Growth Of Candida Albicans Research Articles

Test of the Inhibitory Power of Virgin Coconut Oil on the Growth of Candida albicans

Test of the Inhibitory Power of Virgin Coconut Oil on the Growth of Candida albicans

Candida associated infra-inguinal prosthetic vascular graft infection: A case report

Prosthetic vascular grafts (PVG) are artificial vascular materials used for revascularization in the treatment of vascular diseases. Due to increase in life expectancy, the number of individuals requiring PVGs is increasing and encountering the PVGI is also more frequent. We presented an interesting case operated because of infected graft in which Candida albicans grew. The patient had been operated twice for peripheral artery disease in another hospital before. We performed femoro-popliteal bypass by using great saphenous vein after removal of infected graft. In peripheric bypass surgery performed with PTFE (polytetrafluoroethylene) graft, growth of Candida albicans in graft material is a rare condition and this situation has a high mortality rate. In the patients with comorbidities and who will undergo redo-surgery, excessive care should be given in terms of graft infections.

Moxidectin elevates Candida albicans ergosterol levels to synergize with polyenes against oral candidiasis

Candida albicans, the most common opportunistic pathogenic fungus, is also the main pathogenic organism for oral candidiasis. This condition is particularly prevalent among the elderly, children, and individuals undergoing radiotherapy or suffering from HIV. The lack of new antifungal drugs, and drug resistance coupled with the side effects of current antifungal agents have increased the challenges of clinical antifungal therapies. Polyenes, including amphotericin B and nystatin, are clinical fungicidal drugs, however, their side effects and low solubility have limited their clinical applications. Here, we identified that moxidectin, a novel approved antiparasitic agent, could synergize with both amphotericin B and nystatin to inhibit the growth and biofilm formation of Candida albicans including 60 clinical isolates. The transcriptome and RT-PCR analysis indicated that moxidectin activated the biosynthesis pathway of ergosterol, the direct target of polyenes, further being verified by the loss of the synergistic activities with polyenes against ergosterol pathway mutants, including Δ/Δerg3, Δ/Δerg11 and Δ/Δerg3 Δ/Δerg11. Moxidectin was then confirmed to elevate the ergosterol biosynthesis levels of C. albicans and enhance the binding between cells and polyenes. In a mouse oral candidiasis model, moxidectin combined with low dosages of polyenes to significantly reduce the infection area, colonization of C. albicans and the inflammatory degree of tongue mucosa. Our study originally demonstrated that moxidectin could activate the ergosterol biosynthesis then elevate the ergosterol contents to enhance the antifungal effects of polyenes against C. albicans and its infections. Moxidectin can serve as the candidate potentiator of polyenes for further clinical practice.Key points• Moxidectin synergized with polyenes against Candida albicans.• Moxidectin activated the ergosterol biosynthesis of Candida albicans.• Moxidectin combined with polyenes to effectively combat oral candidiasis in mice.

Construction and evaluation of transdermal delivery system of terbinafine-loaded plant exosomes for the treatment of cutaneous fungal infections

Local transdermal of antifungal agents is a problem that limits the effectiveness of clinical treatment of dermatomycosis. In this study, cucumber-derived plant extracellular vesicles (PEV) were extracted and loaded with the antifungal drug terbinafine (TBF) to form TBF-PEV, which was applied locally to the site of skin fungal infection to improve the transdermal transport capacity of TBF and the antifungal effect in vitro and in vivo. Chemical enhancer and physical enhancer methods were replaced by low immunogenicity and non-irritating PEV. TBF-PEV caused obvious curling and wrinkling in the skin, induced changes in the distribution of skin lipids, and changed the structure and content of skin lipids and proteins, thereby increasing the transdermal efficiency of TBF. The local drug concentration was increased, and the antifungal effect was improved in vitro and in vivo. It was first found that PEV inhibited the growth of Candida albicans with high efflux pump expression. In general, this paper has certain significance in local transdermal treatment of fungal skin infections and reversal of fungal resistance.

Effects of intravaginal curcumin gels combined with electroporation on vulvovaginal candidiasis

ObjectiveTo provide a curcumin-based vaginal gel combined with electroporation for the treatment of vulvovaginal candidiasis (VVC) caused by Candida albicans. MethodsTemperature-sensitive in situ gels (ISG) were prepared using poloxamers 407 and 188 as matrices. The mass ratio of poloxamer 407 and poloxamer 188 was 7:1 with a gelation temperature of approximately 29°C and gelation time of 2.5 min. ResultsElectroporation increased the transmucosal permeability of the model drug, doxorubicin and improved the antifungal effects of curcumin. In vitro antifungal experiments showed that the number of fungal colonies in curcumin ISG combined with electroporation was lower than that in pure curcumin ISG. In vivo pharmacodynamic experiments showed that, compared to the model group, curcumin ISG with electroporation inhibited the growth of Candida albicans, alleviated vaginal mucosal edema, and reduced the inflammatory response. ConclusionCurcumin ISG combined with electroporation has substantial potential for the efficient clinical treatment of VVC.

Synthetic Antimicrobial Peptides. V. Histidine-containing Antifungal Peptides with a “Linear” Type of Amphipathicity

A number of histidine-containing synthetic antifungal peptides with a “linear” type of amphipathicity (SAMP LTA) (F2Hx, H10F2, H10, where x = 7, 10, 13 and 16) have been synthesized and studied. Biological screening of such histidine-containing peptides for their antifungal and hemolytic activity was carried out. It has been shown that the presented histidine-containing SAMP LTAs are capable of effectively inhibiting the growth of opportunistic fungi Candida albicans and have low hemolytic activity in most cases not exceeding 10% even at their relatively high concentration of 400 μM in a medium containing erythrocytes. The antifungal activity of the studied peptides increases with increasing histidine residues in their composition, reaching the maximum value for the histidine-containing peptide F2H16 (MIC50 = 1.0 µM). It has been shown that as the chain length of peptides increases, their hemolytic toxicity also increases. In terms of therapeutic significance, the optimal peptides in the presented series of peptides were F2H10 and F2H13, which have higher selectivity than the short or longer peptides F2H7 or F2H16. The therapeutic index (TI) for these peptides was 233, 247, 79 and 60, respectively. It has been shown that histidine-containing derivatives of peptides with phenylalanine residues at the N-terminus of the peptide (F2H10) are less effective compared to similar peptides (H10F2) containing phenylalanine residues at the C-terminus. Among all the studied peptides, the most active was the H10 peptide (MIC50 = 0.7 µM), which does not contain phenylalanine residues, which in its antifungal activity is not only more effective than all other histidine-containing peptides, including the F2H16 peptide with 16 histidine residues, but also 4-5 times more effective than the antifungal peptide P113 (MIC50 = 3.4 µM), a short active fragment of natural histatin 5, well known in the literature. Due to its relatively low hemolytic and high antifungal activity, the presented histidine-containing SAMP LTAs have relatively high TI values, more than 60. Among all the studied peptides, peptides H10 and P113 have minimal, almost zero, hemolytic activity. However, due to its higher antifungal activity, the selectivity of peptide H10 (TI 1400) exceeds that of peptide P113 (TI 340) by more than 4 times. Thus, peptide H10, due to its high antifungal activity, low hemolytic toxicity and, accordingly, high therapeutic significance, can be used as a promising antifungal peptide drug.

Novel nanoformulation for enhanced amphotericin B efficacy and sustained release using vetiver root cellulose nanofibers against Candida albicans

The formidable antifungal agent, Amphotericin B, is well-known for its potency; however, its clinical application has been significantly limited due to toxicity and poor solubility. This study aims to address these challenges by developing and evaluating a novel nano-cellulose-based formulation of Amphotericin B to enhance its efficacy. Amphotericin B was encapsulated within cellulose nanofibers at varying ratios to optimize formulation parameters, including drug concentration, particle size, zeta potential, and entrapment efficiency. Notably, a composition ratio of 10:1 of cellulose nanofibers to Amphotericin B achieved an impressive encapsulation efficiency of 96.64%. Subsequent physicochemical characterizations employing techniques such as FTIR, DLS, XRD, and SEM provided insights into structural attributes and interactions within formulation. Controlled and extended-release profiles were observed at various physiological pH levels, with the Korsmeyer-Peppas model showing the highest correlation, indicating predominant drug diffusion. Importantly, nanoformulation demonstrated non-toxicity to A431 cells and human erythrocytes up to a maximum concentration of 20 μg/ml, as corroborated by MTT and hemolysis assays. Furthermore, antimicrobial susceptibility and efficacy assessments, conducted using agar disc diffusion and broth micro-dilution methods, revealed enhanced inhibition of Candida albicans growth. The nanoformulation produced a larger diameter of the inhibition zone (DIZ) of 19.66 mm compared to a DIZ of 16.33 mm for Amphotericin B alone. Impressively, the nanoformulation exhibited a minimum inhibitory concentration (MIC) of 25 μg/ml against Candida albicans, underscoring its heightened efficacy. Additionally, the formulation's ability to improve the targetability and bioavailability of Amphotericin B holds promise for enhancing its antifungal effectiveness while reducing associated toxicity.

Effect of Cannabidiol (CBD), a cannabis plant derivative, against Candida albicans growth and biofilm formation.

This study aimed to evaluate the antifungal activities of cannabidiol (CBD) against C. albicans. Yeast cells were treated once or twice with different concentrations (from 0 to 20 mg/ml) of CBD, showing a significant (p < 0.05) decreased the growth of C. albicans, with cell concentrations ranging from 5.1 × 106 cell/mL in the control to 1.8 × 106 cell/mL after one exposure to 20 µg/mL CBD. This growth reduction was greater after two exposures to CBD. After two exposures to 20 µg/mL CBD, the cell concentration was only 1.1 × 106 cell/mL. Such a growth decrease in C. albicans was confirmed by a reduced number of CFUs and a lower MTT value compared to the control. The growth inhibition was supported by a significant (p < 0.001) decrease in the yeast-to-hyphae transition, ranging from 20 ± 0.2% in the control to 2 ± 0.5% after exposure to 20 µg/mL CBD. Biofilm formation was also significantly reduced following CBD exposure. CBD at 10 and 20 µg/mL promoted the death of C. albicans through an apoptosis/necrotic pathway. Altogether, our results suggest the possible use of CBD, a cannabis derivative, to control C. albicans infection, including oral candidiasis.

Influence of nanohydroxyapatite mouthwash on the growth of Candida albicans biofilm on milled denture surfaces: An in vitro study.

There is a need for effective solutions for the persistent prevalence of denture stomatitis (DS) in denture-wearing populations. This study assessed the impact of nanohydroxyapatite (nanoHAP) nanoparticles on Candida albicans biofilm formation on milled polymethylmethacrylate (PMMA) denture bases. Acquired salivary pellicle was formed on disks milled from a prepolymerized PMMA puck. The disks were assigned to two groups, A (n=18) and B (n=18), and each group was further subdivided into three subgroups (6/subgroup), each treated with either Polident solution (antibacterial denture cleanser), nanoHAP mouthwash, or distilled water. Disks in group A subgroups were soaked in their respective treatment solutions for 8h, followed by biofilm formation on thedisk for 24h. Disks in group B subgroups had C. albicans biofilm formed on them for 24h, followed by soaking in their respective treatment solutions for 8h. Biofilm thickness, biomass, and live/dead cell ratio were determined using aconfocal laser scanning microscope. Biofilm morphology was examined with ascanning electron microscope (SEM). Data were analyzed by ANOVA and Tukey-Kramer multiple comparisons (α=0.05). In group A, nanoHAP mouthwash displayed significant anti-adhesive properties. In group B, biofilm biomass and thickness significantly decreased (p<0.05), with the nanoHAP showing the most substantial reduction in existing biofilm compared to other solutions, but it did not significantly affect cell viability. This study demonstrated the efficacy of nanoHAP mouthwash in inhibiting C. albicans biofilm formation when used as a storage medium for acrylic dentures. It suggests its potential clinical application for preventing denture stomatitis in patients.

Clioquinol influences cell membrane, attenuates virulence factors, induces apoptosis to inhibit Candida albicans growth.

Aim: To investigate the antifungal mechanism of clioquinol and indicate that clioquinol has potential as a novel therapeutic antifungal agent.Materials & methods: Analyze differentially expressed genes of Candida albicans treated with clioquinol using RNA-sequencing. The effects on cell wall and membrane features, virulence factors, apoptosis-induced cell death were also investigated.Results: The differentially expressed genes of C. albicans after treated with clioquinol focused on cell wall and membrane synthesis, antioxidant system and energy metabolism. Clioquinol did not change cell wall components levels while it decreased squalene epoxidase activity to influence the ergosterol biosynthesis in cell membrane. It also decreased cellular surface hydrophobicity and induced β-glucan unmasking to attenuate virulence factors. Meanwhile, clioquinol influenced enzyme activities involved in antioxidant system, citrate cycle, oxidative phosphorylation and decreased the ATP levels. Clioquinol induced apoptosis in C. albicans to exert its fungicidal activity. It induced reactive oxygen species and calcium ion elevation, leading to loss of mitochondrial membrane potential, cytochrome C release, metacaspase activation, thereby triggering apoptosis.Conclusion: Clioquinol exerted anti-C. albicans activity through influencing cell membrane, attenuating virulence factors and inducing apoptosis.

Vulvovaginal candidiasis in pregnant women attending a tertiary care centre in North-Eastern India

BackgroundCandida colonisation in vagina was found to be 20 %, rising to 30 % during pregnancy. According to studies, the prevalence of VVC during pregnancy is higher than healthy women. During pregnancy, candidal colonisation increases, both symptomatic and asymptomatic. However, the difference between strains causing symptomatic infection and those that cause asymptomatic infection is unknown. ObjectiveThis study aimed to compare the virulence factors of Candida VVC isolates from symptomatic and asymptomatic pregnant women. MethodsThe study included 120 pregnant women- 60 symptomatic and 60 asymptomatic, who presented to the Obstetrics and Gynaecology Outpatient Department with vaginitis symptoms. High vaginal swabs from the patient and used for gram stain, direct wet mount, pH detection and fungal culture in SDA with and without antibiotics. Germ tube tests, growth in CMA, and HiCrome Candida Differential Agar were used to identify yeast colonies grown in culture. The isolates were then examined for virulence factors like biofilm formation, phospholipase, coagulase, and hemolysin. Antifungal susceptibility was determined using E-test. ResultsThe current study reveals a high prevalence of Vulvovaginal Candidiasis in pregnant women(35 %). Asymptomatic patients had lower proportion of VVC than symptomatic patients. Non albicans Candida(NAC) outnumbered Candida albicans. Although Candida albicans growth was predominant in asymptomatic patients. Virulence studies revealed that Candida spp. isolated from symptomatic patients expressed a higher proportion of virulence factors. Besides NAC has higher proportion of expressing virulence factors than Candida albicans and has higher propensity to cause infection especially in symptomatic pregnant women. Antifungal susceptibility testing shows Itraconazole to be most sensitive for VVC treatment but Candida albicans was most susceptible to fluconazole while NAC had the least. ConclusionsThe study emphasizes the importance of routine screening of symptomatic pregnant women for VVC, as syndromic treatment will increase antifungal resistance, particularly in NAC.

Effect of Katuk Leaves Ethanol Extract Gel as an Antibacterial and Antifungal in Orthodontic Treatment

Fixed orthodontic treatment is one option for treating malocclusion. The intricate design makes it difficult for patients to clean their teeth and can cause the emergence of microorganisms in the oral cavity. Katuk plant (Sauropus androgynus (L.) Merr.) is commonly used as herbal medicine. Flavonoids in katuk leaves have antimicrobial properties. The purpose of this study was to determine the effect of katuk leaf ethanol extract gel as an antimicrobial by inhibiting the growth of bacteria and fungi involved in orthodontic treatment. The study was an experimental study with a post-test-only control group using katuk leaves ethanol extract gel formulation as treatment, aquadest gel as a negative control, ketoconazole as a positive control against Candida albicans, and amoxicillin against Streptococcus mutans. Data were analyzed using the Kruskall– Wallis and Mann–Whitney tests (P &lt; 0.05). The results show that katuk leaves have inhibition on Streptococcus mutans (P = 0.000) growth but have no inhibition on Candida albicans (P = 1.00) growth. The conclusion of this study is that the gel of katuk leaves ethanol extract (S. androgynus (L.) merr.) has antibacterial activity against S. mutans in the oral cavity but no antifungal effect on C. albicans. Keywords: Candida albicans, fixed orthodontics, katuk leaves, Streptococcus mutans

Investigation of bioactive metabolites produced by the endophytic fungus Aspergillus iranicus from Houttuynia cordata Thunb

The endophytic fungus Aspergillus iranicus, capable of producing bioactive substances, was isolated from the roots of Houttuynia cordata Thunb. Through chromatographic methods, five compounds were isolated in this study for the first time from the fermentation broth and mycelia of the endophytic fungus Aspergillus iranicus obtained from Houttuynia cordata Thunb. using ethyl acetate extracts. These compounds were identified as palmitic acid (1), protocatechuic acid (2), 4-hydroxybenzophenone (3), stigmasterol (4), and β-sitosterol (5). The IC50 values for compound 2 was 1.32 mg/mL, which indicate strong DPPH radical scavenging activity. Compounds 2, 3, and 5 significantly inhibited the growth of Escherichia coli, demonstrating MIC values of 6.25, 3.13, and 3.13 mg/mL, respectively. Additionally, displaying a MIC value of 0.78 mg/mL, compound 3 demonstrated remarkable inhibition against Candida albicans growth. These findings suggest the presence of endophytic fungi in H. cordata, producing several valuable medicinal secondary metabolites.

Characterization and biological activity of selenium nanoparticles biosynthesized by Yarrowia lipolytica.

In this research, biogenic selenium nanoparticles were produced by the fungi Yarrowia lipolytica, and the biological activity of its nanoparticles was studied for the first time. The electron microscopy analyses showed the production of nanoparticles were intracellular and the resulting particles were extracted and characterized by XRD, zeta potential, FESEM, EDX, FTIR spectroscopy and DLS. These analyses showed amorphous spherical nanoparticles with an average size of 110 nm and a Zeta potential of -34.51 ± 2.41 mV. Signatures of lipids and proteins were present in the capping layer of biogenic selenium nanoparticles based on FTIR spectra. The antimicrobial properties of test strains showed that Serratia marcescens, Klebsiella pneumonia, Escherichia coli, Pseudomonas aeruginosa and Bacillus subtilis were inhibited at concentrations between 160 and 640 μg/mL, while the growth of Candida albicans was hindered by 80 μg/mL of biogenic selenium nanoparticles. At concentrations between 0.5 and 1.5 mg/mL of biogenic selenium nanoparticles inhibited up to 50% of biofilm formation of Klebsiella pneumonia, Acinetobacter baumannii, Staphylococcus aureus and Pseudomonas aeruginosa. Additionally, the concentration of 20-640 μg/mL of these bioSeNPs showed antioxidant activity. Evaluating the cytotoxicity of these nanoparticles on the HUVEC and HepG2 cell lines did not show any significant toxicity within MIC concentrations of SeNPs. This defines that Y. lipolytica synthesized SeNPs have strong potential to be exploited as antimicrobial agents against pathogens of WHO concern.

Green synthesis, characterization, and multifunctional applications of Ag@CeO2 and Ag@CeO2-pullulan nanocomposites for dye degradation, antioxidant, and antifungal activities

The synthesis and characterization of novel nanocomposites with unique properties have garnered significant interest. Ag@CeO2 nanocomposite and its pullulan counterparts were prepared using a green approach involving rosemary extract. Characterization techniques, including Fourier Transform Infrared Spectroscopy, UV–visible spectroscopy, zeta potential, Dynamic Light Scattering, High-Resolution Transmission Electron Microscopy, Energy-Dispersive X-ray Spectroscopy, Scanning Electron Microscopy, and X-ray Diffraction, confirmed the formation of Ag@CeO2 nanoparticles (NPs). Pullulan led to increased particle size and improved homogeneity. Employing the Artificial Neural Networks (ANN) model to optimize methylene blue removal by Ag@CeO2 NPs and Ag@CeO2-pullulan NPs demonstrated predictive capabilities up to 97.53 % of MB removal (R2 = 0.9991). The antioxidant test demonstrated that rosemary extract exhibited the highest activity (IC50 = 0.011 mg/mL), then Ag@CeO2 NPs (IC50 = 0.039 mg/mL), and Ag@CeO2-pullulan NPs (IC50 = 0.041 mg/mL). Both Ag@CeO2 NPs and Ag@CeO2-pullulan NPs inhibited Candida albicans growth, with the latter exhibiting enhanced efficacy (MIC = 468.27, MFC = 936.53, and IC50 = 129.60 μg/mL). The study successfully synthesized novel Ag@CeO2-based nanocomposites coupled with pullulan with promising applications in dye removal, and antimicrobial therapy. The incorporation of pullulan improved the properties of the nanocomposites, enhancing their potential for practical use in environmental and biomedical applications.

A novel mucoadhesive film containing probiotic extract for oral candidiasis treatment: Formulation and antifungal evaluation

Probiotic strains offer a novel and potentially effective approach to treat oral candidiasis. Buccal mucoadhesive films have attracted considerable attention in recent years due to their unique ability to adhere and persist on the oral mucosa, while gradually releasing their encapsulated drug content. Therefore, the aim of the study was to develop mucoadhesive films containing probiotic extract for treatment of oral candidiasis. Mucoadhesive films were fabricated with hydrophilic polymers, such as polyvinyl alcohol (PVA) and hydroxy propyl methyl cellulose (HPMC). Then, films were evaluated regarding their thickness, pH, tensile strength and elongation, swelling, in vitro release and antifungal activity. The type of polymer used had an impact on the mechanical properties, swelling and release of the films. Films prepared using PVA showed significantly higher tensile strength and elongation at break values compared to those prepared using HPMC. However, swelling index increased with enhancing HPMC concentration in the films. The release of probiotic extract from the film prepared with HPMC occurred slowly. Based on these results, films containing 54 % HPMC and 26 % PVA were selected as optimal formulation. Moreover, it was found that optimal film containing probiotic extract could inhibit the growth of Candida albicans. Regarding to the obtained results, probiotic oral adhesive mucoadhesive films can be considered as a promising alternative to traditional methods in the treatment of candidiasis.

Studies on the antifungal effects of Hinokitiol on Candida albicans: inhibition of germ tube formation and synergistic pharmacological effects of miconazole.

One of the goals of oral healthcare management is to manage dry mouth. Thus, moisturizers containing antimicrobial ingredients, such as hinokitiol (HT), are applied to the oral mucosa after oral care. In this study, we investigated the preventive effect of HT against the growth of Candida albicans (C. al) and its synergistic effect when combined with miconazole (MCZ), an oral treatment for candidiasis. As the concentration of HT increased, the length and percentage of germ tubes (GT) decreased. Larger inhibition circles were observed for MCZ concentrations of 2.0 and 4.0μg/disc compared to the HT medium without HT. The increased inhibitory effect was observed in both aerobic and anaerobic cultures. This suggests that the production of reactive oxygen species (ROS) by C. al cells increased with the combination of HT and MCZ. The length and percentage of GT increased, whereas the amount of ROS decreased when ROS scavengers were used in combination with the drug. HT led to morphological changes that inhibited the GT associated with pathogenic C. al, exhibited a complementary action against MCZ, and showed a possible association with hydrogen peroxide and superhydroxy anion radicals. These effects suggest that HT is a promising candidate for inhibiting C. al. In conclusion, HT demonstrated a prophylactic effect by inhibiting C. al and a synergistic effect with MCZ, a drug used to treat oral candidiasis. HT may also be useful for suppressing the onset and reducing the severity of oral candidiasis.

Inhibitory effects and mode of antifungal action of isobavachalcone on Candida albicans growth and virulence factors

The fungus Candida albicans causes various kinds of human infections, including oral thrush, vulvovaginitis and life-endangering bloodstream infections, the incidence of which are rising. Worsening this, the clinical antifungals are limited to a few, highlighting the necessity to develop novel antifungal therapies. In this study, the antifungal activities of isobavachalcone against C. albicans SC5314 and nine C. albicans clinical isolates were tested. The effects of isobavachalcone (IBC) on C. albicans virulence factors, such as hyphal formation, adhesion, biofilm formation and extracellular phospholipase production, as well as the underlying mechanism, were also evaluated. Antifungal susceptibility test revealed that IBC has significant anti-Candida activities, with both MIC and MFC being 4–5 μg/mL against all strains tested. Hyphal formation in RPMI-1640, Spider and GlcNAc medium, adhesion to abiotic polystyrene surfaces and surfaces of A549 cells, could be inhibited by IBC. Most important, IBC could inhibit the C. albicans biofilm formation and development. PI staining tests showed that IBC could increase the cell membrane permeability, suggesting the damages to the fungal cell membrane. IBC was further demonstrated to induce excessive ROS production in C. albicans planktonic cells and its mature biofilms, as revealed by DCFH fluorescence detection through flowcytometry and relative fluorescence intensity analysis (with a microplate reader). The roles of ROS in the antifungal activity of IBC were further confirmed through antioxidant rescue assays in MIC and biofilm formation tests. Compared to its antifungal activity, the cytotoxicity against mammalian cells was low, indicating its potential in developing antifungal therapies.

Obstructive Bilateral Renal Fungal Bezoars in an Extremely Premature Neonate Treated With Antifungals and Urokinase Irrigation: A Case Report and Review of the Literature.

An ex-27-week gestation female infant developed bilateral forearm nodules at 4 weeks of life during treatment for methicillin-sensitive Staphylococcus aureus bacteremia. A pure growth of Candida albicans was isolated on culture of both sterile aspiration of the forearm abscess and urine without evidence of methicillin-sensitive Staphylococcus aureus. The patient went on to develop bilateral obstructive renal fungal bezoars at 11 weeks of life. Bilateral nephrostomies were required to alleviate obstruction with the addition of local irrigation with amphotericin B deoxycholate. Two weeks later, urokinase via the nephrostomy tubes was added due to an unchanged appearance on ultrasound (US) and ongoing candiduria. A significant reduction in the size of bezoars was seen on US after 3 days. Sterilization of urine culture was achieved 7 weeks into treatment, and resolution of bezoars on US was seen 9 weeks after treatment began. No adverse events occurred from the use of local urokinase. Urokinase irrigation via nephrostomy is an effective and safe adjunctive treatment in refractory obstructive renal candidiasis in neonates.

Green Synthesis of Silver Nanoparticles using Moringa oleifera: Implementation to Photoantimicrobial of Candida albicans with LED Light

Green synthesis of silver nanoparticles using Moringa oleifera (AgNPs/MO) was carried out to produce nanoscale antifungal agents which are used as photosensitizing agents in photoantimicrobial therapy. This study focused on investigating the potential of AgNPs/MO producing some toxic radical compounds that inhibit the growth of Candida albicans biofilms. The inhibition mechanism uses the principle of photoinactivation treatment which combines a photosensitizer with an LED light source at a power of 100 mW for 60 - 300 s of exposure. Quantitative data analyzed were the number of viable cells and radical compounds, formed by malondialdehyde (MDA) level. It is investigated through staining the XTT (2,3-Bis-(2-Methoxy-4-Nitro-5-Sulfophenyl)-2H-Tetrazolium-5-Carboxanilide) and TBARS (Thiobarbituric Acid Reactive Substances). The results show that the maximum wavelength of AgNPs is 440 nm while the Moringa oleifera has 2 peaks at 425 and 635 nm. The maximum effect occurred in the group of photosensitizer AgNPs/MO combined LED with percentage inactivation about 76.80 % for blue LEDs and 76.20 % for red LEDs. The group of LED irradiation without photosensitizer obtained about 51.85 % for blue LEDs and 50.04 % for red LEDs. The MDA level group of AgNPs/MO combined LED also produced MDA levels of 1.772 nmol/mL for blue LED and 1.617 nmol/mL for red LED. Meanwhile, the application of photoantimicrobial using only LEDs produced MDA levels of only 1.353 nmol/mL for blue LEDs and 1.347 nmol/mL for red LEDs. This research has shown that the green synthesis of AgNPs/MO has a good potential to inhibit the growth of Candida albicans biofilms as a photosensitizer agent. HIGHLIGHTS Silver nanoparticles (AgNPs) combined with Moringa oleifera (MO) extract have been shown to have potential as a photosensitizer to inhibit the growth of Candida albicans Green synthesis AgNPs/MO have a characteristic spectrum at 440 nm which is close to the blue light spectrum. Green synthesis AgNPs/MO combined with LED light irradiation energy can reduce the cell viability of Candida albicans up to 76.80 % through the XTT assay staining test method and produce 1.772 nmol/mL of Malondialdehyde that reacts with ROS compounds to cause cell damage. GRAPHICAL ABSTRACT