com baixo potencial tóxico(AU)

Introduction: the study of medicinal plants has been used for medical and pharmaceutical services, but mainly used as an alternative or in addition to therapeutic treatment. Objective: this study aimed to elucidate the main secondary metabolites and antioxidant activity and to evaluate the antifungal and modulating activity of the ethanol extract from Anadenanthera macrocarpa leaves against genus Candida strains. Methods: the chemical component clearance was made by using high-performance liquid chromatography, and checking of the antioxidant activity was performed by FRAP method. The antifungal activity of the extract was measured by determining the minimum inhibitory concentration, the modulation performed by microdilution test, carried out to verify the interactions between the natural product and the antifungal product using the sample at a subinhibitory concentration. Results: high-performance liquid chromatography showed the presence of secondary metabolites, such as: quercitrin, quercetin, isoquercitrin, apigenin, caffeic acid and gallic acid. In the FRAP assay, the reduction was 2,72 mg per equivalence grams of FeSO4 extract. The results of the assessment of minimum inhibitory concentration were ?512 µg/mL and in the evaluation of tests for modulating effect, the extract ethanol did not potentiate the antifungal effect, with neither synergism nor antagonism. Conclusions: from the results we can conclude that this extract can be an alternative since it has chemical constituents with known biological activities and antioxidants with low toxic potential(AU)

Introducción: el estudio de las plantas medicinales se han utilizado para la asistencia médica y farmacéutica, la mayoría utiliza principalmente como una alternativa o complemento al tratamiento terapéutico. Objetivo: el objetivo del estudio para dilucidar los principales metabolitos secundarios y la actividad antioxidante, así como evaluar la actividad antifúngica modulando el extracto de etanol de Anadenanthera macrocarpa frente las cepas del género Candida. Métodos: el esclarecimiento de los componentes químicos se utilizó cromatografía líquida de alta eficiencia y la comprobación de la actividad antioxidante se realizó por el método FRAP. La actividad antifúngica del extracto se midió mediante la determinación de la concentración mínima inhibitoria, y la modulación realizó por la prueba de microdilución, llevado a cabo para comprobar las interacciones entre el producto natural y el antifúngico utilizando la muestra a una concentración subinibitória. Resultados: se demostró mediante análisis por cromatografía líquida de alta eficiencia, de la presencia de metabolitos secundarios, tales como: quercitrina, quercetina, isoquercitrina, apigenina, ácido gálico y ácido cafeico. El ensayo FRAP, la reducción fue de 2,72 mg por equivalencia g de FeSO4 extrato. Na evaluación de la concentración inhibitoria mínima se obtuvieron resultados ≥512 µg/mL y la evaluación de las pruebas para el efecto de modulación, el extracto etanol no potenció el efecto de antifúngico, ni con sinergismo o antagonismo. Conclusión: de los resultados se puede concluir que el extracto puede ser una terapia alternativa, ya que tiene componentes químicos con actividades biológicas reconocidas y antioxidantes con bajo potencial tóxico(AU)

Humans , Candidiasis/drug therapy , Plant Preparations/therapeutic use , Reference Drugs , Brazil , Chromatography, High Pressure Liquid/methods
Braz. j. infect. dis ; 17(3): 283-312, May-June 2013. tab
Article in English | SES-SP, LILACS, SES-SP | ID: lil-676866


Candida infections account for 80% of all fungal infections in the hospital environment, including bloodstream, urinary tract and surgical site infections. Bloodstream infections are now a major challenge for tertiary hospitals worldwide due to their high prevalence and mortality rates. The incidence of candidemia in tertiary public hospitals in Brazil is approximately 2.5 cases per 1000 hospital admissions. Due to the importance of this infection, the authors provide a review of the diversity of the genus Candida and its clinical relevance, the therapeutic options and discuss the treatment of major infections caused by Candida. Each topography is discussed with regard to epidemiological, clinical and laboratory diagnostic and therapeutic recommendations based on levels of evidence.

Humans , Antifungal Agents/therapeutic use , Candidiasis , Societies, Medical , Brazil , Candida/classification , Candidiasis/diagnosis , Candidiasis/drug therapy , Candidiasis/microbiology
Article in Portuguese | LILACS, BBO | ID: lil-673935


Objetivo: Avaliar clinicamente a condição odontológica de pacientes internados em Unidade de Terapia Intensiva (UTI). Método: Foi realizado estudo exploratório, descritivo e transversal com avaliação clínica odontológica de 50 pacientes internados em UTI do Hospital São Vicente de Paula (João Pessoa/PB). Foram coletados os dados dos prontuários médicos relativos à idade, sexo, fator causal da internação e comorbidades relacionadas a problemas pulmonares. A análise da condição bucal foi qualificada em três categorias: boa (condição aceitável de higiene sem sangramento ao toque ou focos de infecção aparentes); regular (paciente apresentava pouco sangramento ao toque e/ou candidíase observada clinicamente como placas esbranquiçadas sobre mucosa inalterada ou avermelhada, removidas mecanicamente); e ruim (presença de abscessos e candidíase disseminada incluindo orofaringe). Resultados: A idade média dos examinados era de 53,8 (±18,5) sendo 23 (46%) do sexo masculino. As causas das internações de 24 (48,0%) pacientes foram neurológicas e de 26 (52%) por problemas renais, cardíacos, metabólicos, respiratórios e septicemia. Foram registrados quadros de pneumonia em 56% dos pacientes. Quanto à distribuição das condições de saúde bucal, observaram-se porcentagens significativamente maiores (p menor que 0,001) da condição de higiene ruim, comparadas às outras condições.Conclusões: A maioria dos pacientes internados em Unidade de Terapia Intensiva apresentava condição odontológica ruim, e a candidíase foi a infecção mais prevalente.

Objective: To evaluate clinically the oral conditions of the patients admitted to an Intensive Care Unit (ICU). Method: An exploratory, descriptive and transversal study was developed with clinical oral evaluation of 50 patients admitted to the ICU of the São Vicente de Paula Hospital (João Pessoa, PB, Brazil). The data were collected from the medical files concerning age, gender, cause of admission and comorbidities relative to lung problems. The oral condition was classified into three categories: good (acceptable hygiene, no gingival bleeding to touch or visible infection foci); regular (little gingival bleeding to touch and/or clinically visible candidiasis as white plaques on healthy or reddish mucosa, removed mechanically) and poor (presence of abscesses and widespread candidiasis, including the oropharynx). Results: The mean age of the patients was 53.8 (±18.5) years, 23 (46%) of them being male. Twenty-four (48%) patients were hospitalized due to neurological causes and 26 (52%) due to kidney, cardiac, metabolic or respiratory problems and septicemia. Pneumonia was present in 56% of the patients. As for the oral health conditions, there were significantly higher percentages (p less than 0.001) of poor conditions compared with the other conditions. Conclusion: Most patients admitted to the ICU presented poor oral condition and candidiasis was the prevalent infection.

Humans , Male , Female , Inpatients , Intensive Care Units , Oral Health , Oral Hygiene , Brazil , Candidiasis/drug therapy , Cross-Sectional Studies/methods , Medical Records , Sex Distribution
Article in English | IMSEAR | ID: sea-145799


Fungal infections in humans occur as a result of defects in the immune system. An increasing emergence in oral Candidal and non-Candidal fungal infections is evident in the past decade owing to the rise in the immunodeficient and immunocompromised population globally. Oral Candidal infection usually involves a compromised host and the compromise may be local or systemic. Local compromising factors include decreased salivation, poor oral hygiene, wearing dentures among others while systemic factors include diabetes mellitus, nutritional deficiency, HIV infection/AIDS and others. Oral candidiasis is generally a localized infection and rarely appears as a systemic fungal disease whereas oral non-Candidal fungal infections are usually signs of disseminated disease. Some of the non-Candidal fungi that were once considered exotic and geographically restricted are now seen worldwide, beyond their natural habitat, probably attributed to globalization and travels. Currently infections from these fungi are more prevalent than before and they may present either as primary oral lesions or as oral manifestations of systemic mycoses. This review discusses the various predisposing factors, clinical presentations, clinical differential diagnosis, diagnosis and management of oral candidiasis, as well as briefly highlights upon a few of the more exotic non-Candidal fungi that infect the oral mucosa.

Candidiasis/drug therapy , Candidiasis/epidemiology , Candidiasis/etiology , Candidiasis/microbiology , Candidiasis/therapy , Humans , Mouth Mucosa/microbiology , Mycoses/drug therapy , Mycoses/epidemiology , Mycoses/etiology , Mycoses/microbiology , Mycoses/therapy , Oral Hygiene
Rev. bras. plantas med ; 14(3): 435-438, 2012. tab
Article in Portuguese | LILACS | ID: lil-658121


A candidíase vaginal é uma doença causada, na maioria das vezes, pelo fungo do gênero Candida sp, que habita o trato gastrintestinal e geniturinário da espécie humana e pode tornar-se patogênico sob determinadas condições. A maioria dos indivíduos desenvolve defesas imunológicas que impedem a proliferação e desenvolvimento de candidíase localizada ou disseminada. Embora a causa exata do aumento de espécies não-albicans seja desconhecida, há evidências de que a própria terapia antifúngica possa estar contribuindo para o processo. Linhagens de C. glabrata são mais resistentes aos imidazólicos do que a C. albicans, sendo necessária uma concentração 10 vezes superior de miconazol para eliminar a C. glabrata quando comparada a C. albicans. Foi realizado um antifungigrama testando o potencial de ação de produtos vegetais sobre o fungo Candida sp. Foi observado que, ocorreu inibição do fungo no contato com os extratos hidroglicólicos das plantas Arctium lappa L., Calendula officinalis L., Stryphnodendron adstringens (Mart.) Coville e Tabebuia avellanedae Lorentz ex Griseb. A importância deste trabalho reside na possibilidade de desenvolvimento de tratamento complementar, menos agressivo, de menor custo e sem toxidade, o que possibilitaria melhor qualidade de vida para portadoras de candidíase vaginal recorrente ou não.

Vaginal candidiasis is a disease caused, in most cases, by the fungus of the genus Candida sp., which inhabits the gastrointestinal and genitourinary tracts of the human species and can become pathogenic under certain conditions. Most individuals develop immune defenses that prevent the proliferation and the development of localized or disseminated candidiasis. Although the exact cause of the increase in non-albicans species is unknown, there is evidence that antifungal therapy itself may have contributed to it. Strains of C. glabrata are more resistant to imidazole than C. albicans, and a 10-fold higher concentration of miconazole is required to eliminate C. glabrata compared to C. albicans. Etest was performed by testing the action potential of plant products on the fungus Candida sp. Inhibition of the fungus occurred when it was in contact with the hydroglycol extracts of plants Arctium lappa L., Calendula officinalis L., Stryphnodendron adstringens (Mart.) Coville and Tabebuia avellanedae Lorentz ex Griseb. The importance of this study lies in the possibility of developing a complementary treatment, less aggressive, of lower cost and without toxicity, which would allow better life quality for women with vaginal candidiases that are recurrent or not.

Candidiasis/drug therapy , Plant Extracts/therapeutic use , Antifungal Agents/analysis , Arctium/metabolism , Calendula/metabolism , Fabaceae/metabolism , Mycoses/prevention & control , Tabebuia/metabolism
EMHJ-Eastern Mediterranean Health Journal. 2011; 17 (5): 425-430
in English | IMEMR | ID: emr-159061


This study was carried out from October 2003 to March 2007 to investigate susceptibility patterns to antifungals of Candida strains isolated from 410 immunocompromised patients in Shiraz, Islamic Republic of Iran. Patients were checked for systemic candidiasis. Fungal colonization was determined and clinical samples collected from those patients with clinical signs of infections were examined. The carbohydrate assimilation patterns of all 354 isolates were studied. Susceptibility of the isolates to antifungal agents was determined using the reference broth microdilution method. Candida Candida albicans was the species most often isolated. Voriconazole was highly active against all the isolates. Major resistance to itraconazole was observed in all Candida spp. Regular investigations into antifungal resistance in medical centres is highly recommended as this will result in more efficient management of invasive candidiasis in immunocompromised patients

Humans , Candidiasis/drug therapy , Candida albicans/drug effects , Antifungal Agents , Itraconazole , Immunocompromised Host , Fluconazole , Amphotericin B
Assiut Medical Journal. 2011; 35 (2): 239-246
in English | IMEMR | ID: emr-135787


To Assess the role of antifungal prophylaxis in decreasing Candida infection and colonization in severely neutropenic children with hematological malignancies. Sixty four patients with severe neutropenia are randomized equally into 2 groups on 1:1 basis either to receive fluconazole prophylaxis [study group], or to receive placebo [control group]. Fluconazole antifungal prophylaxis/ placebo It was continued for 6 weeks, and follow up of the patient done until either Prophylaxis success by recovery from severe neutropenia [ANC

Humans , Male , Female , Neutropenia/blood , Candidiasis/drug therapy , Fluconazole , Antifoaming Agents , Child
Article in English | WPRIM | ID: wpr-123275


Candida haemulonii, one of the non-albicans Candida species, is an emerging yeast pathogen that is known to be resistant to amphotericin B and other antifungal agents such as azoles. These anti-fungal agents have often been associated with clinical treatment failure, so no treatment regimen has been clearly established for invasive C. haemulonii infections. We investigated a catheter-related infection of C. haemulonii candidemia in an adult patient in long-term hospital care. In the early stages, the candidemia remained persistent despite treatment with fluconazole. However, after changing the antifungal agent to caspofungin, the candidemia was resolved. Fluconazole and amphotericin B are not reliable empirical antifungal agents for invasive C. haemulonii infections, as shown in previous case reports. An echinocandin such as caspofungin may be an appropriate empirical choice of antifungal agent for an invasive C. haemulonii infection.

Aged , Amphotericin B/therapeutic use , Antifungal Agents/therapeutic use , Candida/classification , Candidiasis/drug therapy , Catheter-Related Infections/drug therapy , Echinocandins/therapeutic use , Fluconazole/therapeutic use , Hospitals , Humans , Long-Term Care , Male , Phylogeny
Dermatol. argent ; 16(5): 337-343, sep.-oct. 2010. ilus, tab
Article in Spanish | LILACS | ID: lil-714928


La candidiasis sistémica constituye una importante causa de morbimortalidad en pacientes internados en centros de alta complejidad. Las expresiones cutáneas de la infección son múltiples y se observan en un pequeño porcentaje de pacientes. Se presentan cinco casos de candidiasis sistémica con compromiso cutáneo en pacientes inmunosuprimidos: un paciente trasplantado de médula ósea, dos pacientes con leucemia mieloide aguda, un caso de sepsis bacteriana y un paciente con linfoma linfocítico. Todos los pacientes presentaron fiebre persistente y lesiones cutáneas que se biopsiaron para estudio histológico y cultivo. La histopatología mostró seudohifas en tres de los casos. En los cultivos de piel se identificó a Candida tropicalis, Candida Krusei y Candida albicans en dos pacientes. El incremento de cepas resistentes hace necesario el empleo de nuevos antifúngicos como las equinocandinas para el tratamiento de esta entidad.

Systemic candidiasis is a signifi cant cause of morbidity and mortality in immunosuppressed hospitalized patients. Skin signs of systemic candi-diasis are numerous although they can be observed in a small percent-age of patients. We report fi ve cases of systemic candidiasis with cutaneous manifestations in immunosuppressed patients: one case of bone- marrow transplantation, two patients with acute myeloid leukaemia, one with bacterial sepsis and one patient with lymphocitic lymphoma. The patients presented persistent fever and cutaneous lesions. Skin biopsy for histopathological study and cultures were carried out. The histological examination showed yeasts in three of the cases. Skin culture revealed: Candida tropicalis, Candida krusei and Candida albicansin two cases. Due to the increase of resistant species new drugs such as echinocandins are currently available for the treatment of this entity.

Humans , Adult , Aged , Candidiasis/diagnosis , Candidiasis/microbiology , Candidiasis/drug therapy , Echinocandins/administration & dosage , Echinocandins/therapeutic use , Antifungal Agents/therapeutic use , Candida/classification , Fluconazole/therapeutic use , Immunocompromised Host , Skin/pathology
Article in English | IMSEAR | ID: sea-135459


Background & objective: In India, National AIDS Control Organization (NACO) introduced syndromic approach to treat patients with abnormal vaginal discharge without a need for laboratory tests. Simple tools like pH test and Whiff test can be done without high expertise, microscope and even speculum. This can improve diagnostic value of syndromic approach of abnormal vaginal discharge. The present study was conducted to evaluate sensitivity and specificity of pH test and Whiff test in diagnosis of abnormal vaginal discharge, considering microscopic diagnosis as gold standard. Methods: This prospective hospital-based study included 564 women with abnormal vaginal discharge. All women were subjected to gynaecological examination, pH test and Whiff test. The findings were compared with microscopic examination. Statistical analysis was done by calculating proportions, percentage, sensitivity and specificity. Results: Vaginitis was diagnosed in 301 (53.37%) women. Bacterial vaginosis (BV) was the commonest type of vaginitis (39.01%). Cervical erosion was the second most common cause (17.91%) and physiological discharge was the third (14.36%). pH > 4.5 and positive Whiff test had sensitivity of 94.09 per cent and specificity 87.5 per cent in diagnosing BV. Similarly pH < 4.5 and positive or negative Whiff test had sensitivity of 83.72 per cent in diagnosing candidiasis. Interpretation &conclusion: pH test and Whiff test can improve diagnostic value of speculum examination where microscope facilities are not available.

Adolescent , Adult , Anti-Bacterial Agents/therapeutic use , Candidiasis/diagnosis , Candidiasis/drug therapy , Female , Gynecology/methods , Humans , Hydrogen-Ion Concentration , India , Prospective Studies , Sensitivity and Specificity , Syndrome , Treatment Outcome , Trichomonas Vaginitis/diagnosis , Trichomonas Vaginitis/drug therapy , Trichomonas Vaginitis/microbiology , Vaginal Discharge/microbiology , Vaginosis, Bacterial/diagnosis , Vaginosis, Bacterial/drug therapy , Vaginosis, Bacterial/microbiology