Antifungal combination therapy in localized candidosis

A mouse model of localized candidosis in air-filled subcutaneous cysts imitating thrush has been developed. We have now tested various antifungal combinations in this animal model. Flucytosine (5-FC) + amphotericin B (Amph B) showed the highest efficacy, a clear additive or even synergistic effect was seen. The combination of 5-FC + imidazole or triazole derivative was less efficacious, an additive effect was rare. The combination of 5-FC + Amph B was also tested against Candida albicans strains showing various degrees of 5-FC-resistance. A significant reduction in 5-FC-resistant mutants was seen after the treatment with the combination.     

Therapy of systemic fungal infections

The incidence of both community-acquired and nosocomial fungal infections has significantly increased over the past several decades. The major factors for this increase are a heightened use of antibiotics, a growing population of the elderly and of immunocompromised patients as a result of HIV, cancer, and organ transplantation. In this article, we will review the indications, efficacy, and safety of the polyenes, imidazoles, triazoles, and other systemic antifungals in development that are used for systemic fungal infections.     

Systemic mycoses in the immunocompromised host: an update in antifungal therapy

Despite significant advances in the management of immunosuppressed patients, invasive fungal infections remain an important life-threatening complication. In the last decade several new antifungal agents, including compounds in pre-existing classes (new generation of triazoles, polyenes in lipid formulations) and novel classes of antifungals with a unique mechanism of action (echinocandins), have been introduced in clinical practice. Ongoing and future studies will determine their exact role in the management of different mycoses. The acceleration of antifungal drug discovery offers promise for the management of these difficult to treat opportunistic infections.     

Synthesis of some oxime ether derivatives of 1-(2-naphthyl)-2-(1,2,4-triazol-1-yl)ethanone and their anticonvulsant and antimicrobial activities

In this study, oxime and oxime ether derivatives of [1-(2-naphthyl)-2-(1,2,4-triazol-1-yl)ethanone] were prepared as potential anticonvulsant and antimicrobial compounds. The oxime was synthesized by the reaction of ketone and hydroxylamine hydrochloride. O-Alkylation of the oxime by various alkyl halides gave the oxime ether derivatives. Anticonvulsant activity of the compounds was determined by maximal electroshock and subcutaneous metrazole tests in mice and rats according to procedures of the Anticonvulsant Screening Program of National Institutes of Health. Neurotoxicity was determined by the rotorod test in mice and the positional sense test, gait and stance test in rats. In addition to anticonvulsant tests, all compounds were also evaluated against the following microorganisms: S. aureus, E. coli, P. aeruginosa, E. faecalis, C. albicans, C. parapsilosis, and C. krusei using microdilution broth method for possible antibacterial and antifungal activities. Although most of the O-alkyl substituted oxime ethers exhibited both anticonvulsant and antimicrobial activities, the O-arylalkyl substituted compounds were found to be inactive in both screening paradigms.     

Voriconazole for prophylaxis of invasive fungal infections after allogeneic hematopoietic stem cell transplantation

Introduction: Invasive fungal infections (IFIs) following allogeneic hematopoietic stem cell transplantation (alloHSCT) are associated with a high mortality, and accordingly most alloHSCT recipients receive prophylaxis with antifungal agents. Despite some improvement in outcomes of IFIs over time, they continue to represent substantial clinical risk, mortality, and financial burden.

Areas covered: We review the main pathogens responsible for IFIs in recipients of alloHSCT, current treatment recommendations, and discuss clinical and economic considerations associated with voriconazole prophylaxis of IFIs in these patients.

Expert commentary: The clinical efficacy of voriconazole appears to be at least equivalent to other antifungal treatments, and generally well tolerated. Overall, benefit-risk balance is favorable, and findings from cost-effectiveness analyses support the use of voriconazole prophylaxis of IFIs in recipients of alloHSCT.     

Low frequency of itraconazole resistance found among Aspergillus fumigatus originating from poultry farms in Southwest Poland

Aim

The aim of this study was to investigate the collection of avian Aspergillus fumigatus isolates for the presence of triazole resistance.

Efficient regioselective three-component domino synthesis of 3-(1,2,4-Triazol-5-yl)-1,3-thiazolidin-4-ones as potent antifungal and antituberculosis agents

In research for promising antibacterial and antifungal compounds, a series of 2‐aryl 3‐[1,2,4]triazol‐5‐yl 4‐thiazolidinones 1 were synthesized by a domino reaction of 5‐amino‐1H‐[1,2,4]triazoles 3 , aromatic aldehydes, and α‐mercaptoacids in boiling toluene in the presence of molecular sieves 4 Å. Of the twenty novel 3‐[1,2,4]triazol‐5‐yl 4‐thiazolidinone derivatives, four compounds 2‐benzo[d][1,3]dioxol‐6‐yl‐3‐[(3‐morpholin‐4‐yl)‐1H‐1,2,4‐triazol‐5‐yl)]‐1,3‐thiazolidin‐4‐one ( 1i ), 2‐(4‐chlorophenyl)‐5‐methyl‐3‐[3‐(4‐methylpiperazin‐1‐yl)‐1H‐1,2,4‐triazol‐5‐yl]‐1,3‐thiazolidin‐4‐one ( 1p ), 2‐benzo[d][1,3]dioxol‐6‐yl‐3‐[3‐(4‐methylpiperazin‐1‐yl)‐1H‐1,2,4‐triazol‐5‐yl]‐1,3‐thiazolidin‐4‐one ( 1s ), 2‐benzo[d][1,3]dioxol‐6‐yl‐5‐methyl‐3‐[3‐(4‐methylpiperazin‐1‐yl)‐1H‐1,2,4‐triazol‐5‐yl]‐1,3‐thiazolidin‐4‐one ( 1t ) exhibited MICs of 4 µg/mL or less versus Mycobacterium tuberculosis. Moreover, these compounds were screened against Candida albicans. Compounds 1p , 1s gave MICs of 1 µg/mL or less, and were fungicidal. Finally, compound 1s was evaluated against an expanded fungal panel and showed good activity against Cryptococcus neoformans. In addition, compound 1s also appeared to be fungicidal against Aspergillus arrhizus, with MIC <1 µg/mL.     

Green synthesis of novel antifungal 1,2,4-triazoles effective against γ-irradiated Candida parapsilosis

This study reports the green synthesis of 11 novel 3-substituted-4-amino-5-mercapto-1,2,4-triazole derivatives using water as a readily available nontoxic solvent. Evaluation of their antimicrobial potential against several clinical pathogenic microorganisms was carried out. The newly synthesized cysteine derivative 6 showed promising antifungal activity against both γ-irradiated and nonirradiated Candida parapsilosis 216, with the lowest MIC (minimum inhibitory concentration) value of 3.125 µg/ml, probably through inhibition of 14α-demethylase. In addition, compound 6 showed complete inhibition of gelatinase, a virulence enzyme of C. parapsilosis. Also, scanning electron microscopy was carried out. Interestingly, compound 6 acted as a dual agent as it also showed good antibacterial activity against strains of Gram-positive bacteria used in the study. The synthesized compounds showed no cytotoxicity.     

隐球菌抗原对隐球菌脑膜炎的早期诊断

为了提高隐球菌脑膜炎患者脑脊液检测的阳性率，首次使用隐球菌抗原乳胶凝结试验法，对１２例患者进行了检测，阳性率为１００％。该方法快速、敏感和可靠，是诊断隐球菌脑膜炎的一种新方法。