The Antimicrobial Activity of Omiganan Alone and In Combination against Candida Isolated from Vulvovaginal Candidiasis and Bloodstream Infections.

Dawid Żyrek,Joanna Nowicka,Andrzej Wajda,Paulina Czechowicz,Maciej Jaśkiewicz,Damian Neubauer,Wojciech Kamysz

doi:10.3390/antibiotics10081001

Dawid Żyrek, Joanna Nowicka + Show 5 more

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https://doi.org/10.3390/antibiotics10081001

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Abstract

Fungi from the Candida genus are widespread commensals and, at the same time, are the leading cause of fungal infections worldwide. For instance, vulvovaginal candidiasis (VVC) affects approximately 75% of women at least once in their lifetime, remaining the second most common gynecological infection. On the contrary, hospital-acquired fungal bloodstream infections (BSIs), although less frequent, are characterized by a high mortality rate. Undoubtedly, the main reason for this situation are virulence factors that these yeast-like fungi can produce, and the ability to form a biofilm is one of the most important of them. Due to the low effectiveness of classic antimycotics against Candida biofilms, an intense search for new drugs capable of eradicating this structure is highly demanded. One of the most promising groups of compounds exhibiting such properties are antimicrobial peptides (AMPs). This study focuses on a comparison of the efficacy of Omiganan and fluconazole alone and in combination against Candida strains isolated from BSIs. The obtained results are consistent with our previous reports on the effectiveness of Omiganan against clinical strains isolated from VVC. This is also the first report on the combinatory application of Omiganan in the context of fungal BSI. The majority of combinations with fluconazole showed an additive effect, as well as a synergistic effect in the range of certain concentrations. Importantly, such effects are visible at concentrations much lower than for those compounds used individually. Potentially, this entails the possibility of limiting the adverse effects (e.g., toxicity) of Omiganan and fluconazole applied in vivo, thus improving the safety profile of this particular antifungal therapy.

Highlights

Introduction published maps and institutional affilCandida species are widespread commensals that can be part of the microbiota of mucous membranes and skin
Vulvovaginal candidiasis (VVC) is diagnosed if the typical symptoms of vaginitis and vulvitis are accompanied by the presence of Candida spp. in a material obtained from the external genitalia [4]
This study focuses on a comparison of the efficacy of Omiganan and fluconazole and their combination against planktonic forms and biofilms of blood-derived and vaginal isolates of Candida spp

Summary

Introduction

Introduction published maps and institutional affilCandida species are widespread commensals that can be part of the microbiota of mucous membranes and skin. Despite the fact that Candida spp. belong to normal flora, they may lead to opportunistic infections and, at the same time, they are indicated as a frequent cause of symptomatic infections all over the world [3]. Vulvovaginal candidiasis (VVC) is diagnosed if the typical symptoms of vaginitis and vulvitis are accompanied by the presence of Candida spp. in a material obtained from the external genitalia [4]. VVC affects approximately 75% of women at least once during their lifetime, which makes it the second most common vulvovaginal infection in the world, after bacterial vaginosis (BV) [5]. In more than half of cases, VVC occurs at least twice a lifetime, and in 5–8%, at least four times a year (recurrent vulvovaginal candidiasis (RVVC)) [6]. Recent epidemiological data indicate that RVVC affects nearly iations

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