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1.
BMC Microbiol ; 24(1): 154, 2024 May 04.
Article in English | MEDLINE | ID: mdl-38704559

ABSTRACT

BACKGROUND: Side effects associated with antimicrobial drugs, as well as their high cost, have prompted a search for low-cost herbal medicinal substances with fewer side effects. These substances can be used as supplements to medicine or to strengthen their effects. The current study investigated the effect of oleuropein on the inhibition of fungal and bacterial biofilm in-vitro and at the molecular level. MATERIALS AND METHODS: In this experimental study, antimicrobial properties were evaluated using microbroth dilution method. The effect of oleuropein on the formation and eradication of biofilm was assessed on 96-well flat bottom microtiter plates and their effects were observed through scanning electron microscopy (SEM). Its effect on key genes (Hwp1, Als3, Epa1, Epa6, LuxS, Pfs) involved in biofilm formation was investigated using the quantitative reverse transcriptase-polymerase chain reaction (RT-qPCR) method. RESULTS: The minimum inhibitory concentration (MIC) and minimum fungicidal/bactericidal concentration (MFC/MBC) for oleuropein were found to be 65 mg/ml and 130 mg/ml, respectively. Oleuropein significantly inhibited biofilm formation at MIC/2 (32.5 mg/ml), MIC/4 (16.25 mg/ml), MIC/8 (8.125 mg/ml) and MIC/16 (4.062 mg/ml) (p < 0.0001). The anti-biofilm effect of oleuropein was confirmed by SEM. RT-qPCR indicated significant down regulation of expression genes involved in biofilm formation in Candida albicans (Hwp1, Als3) and Candida glabrata (Epa1, Epa6) as well as Escherichia coli (LuxS, Pfs) genes after culture with a MIC/2 of oleuropein (p < 0.0001). CONCLUSIONS: The results indicate that oleuropein has antifungal and antibacterial properties that enable it to inhibit or destroy the formation of fungal and bacterial biofilm.


Subject(s)
Antifungal Agents , Biofilms , Candida albicans , Candida glabrata , Escherichia coli , Fluconazole , Iridoid Glucosides , Iridoids , Microbial Sensitivity Tests , Biofilms/drug effects , Biofilms/growth & development , Iridoid Glucosides/pharmacology , Candida glabrata/drug effects , Candida glabrata/physiology , Candida glabrata/genetics , Candida albicans/drug effects , Candida albicans/genetics , Candida albicans/physiology , Escherichia coli/drug effects , Escherichia coli/genetics , Iridoids/pharmacology , Fluconazole/pharmacology , Antifungal Agents/pharmacology , Drug Resistance, Fungal , Anti-Bacterial Agents/pharmacology , Microscopy, Electron, Scanning
2.
Arch Microbiol ; 206(6): 270, 2024 May 20.
Article in English | MEDLINE | ID: mdl-38767668

ABSTRACT

Candida tropicalis is a human pathogen and one of the most prevalent non-Candida albicans Candida (NCAC) species causing invasive infections. Azole antifungal resistance in C. tropicalis is also gradually increasing with the increasing incidence of infections. The pathogenic success of C. tropicalis depends on its effective response in the host microenvironment. To become a successful pathogen, cellular metabolism, and physiological status determine the ability of the pathogen to counter diverse stresses inside the host. However, to date, limited knowledge is available on the impact of carbon substrate metabolism on stress adaptation and azole resistance in C. tropicalis. In this study, we determined the impact of glucose, fructose, and sucrose as the sole carbon source on the fluconazole resistance and osmotic (NaCl), oxidative (H2O2) stress adaptation in C. tropicalis clinical isolates. We confirmed that the abundance of carbon substrates influences or increases drug resistance and osmotic and oxidative stress tolerance in C. tropicalis. Additionally, both azole-resistant and susceptible isolates showed similar stress adaptation phenotypes, confirming the equal efficiency of becoming successful pathogens irrespective of drug susceptibility profile. To the best of our knowledge, our study is the first on C. tropicalis to demonstrate the direct relation between carbon substrate metabolism and stress tolerance or drug resistance.


Subject(s)
Antifungal Agents , Candida tropicalis , Carbon , Drug Resistance, Fungal , Fluconazole , Microbial Sensitivity Tests , Oxidative Stress , Candida tropicalis/drug effects , Candida tropicalis/physiology , Antifungal Agents/pharmacology , Humans , Fluconazole/pharmacology , Carbon/metabolism , Candidiasis/microbiology , Osmotic Pressure , Glucose/metabolism , Sucrose/metabolism , Sucrose/pharmacology , Hydrogen Peroxide/pharmacology , Hydrogen Peroxide/metabolism , Fructose/metabolism , Fructose/pharmacology , Stress, Physiological
3.
Sci Rep ; 14(1): 11597, 2024 05 21.
Article in English | MEDLINE | ID: mdl-38773138

ABSTRACT

Candida is the most prevalent fungal bloodstream infection (BSI) with a high mortality rate among hospitalized patients. Another concern facing physicians is rising global incidence of drug-resistant Candida. This study aimed to characterize the prevalence, antifungal susceptibility, biofilm formation, and virulence genes (HWP1, ALS1, SAP2) of different Candida spp. isolated from patients with candidemia. 52 isolates of Candida spp. were identified from blood cultures by chromogenic Candida agar and confirmed by the VITEK 2 system. Isolates were tested for antifungal susceptibility by disk diffusion and VITEK 2 system. Biofilm formation and investigated genes were detected by the Congo red method and conventional PCR, respectively. Candida spp. caused 2.3% of detected BSIs, of which 32.7% were caused by Candida albicans (C. albicans) and 67.3% by non-albicans Candida (NAC), with the predominance of C. tropicalis (25%), followed by C. parapsilosis (17.3%), and C. krusei (13.5%). The susceptibility rates to fluconazole, voriconazole, caspofungin, micafungin, amphotericin B, and flucytosine were 64.7%, 76.5%, 100.0%, 100%, 100.0%, and 100.0% in C. albicans, while 53.6%, 71.4%, 91.4%, 91.4%, 94.3%, and 94.3% in NAC, respectively. Biofilm production, HWP1, ALS1, and SAP2 were detected in 70.6%, 82.4%, 76.5%, and 52.9% of C. albicans and 74.3%, 85.7%, 80.0%, and 48.6% of NAC, respectively. There is remarkable shift to NAC BSIs and high azole resistance. Antifungal stewardship and analysis of risk factors associated with this shift are needed.


Subject(s)
Antifungal Agents , Biofilms , Candida , Candidemia , Drug Resistance, Fungal , Microbial Sensitivity Tests , Humans , Candidemia/microbiology , Candidemia/drug therapy , Candidemia/epidemiology , Antifungal Agents/pharmacology , Biofilms/drug effects , Biofilms/growth & development , Candida/drug effects , Candida/isolation & purification , Candida/pathogenicity , Candida/genetics , Virulence Factors/genetics , Virulence , Female , Male , Middle Aged , Adult
4.
BMC Infect Dis ; 24(1): 506, 2024 May 21.
Article in English | MEDLINE | ID: mdl-38773459

ABSTRACT

BACKGROUND: The sharp increase in fungal infections, insufficient diagnostic and treatment capabilities for fungal infections, poor prognosis of patients with fungal infections as well as the increasing drug resistance of fungi are serious clinical problems. It is necessary to explore the implementation and evaluation methods of antifungal stewardship (AFS) to promote the standardized use of antifungal drugs. METHODS: The AFS programme was implemented at a tertiary first-class hospital in China using a plan-do-check-act (PDCA) quality management tool. A baseline investigation was carried out to determine the utilization of antifungal drugs in pilot hospitals, analyse the existing problems and causes, and propose corresponding solutions. The AFS programme was proposed and implemented beginning in 2021, and included various aspects, such as team building, establishment of regulations, information construction, prescription review and professional training. The management effectiveness was recorded from multiple perspectives, such as the consumption of antifungal drugs, the microbial inspection rate of clinical specimens, and the proportion of rational prescriptions. The PDCA management concept was used for continuous improvement to achieve closed-loop management. RESULTS: In the first year after the implementation of the AFS programme, the consumption cost, use intensity and utilization rate of antifungal drugs decreased significantly (P < 0.01). The proportion of rational antifungal drug prescriptions markedly increased, with the proportion of prescriptions with indications increasing from 86.4% in 2019 to 97.0% in 2022, and the proportion of prescriptions with appropriate usage and dosage increased from 51.9 to 87.1%. In addition, after the implementation of the AFS programme, physicians' awareness of the need to complete microbial examinations improved, and the number of fungal cultures and serological examinations increased substantially. Statistics from drug susceptibility tests revealed a decrease in the resistance rate of Candida to fluconazole. CONCLUSION: This study indicated that the combination of AFS and the PDCA cycle could effectively reduce antifungal consumption and promote the rational use of antifungal drugs, providing a reference for other health care systems to reduce the overuse of antifungal drugs and delay the progression of fungal resistance.


Subject(s)
Antifungal Agents , Antimicrobial Stewardship , Mycoses , Tertiary Care Centers , Antifungal Agents/therapeutic use , Humans , China , Mycoses/drug therapy , Mycoses/microbiology , Drug Resistance, Fungal , Drug Utilization/standards , Drug Utilization/statistics & numerical data
5.
Einstein (Sao Paulo) ; 22: eAO0138, 2024.
Article in English | MEDLINE | ID: mdl-38775603

ABSTRACT

OBJECTIVE: This study aimed to verify oral candidiasis, identify the causative species, and investigate the antifungal susceptibility of yeasts isolated from liver transplant patients. METHODS: A descriptive analysis of 97 patients who underwent liver transplantation was conducted at a hospital. Two clinical examinations (Collections A and B) of the oral cavity were performed. Oral material was collected from all patients, inoculated in Sabouraud Dextrose Agar, and incubated at 35℃ for 48 hours. Samples were identified by molecular sequencing of the internal trascribed space region of rDNA. RESULTS: An antifungal susceptibility test with fluconazole, amphotericin B, and micafungin was performed using the Clinical and Laboratory Standards Institute yeast broth microdilution method. Among the patients, 15 presented with oral candidiasis: eight in Collection A and seven in Collection B. The primary type of candidiasis was atrophic, followed by pseudomembranous candidiasis. The most prevalent species was Candida albicans (nine), followed by Candida glabrata (three), Candida tropicalis (two), and Candida dubliniensis (one). Regarding susceptibility to fluconazole, of the 15 samples, 11 were susceptible, three were susceptible in a dose-dependent manner, and one was resistant. CONCLUSION: The most commonly identified type of candidiasis was atrophic, with C. albicans and C. glabrata being the most prevalent causative species. One fluconazole-resistant isolate each of C. tropicalis and C. albicans were identified.


Subject(s)
Antifungal Agents , Candida , Candidiasis, Oral , Fluconazole , Liver Transplantation , Microbial Sensitivity Tests , Humans , Antifungal Agents/pharmacology , Antifungal Agents/therapeutic use , Liver Transplantation/adverse effects , Male , Candidiasis, Oral/microbiology , Candidiasis, Oral/drug therapy , Female , Middle Aged , Candida/drug effects , Candida/classification , Candida/isolation & purification , Fluconazole/pharmacology , Adult , Amphotericin B/pharmacology , Aged , Drug Resistance, Fungal , Micafungin/pharmacology , Micafungin/therapeutic use , Young Adult
6.
Mycopathologia ; 189(3): 45, 2024 May 11.
Article in English | MEDLINE | ID: mdl-38734753

ABSTRACT

INTRODUCTION: The global spread of Trichophyton indotineae presents a pressing challenge in dermatophytosis management. This systematic review explores the current landscape of T. indotineae infections, emphasizing resistance patterns, susceptibility testing, mutational analysis, and management strategies. METHODS: A literature search was conducted in November 2023 using Embase, PubMed, Scopus, and Web of Science databases. Inclusion criteria covered clinical trials, observational studies, case series, or case reports with T. indotineae diagnosis through molecular methods. Reports on resistance mechanisms, antifungal susceptibility testing, and management were used for data extraction. RESULTS AND DISCUSSION: A total of 1148 articles were identified through the systematic search process, with 45 meeting the inclusion criteria. The global spread of T. indotineae is evident, with cases reported in numerous new countries in 2023. Tentative epidemiological cut-off values (ECOFFs) suggested by several groups provide insights into the likelihood of clinical resistance. The presence of specific mutations, particularly Phe397Leu, correlate with higher minimum inhibitory concentrations (MICs), indicating potential clinical resistance. Azole resistance has also been reported and investigated in T. indotineae, and is a growing concern. Nevertheless, itraconazole continues to be an alternative therapy. Recommendations for management include oral or combination therapies and individualized approaches based on mutational analysis and susceptibility testing. CONCLUSION: Trichophyton indotineae poses a complex clinical scenario, necessitating enhanced surveillance, improved diagnostics, and cautious antifungal use. The absence of established clinical breakpoints for dermatophytes underscores the need for further research in this challenging field.


Subject(s)
Antifungal Agents , Drug Resistance, Fungal , Microbial Sensitivity Tests , Mutation , Tinea , Antifungal Agents/pharmacology , Antifungal Agents/therapeutic use , Humans , Drug Resistance, Fungal/genetics , Tinea/drug therapy , Tinea/microbiology , Trichophyton/drug effects , Trichophyton/genetics , Global Health
7.
Life Sci ; 348: 122699, 2024 Jul 01.
Article in English | MEDLINE | ID: mdl-38718854

ABSTRACT

AIMS: Azoles have been widely employed for the treatment of invasive fungal diseases; however, their efficacy is diminished as pathogenic fungi tolerate them due to their fungistatic properties. Geldanamycin (GdA) can render azoles fungicidal by inhibiting the ATPase and molecular chaperone activities of heat shock protein 90 (Hsp90). Nonetheless, the clinical applicability of GdA is restricted due to its cytotoxic ansamycin scaffold structure, its induction of cytoprotective heat shock responses, and the conservative nature of Hsp90. Hence, it is imperative to elucidate the mechanism of action of GdA to confer fungicidal properties to azoles and mitigate the toxic adverse effects associated with GdA. MATERIALS AND METHODS: Through various experimental methods, including the construction of gene-deleted Candida albicans mutants, in vitro drug sensitivity experiments, Western blot analysis, reactive oxygen species (ROS) assays, and succinate dehydrogenase activity assays, we identified Hsp90 client proteins associated with the tolerance of C. albicans to azoles. KEY FINDINGS: It was observed that GdA effectively hindered the entry of Hsp90 into mitochondria, resulting in the alleviation of inhibitory effect of Hsp90 on succinate dehydrogenase. Consequently, the activation of succinate dehydrogenase led to an increased production of ROS. within the mitochondria, thereby facilitating the antifungal effects of azoles against C. albicans. SIGNIFICANCE: This research presents a novel approach for conferring fungicidal properties to azoles, which involves specifically disrupting the interaction of between Hsp90 and succinate dehydrogenase rather than employing a non-specific inhibition of ATPase activity of Hsp90.


Subject(s)
Antifungal Agents , Azoles , Benzoquinones , Candida albicans , HSP90 Heat-Shock Proteins , Lactams, Macrocyclic , Reactive Oxygen Species , Succinate Dehydrogenase , Benzoquinones/pharmacology , Lactams, Macrocyclic/pharmacology , Candida albicans/drug effects , Antifungal Agents/pharmacology , HSP90 Heat-Shock Proteins/metabolism , Succinate Dehydrogenase/metabolism , Succinate Dehydrogenase/antagonists & inhibitors , Azoles/pharmacology , Reactive Oxygen Species/metabolism , Microbial Sensitivity Tests , Mitochondria/drug effects , Mitochondria/metabolism , Fungal Proteins/metabolism , Fungal Proteins/genetics , Drug Resistance, Fungal/drug effects
8.
Expert Rev Anti Infect Ther ; 22(5): 289-296, 2024 May.
Article in English | MEDLINE | ID: mdl-38720183

ABSTRACT

INTRODUCTION: In the face of increased frequency of non-albicans Candida vulvovaginitis (VVC) reported worldwide, there is a paucity of effective oral and topical antifungal drugs available. Drug selection is further handicapped by an absence of data of clinical efficacy of available antifungal drugs for these infections. AREAS COVERED: In this review, attention is directed at the cause of drug shortage as well as increased frequency of non-albicans Candida (NAC) vulvovaginitis. There is widespread recognition of reduced in vitro azole drug susceptibility in NAC species. Moreover, antifungal susceptibility tests have not been standardized or validated for NAC isolates, hence clinicians rely on an element of empiricism especially given the absence of randomized controlled comparative studies targeting NAC species. Clinical spectrum of NAC species isolates is highly variable with ongoing difficulty in determining a causal role in symptomatic patients. EXPERT OPINION: We have entered the era of demand for Candida species-specific therapy and although consensus treatment guidelines are emerging, new antifungal agents that target these multiple-azole resistant or relatively resistant vaginal NAC species are urgently needed.


Subject(s)
Antifungal Agents , Candida , Candidiasis, Vulvovaginal , Drug Resistance, Fungal , Microbial Sensitivity Tests , Humans , Candida/drug effects , Candida/isolation & purification , Antifungal Agents/administration & dosage , Antifungal Agents/pharmacology , Female , Candidiasis, Vulvovaginal/drug therapy , Candidiasis, Vulvovaginal/microbiology , Azoles/pharmacology , Azoles/administration & dosage , Species Specificity , Practice Guidelines as Topic
9.
Article in English | MEDLINE | ID: mdl-38710584

ABSTRACT

The growing prevalence of fungal infections alongside rising resistance to antifungal drugs poses a significant challenge to public health safety. At the close of the 2000s, major pharmaceutical firms began to scale back on antimicrobial research due to repeated setbacks and diminished economic gains, leaving only smaller companies and research labs to pursue new antifungal solutions. Among various natural sources explored for novel antifungal compounds, antifungal peptides (AFPs) emerge as particularly promising. Despite their potential, AFPs receive less focus than their antibacterial counterparts. These peptides have been sourced extensively from nature, including plants, animals, insects, and especially bacteria and fungi. Furthermore, with advancements in recombinant biotechnology and computational biology, AFPs can also be synthesized in lab settings, facilitating peptide production. AFPs are noted for their wide-ranging efficacy, in vitro and in vivo safety, and ability to combat biofilms. They are distinguished by their high specificity, minimal toxicity to cells, and reduced likelihood of resistance development. This review aims to comprehensively cover AFPs, including their sources-both natural and synthetic-their antifungal and biofilm-fighting capabilities in laboratory and real-world settings, their action mechanisms, and the current status of AFP research. ONE-SENTENCE SUMMARY: This comprehensive review of AFPs will be helpful for further research in antifungal research.


Subject(s)
Antifungal Agents , Biofilms , Fungi , Antifungal Agents/pharmacology , Antifungal Agents/chemistry , Antifungal Agents/therapeutic use , Biofilms/drug effects , Fungi/drug effects , Animals , Humans , Mycoses/drug therapy , Peptides/pharmacology , Peptides/chemistry , Drug Resistance, Fungal , Antimicrobial Peptides/pharmacology , Antimicrobial Peptides/chemistry
10.
PLoS One ; 19(5): e0303747, 2024.
Article in English | MEDLINE | ID: mdl-38776347

ABSTRACT

The transmembrane protein Agp2, initially shown as a transporter of L-carnitine, mediates the high-affinity transport of polyamines and the anticancer drug bleomycin-A5. Cells lacking Agp2 are hyper-resistant to polyamine and bleomycin-A5. In these earlier studies, we showed that the protein synthesis inhibitor cycloheximide blocked the uptake of bleomycin-A5 into the cells suggesting that the drug uptake system may require de novo synthesis. However, our recent findings demonstrated that cycloheximide, instead, induced rapid degradation of Agp2, and in the absence of Agp2 cells are resistant to cycloheximide. These observations raised the possibility that the degradation of Agp2 may allow the cell to alter its drug resistance network to combat the toxic effects of cycloheximide. In this study, we show that membrane extracts from agp2Δ mutants accentuated several proteins that were differentially expressed in comparison to the parent. Mass spectrometry analysis of the membrane extracts uncovered the pleiotropic drug efflux pump, Pdr5, involved in the efflux of cycloheximide, as a key protein upregulated in the agp2Δ mutant. Moreover, a global gene expression analysis revealed that 322 genes were differentially affected in the agp2Δ mutant versus the parent, including the prominent PDR5 gene and genes required for mitochondrial function. We further show that Agp2 is associated with the upstream region of the PDR5 gene, leading to the hypothesis that cycloheximide resistance displayed by the agp2Δ mutant is due to the derepression of the PDR5 gene.


Subject(s)
ATP-Binding Cassette Transporters , Cycloheximide , Protein Synthesis Inhibitors , Saccharomyces cerevisiae Proteins , Saccharomyces cerevisiae , Cycloheximide/pharmacology , Protein Synthesis Inhibitors/pharmacology , Saccharomyces cerevisiae Proteins/metabolism , Saccharomyces cerevisiae Proteins/genetics , ATP-Binding Cassette Transporters/metabolism , ATP-Binding Cassette Transporters/genetics , Saccharomyces cerevisiae/metabolism , Saccharomyces cerevisiae/drug effects , Saccharomyces cerevisiae/genetics , Up-Regulation/drug effects , Drug Resistance, Fungal/genetics , Drug Resistance, Fungal/drug effects , Gene Expression Regulation, Fungal/drug effects
11.
Med Mycol ; 62(5)2024 May 03.
Article in English | MEDLINE | ID: mdl-38734886

ABSTRACT

Despite previous reports on the emergence of Malassezia pachydermatis strains with decreased susceptibility to azoles, there is limited information on the actual prevalence and genetic diversity of azole-resistant isolates of this yeast species. We assessed the prevalence of azole resistance in M. pachydermatis isolates from cases of dog otitis or skin disease attended in a veterinary teaching hospital during a 2-year period and analyzed the ERG11 (encoding a lanosterol 14-α demethylase, the primary target of azoles) and whole genome sequence diversity of a group of isolates that displayed reduced azole susceptibility. Susceptibility testing of 89 M. pachydermatis isolates from 54 clinical episodes (1-6 isolates/episode) revealed low minimum inhibitory concentrations (MICs) to most azoles and other antifungals, but 11 isolates from six different episodes (i.e., 12.4% of isolates and 11.1% of episodes) had decreased susceptibility to multiple azoles (fluconazole, itraconazole, ketoconazole, posaconazole, ravuconazole, and/or voriconazole). ERG11 sequencing of these 11 azole-resistant isolates identified eight DNA sequence profiles, most of which contained amino acid substitutions also found in some azole-susceptible isolates. Analysis of whole genome sequencing (WGS) results revealed that the azole-resistant isolates from the same episode of otitis, or even different episodes affecting the same animal, were more genetically related to each other than to isolates from other dogs. In conclusion, our results confirmed the remarkable ERG11 sequence variability in M. pachydermatis isolates of animal origin observed in previous studies and demonstrated the value of WGS for disentangling the epidemiology of this yeast species.


We analyzed the prevalence and diversity of azole-resistant Malassezia pachydermatis isolates in a veterinary hospital. A low prevalence of multi-azole resistance (c.10% of isolates and cases) was found. Whole genome and ERG11 sequencing of resistant isolates revealed remarkable genetic diversity.


Subject(s)
Antifungal Agents , Azoles , Dog Diseases , Drug Resistance, Fungal , Genetic Variation , Malassezia , Microbial Sensitivity Tests , Dogs , Animals , Malassezia/genetics , Malassezia/drug effects , Malassezia/isolation & purification , Malassezia/classification , Azoles/pharmacology , Dog Diseases/microbiology , Dog Diseases/epidemiology , Antifungal Agents/pharmacology , Prevalence , Otitis/microbiology , Otitis/epidemiology , Otitis/veterinary , Dermatitis/microbiology , Dermatitis/veterinary , Dermatitis/epidemiology , Dermatomycoses/microbiology , Dermatomycoses/veterinary , Dermatomycoses/epidemiology , Whole Genome Sequencing , Sterol 14-Demethylase/genetics
12.
Mycopathologia ; 189(3): 40, 2024 May 05.
Article in English | MEDLINE | ID: mdl-38704798

ABSTRACT

Candida parapsilosis complex has recently received special attention due to naturally occurring FKS1 polymorphism associated with high minimal inhibitory concentrations for echinocandin and the increase of clonal outbreaks of strains resistant to commonly used antifungals such as fluconazole. Despite the previous fact, little is known about the genetic mechanism associated with echinocandin resistance. Therefore, the present study was designed to investigate the mechanism of acquired echinocandin resistance in C. parapsilosis complex strains. A total of 15 clinical C. parapsilosis complex isolates were sub-cultured for 30 days at a low concentration of micafungin at ½ the lowest MIC value of the tested isolates (0.12 µg/ml). After culturing, all the isolates were checked phenotypically for antifungal resistance and genotypically for echinocandin resistance by checking FKS1 gene hot spot one (HS1) and HS2 mutations. In vitro induction of echinocandin resistance confirmed the rapid development of resistance at low concentration micafungin, with no difference among C. parapsilosis, C. metapsilosis, and C. orthopsilosis in the resistance development. For the first time we identified different FKS1 HS1 and or HS2 mutations responsible for echinocandin resistance such as R658S and L1376F in C. parapsilosis, S656X, R658X, R658T, W1370X, X1371I, V1371X, and R1373X (corresponding to their location in C. parapsilosis) in C. metapsilosis, and L648F and R1366H in C. orthopsilosis. Our results are of significant concern, since the rapid development of resistance may occur clinically after short-term exposure to antifungals as recently described in other fungal species with the potential of untreatable infections.


Subject(s)
Antifungal Agents , Candida parapsilosis , Drug Resistance, Fungal , Echinocandins , Microbial Sensitivity Tests , Drug Resistance, Fungal/genetics , Antifungal Agents/pharmacology , Echinocandins/pharmacology , Humans , Candida parapsilosis/genetics , Candida parapsilosis/drug effects , Candidiasis/microbiology , Fungal Proteins/genetics , Glucosyltransferases/genetics , Mutation, Missense , Micafungin/pharmacology , Mutation
13.
Mycoses ; 67(5): e13732, 2024 May.
Article in English | MEDLINE | ID: mdl-38712846

ABSTRACT

BACKGROUND: Triazole-resistant Aspergillus fumigatus (TRAF) isolates are a growing public health problem with worldwide distribution. Epidemiological data on TRAF is limited in Africa, particularly in West Africa. OBJECTIVES: This study aimed to screen for the environmental presence of TRAF isolates in the indoor air of two hospitals in Burkina Faso. MATERIALS AND METHODS: Air samples were collected in wards housing patients at risk for invasive aspergillosis, namely infectious diseases ward, internal medicine ward, nephrology ward, pulmonology ward, medical emergency ward and paediatric ward. Sabouraud Dextrose Agar supplemented with triazoles was used to screen the suspected TRAF isolates and EUCAST method to confirm the resistance of suspected isolates. Sequencing of cyp51A gene was used to identify the resistance mechanism of confirmed TRAF isolates. RESULTS: Of the 198 samples collected and analysed, 67 showed growth of A. fumigatus isolates. The prevalence of TRAF isolates was 3.23% (4/124). One TRAF isolate exhibited a pan-triazole resistance. Sequencing of cyp51A gene identified the TR34/L98H mutation for this pan-triazole resistant isolate. This study showed for the first time the circulation of the pan-azole resistant isolate harbouring the TR34/L98H mutation in Burkina Faso. CONCLUSIONS: These findings emphasise the need to map these TRAF isolates in all parts of Burkina Faso and to establish local and national continuous surveillance of environmental and clinical TRAF isolates in this country.


Subject(s)
Antifungal Agents , Aspergillus fumigatus , Cytochrome P-450 Enzyme System , Drug Resistance, Fungal , Fungal Proteins , Mutation , Triazoles , Aspergillus fumigatus/genetics , Aspergillus fumigatus/drug effects , Aspergillus fumigatus/isolation & purification , Drug Resistance, Fungal/genetics , Triazoles/pharmacology , Humans , Burkina Faso/epidemiology , Fungal Proteins/genetics , Antifungal Agents/pharmacology , Cytochrome P-450 Enzyme System/genetics , Microbial Sensitivity Tests , Aspergillosis/microbiology , Aspergillosis/epidemiology , Air Microbiology
14.
J Med Microbiol ; 73(5)2024 May.
Article in English | MEDLINE | ID: mdl-38771623

ABSTRACT

The emergent fungal pathogen Candida auris is increasingly recognised as an important cause of healthcare-associated infections globally. It is highly transmissible, adaptable, and persistent, resulting in an organism with significant outbreak potential that risks devastating consequences. Progress in the ability to identify C. auris in clinical specimens is encouraging, but laboratory diagnostic capacity and surveillance systems are lacking in many countries. Intrinsic resistance to commonly used antifungals, combined with the ability to rapidly acquire resistance to therapy, substantially restricts treatment options and novel agents are desperately needed. Despite this, outbreaks can be interrupted, and mortality avoided or minimised, through the application of rigorous infection prevention and control measures with an increasing evidence base. This review provides an update on epidemiology, the impact of the COVID-19 pandemic, risk factors, identification and typing, resistance profiles, treatment, detection of colonisation, and infection prevention and control measures for C. auris. This review has informed a planned 2024 update to the United Kingdom Health Security Agency (UKHSA) guidance on the laboratory investigation, management, and infection prevention and control of Candida auris. A multidisciplinary response is needed to control C. auris transmission in a healthcare setting and should emphasise outbreak preparedness and response, rapid contact tracing and isolation or cohorting of patients and staff, strict hand hygiene and other infection prevention and control measures, dedicated or single-use equipment, appropriate disinfection, and effective communication concerning patient transfers and discharge.


Subject(s)
Antifungal Agents , COVID-19 , Candida auris , Candidiasis , Infection Control , Humans , Candidiasis/prevention & control , Candidiasis/epidemiology , Candidiasis/drug therapy , Candidiasis/microbiology , Infection Control/methods , Candida auris/drug effects , COVID-19/prevention & control , COVID-19/epidemiology , Antifungal Agents/therapeutic use , Antifungal Agents/pharmacology , England/epidemiology , Cross Infection/prevention & control , Cross Infection/epidemiology , Cross Infection/microbiology , SARS-CoV-2 , Drug Resistance, Fungal , Candida/drug effects , Candida/classification , Candida/isolation & purification , Disease Outbreaks/prevention & control
15.
Clin Lab ; 70(5)2024 May 01.
Article in English | MEDLINE | ID: mdl-38747929

ABSTRACT

BACKGROUND: Female vulvovaginitis was one of the most common gynecological diseases. It had a great negative impact on their work and quality of life. This retrospective study evaluated the clinical and laboratory data of patients with vulvovaginitis in Hangzhou, China. To analyze the clinical situation, species distribution and antibiotic resistance of pathogenic fungi and bacteria in 626 cases of vulvovaginitis in Hangzhou. Microorganism culture, identification, and antibiotic susceptibility testing were conducted. The study aimed to provide a theoretical value for an effective treatment of vulvovaginitis. METHODS: In total, 626 outpatients and inpatients diagnosed with vulvovaginitis were selected from January 2018 to January 2023. Data of all the patients were collected from the hospital's electronic medical records. Vaginal secretion was collected for testing and SPSS 25.0 software was used to perform statistical analysis. RESULTS: A total of 626 strains of fungi, Gram-positive, and -negative bacteria were detected. Clinical situations of patients infected with the top five pathogenic fungi and bacteria were analyzed. Pathogenic fungi and bacteria were slightly different in each age group and in each onset time group. The results of antibiotic susceptibility testing showed that the resistance rates of itraconazole and fluconazole were high and Gram- negative and -positive bacteria were multidrug resistant. Gram-negative bacteria were more sensitive to carbenicillins and compound antibiotics, while Gram-positive bacteria were sensitive to rifampicin and daptomycin. MRSA and non vancomycin-resistant strains were detected. CONCLUSIONS: Fungi and bacteria were usually detected as pathogenes in patients with vulvovaginitis in Hangzhou. Some factors, such as age and onset time, often affected the incidence. Pathogenic fungi and bacteria were resistant to some common antibiotics, and clinical treatments should be carried out in a timely and reasonable manner according to the results of antibiotic susceptibility testing.


Subject(s)
Fungi , Microbial Sensitivity Tests , Vulvovaginitis , Humans , Female , China/epidemiology , Adult , Vulvovaginitis/microbiology , Vulvovaginitis/drug therapy , Vulvovaginitis/epidemiology , Vulvovaginitis/diagnosis , Retrospective Studies , Fungi/drug effects , Fungi/isolation & purification , Fungi/classification , Middle Aged , Young Adult , Adolescent , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Bacteria/drug effects , Bacteria/isolation & purification , Bacteria/classification , Drug Resistance, Fungal , Antifungal Agents/pharmacology , Antifungal Agents/therapeutic use , Drug Resistance, Bacterial , Aged
17.
Environ Microbiol ; 26(4): e16614, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38570900

ABSTRACT

Sustainable crop protection is vital for food security, yet it is under threat due to the adaptation of a diverse and evolving pathogen population. Resistance can be managed by maximising the diversity of selection pressure through dose variation and the spatial and temporal combination of active ingredients. This study explores the interplay between operational drivers for maximising the sustainability of management strategies in relation to the resistance status of fungal populations. We applied an experimental evolution approach to three artificial populations of Zymoseptoria tritici, an economically significant wheat pathogen, each differing in initial resistance status. Our findings reveal that diversified selection pressure curtails the selection of resistance in naïve populations and those with low frequencies of single resistance. Increasing the number of modes of action most effectively delays resistance development, surpassing the increase in the number of fungicides, fungicide choice based on resistance risk, and temporal variation in fungicide exposure. However, this approach favours generalism in the evolved populations. The prior presence of multiple resistant isolates and their subsequent selection in populations override the effects of diversity in management strategies, thereby invalidating any universal ranking. Therefore, the initial resistance composition must be specifically considered in sustainable resistance management to address real-world field situations.


Subject(s)
Drug Resistance, Fungal , Fungicides, Industrial , Drug Resistance, Fungal/genetics , Fungicides, Industrial/pharmacology , Plant Diseases/prevention & control , Plant Diseases/microbiology
18.
Pestic Biochem Physiol ; 201: 105848, 2024 May.
Article in English | MEDLINE | ID: mdl-38685210

ABSTRACT

Fusarium asiaticum is a destructive phytopathogenic fungus that causes Fusarium head blight of wheat (FHB), leading to serious yield and economic losses to cereal crops worldwide. Our previous studies indicated that target-site mutations (K216R/E, S217P/L, or E420K/G/D) of Type I myosin FaMyo5 conferred high resistance to phenamacril. Here, we first constructed one sensitive strain H1S and three point mutation resistant strains HA, HC and H1R. Then we conducted comparative transcriptome analysis of these F. asiaticum strains after 1 and 10 µg·mL-1 phenamacril treatment. Results indicated that 2135 genes were differentially expressed (DEGs) among the sensitive and resistant strains. The DEGs encoding ammonium transporter MEP1/MEP2, nitrate reductase, copper amine oxidase 1, 4-aminobutyrate aminotransferase, amino-acid permease inda1, succinate-semialdehyde dehydrogenase, 2, 3-dihydroxybenzoic acid decarboxylase, etc., were significantly up-regulated in all the phenamacril-resistant strains. Compared to the control group, a total of 1778 and 2097 DEGs were identified in these strains after 1 and 10 µg·mL-1 phenamacril treatment, respectively. These DEGs involved in 4-aminobutyrate aminotransferase, chitin synthase 1, multiprotein-bridging factor 1, transcriptional regulatory protein pro-1, amino-acid permease inda1, ATP-dependent RNA helicase DED1, acetyl-coenzyme A synthetase, sarcoplasmic/endoplasmic reticulum calcium ATPase 2, etc., showed significantly down-regulated expression in phenamacril-sensitive strain but not in resistant strains after phenamacril treatment. In addition, cyanide hydratase, mating-type protein MAT-1, putative purine nucleoside permease, plasma membrane protein yro2, etc., showed significantly co-down-regulated expression in all the strains after phenamacril treatment. Taken together, This study provides deep insights into the resistance regulation mechanism and the inhibitory effect of fungicide phenamacril and these new annotated proteins or enzymes are worth for the discovery of new fungicide targets.


Subject(s)
Drug Resistance, Fungal , Fungicides, Industrial , Fusarium , Fusarium/drug effects , Fusarium/genetics , Fungicides, Industrial/pharmacology , Drug Resistance, Fungal/genetics , Gene Expression Profiling , Transcriptome/drug effects , Gene Expression Regulation, Fungal/drug effects , Plant Diseases/microbiology , Fungal Proteins/genetics , Fungal Proteins/metabolism
19.
Pestic Biochem Physiol ; 201: 105862, 2024 May.
Article in English | MEDLINE | ID: mdl-38685239

ABSTRACT

Phomopsis longicolla, a causal agent of soybean root rot, stem blight, seed decay, pod and stem canker, which seriously affects the yield and quality of soybean production worldwide. The phenylpyrrole fungicide fludioxonil exhibits a broad spectrum and high activity against phytopathogenic fungi. In this study, the baseline sensitivity of 100 P. longicolla isolates collected from the main soybean production areas of China to fludioxonil were determined. The result showed that the EC50 values of all the P. longicolla isolates ranged from 0.013 to 0.035 µg/ml. Furthermore, 12 fludioxonil-resistance (FluR) mutants of P. longicolla were generated from 6 fludioxonil-sensitive (FluS) isolates. and the resistance factors (RF) of 12 FluR mutants were >3500. Sequence alignment showed that multiple mutation types were found in PlOS1, PlOS4 or/and PlOS5 of FluR mutants. All the FluR mutants exhibited fitness penalty in mycelial growth, conidiation, virulence and osmo-adaptation. Under fludioxonil or NaCl treatment condition, the glycerol accumulation was significantly increased in FluS isolates, but was slightly increased in FluR mutants, and the phosphorylation level of most FluR mutants was significantly decreased when compared to the FluS isolates. Additionally, positive cross-resistance was observed between fludioxonil and procymidone but not fludioxonil and pydiflumetofen, pyraclostrobin or fluazinam. This is first reported that the baseline sensitivity of P. longicolla to fludioxonil, as well as the biological and molecular characterizations of P. longicolla FluR mutants to fludioxonil. These results can provide scientific directions for controlling soybean diseases caused by P. longicolla using fludioxonil.


Subject(s)
Ascomycota , Dioxoles , Drug Resistance, Fungal , Fungicides, Industrial , Pyrroles , Pyrroles/pharmacology , Fungicides, Industrial/pharmacology , Drug Resistance, Fungal/genetics , Dioxoles/pharmacology , Ascomycota/drug effects , Ascomycota/genetics , Ascomycota/metabolism , Mutation , Fungal Proteins/genetics , Fungal Proteins/metabolism , Plant Diseases/microbiology , Glycine max/microbiology , Glycine max/drug effects
20.
Pestic Biochem Physiol ; 201: 105876, 2024 May.
Article in English | MEDLINE | ID: mdl-38685244

ABSTRACT

Black shank, a devastating disease in tobacco production worldwide, is caused by the oomycete plant pathogen Phytophthora nicotianae. Fluopicolide is a pyridinylmethyl-benzamides fungicide with a unique mechanism of action and has been widely used for controlling a variety of oomycetes such as Plasmopara viticola, Phytophthora infestans, Pseudoperonospora cubensis, P. nicotianae and Bremia lactucae. However, the fluopicolide-resistance risk and molecular basis in P. nicotianae have not been reported. In this study, the sensitivity profile of 141 P. nicotianae strains to fluopicolide was determined, with a mean median effective concentration (EC50) value of 0.12 ± 0.06µg/mL. Five stable fluopicolide-resistant mutants of P. nicotianae were obtained by fungicide adaptation, and the compound fitness index of these resistant mutants were lower than that of their parental isolates. Additionally, cross-resistance tests indicated that the sensitivity of fluopicolide did not correlate with other oomycete fungicides, apart from fluopimomide. DNA sequencing revealed two point mutations, G765E and N769Y, in the PpVHA-a protein in the fluopicolide-resistant mutants. Transformation and expression of PpVHA-a genes carrying G765E and N769Y in the sensitive wild-type isolate confirmed that it was responsible for fluopicolide resistance. These results suggest that P. nicotianae has a low to medium resistance risk to fluopicolide in laboratory and that point mutations, G765E and N769Y, in PpVHA-a are associated with the observed fluopicolide resistance.


Subject(s)
Fungicides, Industrial , Mutation , Nicotiana , Phytophthora , Plant Diseases , Phytophthora/drug effects , Phytophthora/genetics , Nicotiana/microbiology , Fungicides, Industrial/pharmacology , Plant Diseases/microbiology , Benzamides/pharmacology , Pyridines/pharmacology , Drug Resistance, Fungal/genetics
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