Possible role of azole and echinocandin lock solutions in the control of Candida biofilms associated with silicone

Until now, management of candidiasis related to implanted devices has remained problematic. The aim of this study was to investigate antifungal lock strategies against Candida albicans and Candida glabrata biofilms in vitro. Three antifungal agents were used against eight C. albicans and six C. glabrata clinical strains isolated from infected catheters. Caspofungin and micafungin, both echinocandins, as well as the azole posaconazole were tested. An in vitro model of Candida biofilm on 100% silicone catheters was used. Efficacy of the antifungal lock was tested against biofilms aged 12h and 5 days following exposure to caspofungin (5mg/L and 25mg/L), micafungin (5mg/L and 15 mg/L) and posaconazole (10mg/L) for 12h. Persistence of antibiofilm activity was investigated 1-3 days following drug elimination. Antifungal lock was considered effective in the event of a significant decrease (P<0.001) in the metabolic activity of the biofilm yeast. The results showed that micafungin had significant inhibitory effectiveness against young and mature C. albicans and C. glabrata biofilms. Moreover, this activity appeared to persist for up to 3 days. Caspofungin displayed similar activity against all C. albicans biofilms, but the activity was less persistent for C. glabrata biofilms. Posaconazole was less effective against C. albicans biofilms, but its activity was sustained. Echinocandin lock therapy could significantly enhance the management of candidiasis in patients with indwelling catheters by combating biofilms and enabling device maintenance in situ.     

The in vivo genotoxic effects of carvacrol and thymol in rat bone marrow cells

The aim of this study was to investigate the in vivo genotoxic effects of carvacrol and thymol in bone marrow cells of rats. In the present study, both carvacrol (10, 30, 50, and 70 mg/kg b.w.) and thymol (40, 60, 80, and 100 mg/kg b.w.) significantly induced the structural and total chromosome abnormalities (CA) for all treatment periods (6, 12, and 24 h) when compared with control in bone marrow cells of rats intraperitonally administered. Both carvacrol and thymol showed similar effects with the positive control urethane on induction of the percentage of structural and total CA at the highest concentrations except the effects of carvacrol for 6 h treatment (70 mg/kg b.w. and 100 mg/kg b.w., respectively). In addition, carvacrol induced the numerical CA at all concentrations when compared to control and at two highest concentrations (50 and 70 mg/kg b.w.) when compared to solvent control. Thymol also induced the numerical CA especially at the highest concentration (100 mg/kg b.w.) for all treatment periods. It was shown that there was a dose-dependent effect on induction of structural, numerical and total CA for both carvacrol and thymol. Carvacrol and thymol decreased the mitotic index (MI) in all the concentrations and treatment times when compared with control. Carvacrol showed the similar effects with EC on decreasing the MI at 70 mg/kg b.w. for 6 h, at 30 and 50 mg/kg b.w. for 12 h and at all concentrations for 24 h treatment periods. Thymol also showed a similar effect with urethane (ethyl carbamate, EC) on decreasing the MI at 60, 80, and 100 mg/kg b.w. for 6 h and at all concentrations for 24 h treatment periods. Test substances decreased the MI in a dose-dependent manner.     

Fungal biofilm inhibition by a component naturally produced by Candida albicans yeasts growing as a biofilm

The purpose of this work was to demonstrate production by the Candida yeasts growing as a biofilm of a compound that reduces candidal biofilm growth. An in vitro model of Candida albicans biofilm associated with silicone catheters was used. Supernatant medium recovered from 24-h-old C. albicans (ATCC 3153) biofilm (S24h) was added during the course of new biofilm formation by four C. albicans strains (182, 444, 2091 or ATCC 3153). Addition of S24h to adherent C. albicans cells induced an inhibition of biofilm growth (P<0.001) but displayed no activity on established biofilms. Ultrafiltration and purification assays demonstrated that the antagonistic molecule is hydrophilic and <3000Da in size.     

卡泊芬净对生物膜态白色念珠菌体外抑菌作用的试验研究

目的:检测卡泊芬净对生物膜态白色念珠菌分离株的抑菌作用,探讨临床治疗其相关感染的最适治疗剂量。方法:分别测定卡泊芬净对10株白色念珠菌临床株游离态及生物膜态的半数抑菌浓度(MIC50),并对比观察不同浓度卡泊芬净作用下白色念珠菌的增殖活性。结果:卡泊芬净对游离态白色念珠菌的MIC50为0.125～0.5mg.L-1,对生物膜态白色念珠菌的MIC50为0.25～256mg.L-1,当卡泊芬净浓度高于白色念珠菌MIC50时,全部游离态白色念珠菌的增殖活性几乎完全受到抑制,但有7株生物膜态白色念珠菌的增殖活性再次增强,且大于阳性对照的50%。结论:卡泊芬净对生物膜态白色念珠菌有抑菌作用,但并不呈浓度依赖性,当其用于治疗生物膜态白色念珠菌相关感染时的最适治疗剂量有待临床研究验证。     

Role of ethylene diamine tetra-acetic acid (EDTA) in catheter lock solutions: EDTA enhances the antifungal activity of amphotericin B lipid complex against Candida embedded in biofilm

Ethylene diamine tetra-acetic acid (EDTA) is an anticoagulant with antibiofilm-enhancing activity. We therefore used an in vitro biofilm model to determine the activity of amphotericin B lipid complex (ABLC) with or without EDTA against Candida embedded in biofilm on silicone disk surfaces. Clinical blood isolates from cancer patients infected with Candida albicans or Candida parapsilosis were used. Silicone disks were colonised with C. albicans or C. parapsilosis and were sequentially incubated in plasma and then in Mueller-Hinton broth containing 10(5) colony-forming units of each organism. All tests were performed in triplicate. The disks were subsequently placed and incubated for 6h and 8h in solutions containing ABLC alone, EDTA alone, ABLC+EDTA or broth (control). Disks were then removed, sonicated and colony counts were determined. ABLC+EDTA (30 mg/mL) was significantly more effective than ABLC, EDTA and control against C. parapsilosis at 6h (P < or = 0.01) and against C. albicans at 8h (P < or = 0.04). In patients with catheter-related candidaemia when catheter removal is not feasible, the combination of ABLC+EDTA may be considered for antifungal catheter lock solution as part of a catheter salvage therapy.     

Correlation between the chemical composition and the antimicrobial properties of seven samples of essential oils of endemic Thymes in Morocco against multi-resistant bacteria and pathogenic fungi

Thymus vulgaris, Thymus satureioides, and Thymus zygis are endemic Moroccan species that are intensively used due to their extensive medications and culinary properties. To enhance and preserve these overexploited species, the effect of provenance on the chemical composition of essential oils and antimicrobial activity against human pathogens were studied. Essential oils (EO) obtained by hydrodistillation from the flowering tops of thyme species were analyzed by GC-SM. The determination of minimum inhibitory (MIC), bactericidal (MBC), and fungicide (MFC) concentrations of EO were studied by microplate microdilution. The correlation between the chemical composition of EO and antimicrobial properties were evaluated using R software. The samples studied gave variable yields, ranging from 0.70 ± 0.03% to 4.12 ± 0.21%. The main constituents of Thymus vulgaris harvested from the municipality of El Hammam are carvacrol (68.8%), γ-terpinene (11.5%), and p-cymene (3.9%), while borneol (41.3% and 31.7%) and carvacrol (14.6% and 9.8%) are the most abundant in Thymus satureioides of the communes of Tata and Tigrigra respectively. For Thymus zygis, the results revealed the dominance of carvacrol (51.7% and 57.5%) for the municipalities of Tigrigra and Ain Aghbal, thymol (47.1% and 42.1%) for the municipalities of Bensmim and Timahdite respectively. These chemical profiles have similarities, but also reveal differences from the results given in the literature. In addition, the essential oils most active towards the microorganisms evaluated were those of Thymus vulgaris, followed by Thymus zygis and Thymus satureioides. These EO have very powerful MIC (MIC ? 300 μg/ml) against Gram-negative bacteria, and in particular, concerning Enterobacters cloacae, Citrobacter koseri, and Acinetobacter baumannii. Thymus zygis EO is the most active on candidates compared to Thymus vulgaris and Thymus satureioides EO, except Candida dubliniensis which was inhibited by Thymus satureioides EO from the commune of Azrou with a MIC = 18.75 μg/ml. The correlation determined between the major components and MIC showed that phenols have the strongest positive effects on antimicrobial properties, followed by terpenes and non-aromatic alcohols. In addition, different sensitivities of pathogens to chemical families have been observed against Enterobacter cloacae, Citrobacter koseri, Candida parapsilosis, Staphylococcus aureus multiresistant, Pseudomonas aeruginosa, Acinetobacter baumannii, and Aspergillus niger. Our results support the idea that these oils could be very useful in flavoring, food preservation, as well as a source of antimicrobial agents of great power against multidrug-resistant strains.     

Terpenes in propylene glycol as skin-penetration enhancers: permeation and partition of haloperidol,Fourier transform infrared spectroscopy,and differential scanning calorimetry

The respective alcoholic terpenes carvacrol, linalool, and alpha-terpineol were used at 5% w/v in propylene glycol (PG) to increase the in vitro permeation of haloperidol (HP) through human skin. The possible enhancement mechanism was then elucidated with HP-stratum corneum (SC) binding studies, Fourier transform infrared spectroscopy, and differential scanning calorimetry. The greatest increase in the permeation of HP was achieved with linalool followed by carvacrol and terpineol. HP permeation with linalool was predicted to reach a therapeutic plasma concentration and therapeutic daily-permeated amounts. Carvacrol increased lag time, which was attributed to slow redistribution of the enhancer within SC. Carvacrol increased the partition of the drug to the pulverized SC. Pure PG extracted lipids from SC but less than that achieved by the terpenes in PG. Terpenes extracted lipids to a similar extent. An increase in bilayer cohesion in the remaining lipids present in the SC could be attributed to the alignment of terpenes within the lipid bilayer. The higher permeation with linalool was attributed to its molecular orientation within the lipid bilayer. Terpenes showed different rates of SC dehydration but did not change the percentages of secondary structures of keratin.     

2—（2，4—二氟苯基）—3—（N—甲基—N—取代磺酰胺基）—1—（1H—1，2，4—三唑—1—基）—2—丙醇的合成和抗真菌活性的研究

本文设计合成了10个新的具有3－取代磺酰胺基－2－芳基－1－三唑基结构特征的三氮唑类化合物作为真菌细菌色素P450 14α－去甲基化酶的抑制剂。体外抗真菌活性试验表明化合物1b,1c,和1g对白色念珠菌,近平滑念珠菌和裴氏着色菌具有较强的抑菌活性,但总体来说活性不如酮康唑。与标准对照品氟康唑相比,化合物1b,1c和1g对近平滑念珠菌的作用分别比氟康唑强32倍,16倍和4倍;对裴氏着色菌的抑制作用分别双氟康唑强4倍,8倍和8倍。     

The efficiency of the benzothiazole APB, the echinocandin micafungin, and amphotericin B in fluconazole-resistant Candida albicans and Candida dubliniensis

This study presents the efficiency of the experimental antifungal agents 6-amino-2-n-pentylthiobenzothiazole (APB) and the echinocandin micafungin, and amphotericin B against fluconazole-resistant Candida albicans and Candida dubliniensis (MIC95 for fluconazole > 64 mg/l). The benzothiazole APB was less active against C. albicans and C. dubliniensis (MIC80 = 8 - 32 mg/l, MIC95 = 16 - 64 mg/l) than amphotericin B, which was efficient in a concentration range from 0.125 to 2 mg/l. However, the efficiency of micafungin was very high with MIC80, and MIC100 < or = 0.031 mg/l.     

Effects of terpenoid phenol derivatives on calcium current in canine and human ventricular cardiomyocytes

Concentration-dependent (10-1000 microM) effects of terpenoid phenol derivatives were studied on L-type Ca(2+) current in isolated canine and human ventricular cardiomyocytes using the whole-cell configuration of patch clamp technique. Carvacrol, thymol and eugenol suppressed peak Ca(2+) current at +5 mV, having EC(50) values and Hill coefficients of 98+/-11, 158+/-7 and 187+/-15 microM and 1.42+/-0.05, 2.96+/-0.43 and 1.6+/-0.1, respectively, in canine myocytes. Zingerone displayed a weak effect (estimated EC(50): 2+/-0.37 mM, Hill coefficient: 0.73+/-0.07), while vanillin and guaiacol failed to substantially modify Ca(2+) current up to the concentration of 1 mM. In addition to tonic block, thymol and carvacrol, but not eugenol, evoked marked rate-dependent block at 2 Hz. Carvacrol and eugenol accelerated inactivation of Ca(2+) current and caused leftward shift in the voltage dependence of steady-state inactivation without altering activation kinetics. Carvacrol, but not eugenol, increased the time constant of recovery from inactivation. These effects of carvacrol and eugenol developed rapidly and were largely reversible. In myocytes isolated from undiseased human hearts, the effect of carvacrol was similar to that observed in canine cells. It is concluded that suppression of cardiac Ca(2+) currents by phenol derivatives is influenced by the substituent in the benzene ring, and the blocking effect of these drugs may involve interactions with the inactivation machinery of the channel.     

Thymol inhibits Candida albicans biofilm formation and mature biofilm

Candida albicans has a high propensity to develop biofilms that are resistant to traditional antifungal agents. Thymol is credited with a series of pharmacological properties including antimicrobial and antifungal effects. As C. albicans biofilms are known to be important factors underlying its virulence and pathogenicity, the aim of this study was to investigate whether thymol can interfere with biofilm formation as well as acting on mature biofilms. Tests of C. albicans strains ATCC 3153A and ATCC MYA 2876 showed that thymol interferes with the starting phases of biofilm production as well as with mature C. albicans biofilms. The metabolic activity of sessile cells was reduced by >90% at twice the minimum inhibitory concentration of planktonic cells. As biofilm is a multifactorial phenomenon, the multiple mechanisms of thymol (terpenes) could act on different steps in the evolution of mature biofilm.     

In vitro activity of sertaconazole, fluconazole, ketoconazole, fenticonazole, clotrimazole and itraconazole against pathogenic vaginal yeast isolates

The in vitro activity of sertaconazole was compared with those of the most commonly used vaginal antimycotic agents--fluconazole, ketoconazole, fenticonazole, clotrimazole and itraconazole--against 94 strains of clinical isolates of Candida spp. using a macrodilution method in Casitone agar medium. The sertaconazole concentration (microgram/ml), at which 90% of the strains were inhibited, was 0.06 for C. albicans, 0.25 for C. glabrata and C. parapsilosis, 1 for C. krusei and 2 for C. tropicalis. These values show that sertaconazole is one of the most active products against yeasts causing vulvovaginal candidiasis, its activity against C. glabrata being particularly relevant.     

医院内泌尿系真菌感染的调查研究

目的对可疑泌尿系统真菌感染患者的尿液进行培养鉴定,了解患者泌尿系统真菌感染状况,为临床真菌感染的诊断提供病原学依据,指导治疗。方法按常规方法培养,沙堡弱培养基培养24h,将有酵母菌生长的标本接种于科玛嘉念珠菌显色培养基进行培养鉴定。结果440例标本中,真菌菌株51例,阳性率为11.59%;以白色念珠菌最多,占45%,依次为克柔念珠菌(18%),热带念珠菌(16%),光滑念珠菌(14%)等;科室分布以内分泌科发病率最高,占20%。结论医院内泌尿系真菌感染仍以白色念珠菌为主,各科室均有院内泌尿系真菌感染,发病年龄以老年人多见,女性多于男性。     

In vitro interactions of anidulafungin with azole antifungals, amphotericin B and 5-fluorocytosine against Candida species

Anidulafungin, an echinocandin, is in late stage development for the treatment of fungal infections. We investigated the activity of anidulafungin in combination with other antifungal agents (fluconazole, itraconazole, ketoconazole, amphotericin B and 5-fluorocytosine) against four isolates each of Candida albicans, Candida glabrata, Candida parapsilosis and Candida tropicalis, and two isolates of Candida krusei using a macrobroth chequerboard method with interactions evaluated by fractional inhibitory concentration indices (FICIs). Additive activity (FICI > 0.5 to 1) or indifference (FICI > 1 to < 4) was observed in 85 of 90 interactions of anidulafungin with another antifungal agent. Synergy with itraconazole (FICIor=4), a drug rarely used systemically, was noted for four strains of C. tropicalis. The combination of anidulafungin and amphotericin B demonstrated additive activity for each of the 18 isolates of Candida tested. These results suggest additional studies are warranted, for example in animal models, to evaluate further the potential of combination antifungal therapy with anidulafungin for Candida infections.     

In vitro activity of a new semisynthetic echinocandin, micafungin, against clinical isolates of Candida species isolated in Tenri Hospital

We have examined the antifungal activities of the available antifungal agents including micafungin (MCFG), one of the echinocandin antifungal group, against 92 yeast-like fungi isolated at our hospital during a 3-month period from November 2002 to February 2003. Determination of the antifungal susceptibility was conducted in conformity with the Standards of the Japanese Society for Medical Mycology. The MIC 80% of the antifungal agents against 4 fungi species including C. albicans (55 strains), C. tropicalis (20 strains), C. glabrata (8 strains), C. krusei (5 strains) were as follows; MCFG: 0.03-0.125 microgram/ml, amphotericin-B: 0.125-0.25 microgram/ml, 5-fluorocytosine: 0.125-16 micrograms/ml, itraconazole: 0.25-2 micrograms/ml, fluconazole: 0.5-32 micrograms/ml. The isolation rate of the drug-resistant fungi was 20% for the fluconazole (FLCZ)-resistant C. tropicalis and 33% when including the susceptible dose dependent (S-DD) class. The rate was 5% for FLCZ-resistant strains of C. albicans and 11% when including the S-DD class. However, MCFG was shown to have an excellent antifungal activity against those azole-resistant strains of Candida species. An analysis of the randomly amplified polymorphic DNA pattern (RAPD) was carried out to assess the fingerprinting of the azole-resistant strains. The results demonstrated a common pattern in 3 of the 6 strains of C. tropicalis that showed MIC of > or = 16 micrograms/ml for fluconazole, while all of the 6 strains of C. albicans demonstrated their respective patterns.     

Cognitive-enhancing activity of thymol and carvacrol in two rat models of dementia

This study evaluated the efficacy of thymol and carvacrol against cognitive deficits induced by amyloid β (Aβ) or scopolamine. Rats received bilateral intrahippocampal injections of Aβ(25-35) or intraperitoneal injections of scopolamine, and the effect of different doses of thymol, or carvacrol (0.5, 1, or 2 mg/kg) on cognitive function was determined. Animals were subjected to 5 days of training in the Morris water maze: 4 days with an invisible platform to test spatial learning and the 5th day with a visible platform to test motivation and sensorimotor coordination. The acute toxicities of thymol and carvacrol were also studied. The results showed increases in escape latency and decreases in target quadrant entries in Aβ or scopolamine-treated groups. These impairments were reversed by pretraining administration of either thymol or carvacrol. The calculated LD50's of thymol (565.7 mg/kg) and carvacrol (471.2 mg/kg) were found to be much higher than their therapeutic doses (thymol 0.5 mg/kg, carvacrol 1 mg/kg). These findings provide preliminary positive evidence for the effectiveness and safety of thymol and carvacrol in alleviating cognitive impairments caused by increased Aβ levels or cholinergic hypofunction. Anticholinesterase, antioxidant, and anti-inflammatory activities may be the mechanisms contributing toward their beneficial effects in these models.     

Inhibitory effects of Zataria multiflora essential oil and its main components on nitric oxide and hydrogen peroxide production in lipopolysaccharide-stimulated macrophages

Objectives Zataria multiflora is an aromatic plant that is used in flavouring and preserving foods and also used as an antispasmodic, anaesthetic and antinociceptive agent. In this study, the effects of Z. multiflora essential oil on nitric oxide (NO) and hydrogen peroxide (H₂O₂) production in lipopolysaccharide (LPS)‐stimulated macrophages was investigated. Methods Z. multiflora essential oil was extracted by water‐distillation, analysed by GC‐MS and then the effect of the essential oil on NO and H₂O₂ production was investigated. Key findings Carvacrol (52%), thymol (16%) and p‐cymene (10%) were the main components of the oil. The IC50 (concentration providing 50% inhibition) for reactive oxygen scavenging was estimated to be 5.7, 3 and 4.2 µg/ml for the essential oil, thymol and carvacrol, respectively, while the corresponding IC50 values for reactive nitrogen scavenging were estimated to be 8.6, 4.7 and 6.6 µg/ml. Z. multiflora essential oil, thymol, and carvacrol significantly reduced NO and H₂O₂ production as well as NO synthase and NADH oxidase activity in LPS‐stimulated murine macrophages while p‐cymene did not show any antioxidant activity. Conclusions Z. multiflora essential oil has the potential to be used in the therapy of oxidative damage.     

Synthesis and antimicrobial activity evaluation of some new adamantane derivatives

In this study, some new Schiff bases were synthesized as antimicrobial agents using benzaldehyde derivatives and 1- or 2-aminoadamantane. The structures of the synthesized compounds were confirmed by IR, 1H-NMR and elementary analysis. Antimicrobial activities of the synthesized compounds were tested against some bacteria and yeast-like fungi. The antimicrobial activity of the compounds was investigated by broth microdilution method using two Gram positive (Staphylococcus aureus ATCC 25923, Enterococcus faecalis ATCC 29212) and two Gram negative (Escherichia coli ATCC 25922, Pseudomonas aeruginosa ATCC 27853) bacteria and yeast-like fungi (Candida albicans ATCC 90028, Candida krusei ATCC 6258, Candida parapsilosis ATCC 22019). The antifungal activity of 1-((2-chloro-3,4-dimethoxybenzylidene) amino(adamantane (compound 3) against C. krusei and C. parapsilosis (minimal inhibitory concentration 32 micrograms/ml) was higher than that of the other tested compounds.     

Voriconazole activity against clinical yeast isolates: a multicentre Italian study

The activity of voriconazole was tested in vitro against 1996 clinical yeast isolates collected in 20 Italian microbiology laboratories. Voriconazole susceptibility testing was carried out with the broth microdilution (NCCLS M27-A2), Etest and disk diffusion methods. The minimum inhibitory concentrations at which 90% of the isolates were inhibited (MIC90) obtained with the NCCLS method were 0.03 mg/L for Candida albicans, 0.5 mg/L for Candida non-albicans and 0.25 mg/L for other genera; those obtained with Etesting were, respectively, 0.032 mg/L, 0.125 mg/L and 0.125 mg/L. With the disk diffusion method, the majority of isolates (92.3%) showed inhibition zone diameters between 21 mm and 40 mm. Using a tentative MIC cut-off of 1mg/L as indicative of in vitro susceptibility, 98.1% of the isolates tested in our study would be classified as susceptible, and only 28 (1.4%) of the isolates, with MICs higher than 2mg/L, would be classified as resistant to the drug. Our findings confirm the broad-spectrum in vitro activity of voriconazole against yeasts, including Candida species that are generally less susceptible to other azoles.