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Plant-based Nanomaterials and their Antimicrobial Activity
Published in Mahendra Rai, Chistiane M. Feitosa, Eco-Friendly Biobased Products Used in Microbial Diseases, 2022
Mayuri Napagoda, Priyalatha Madhushanthi, Dharani Wanigasekara, Sanjeeva Witharana
The antifungal resistance depends on a combination of factors such as the host, antifungal agent or the fungal pathogen. However clinical resistance is not always able to predict, it highlights the significance of individualizing antifungal treatment strategies based on the clinical situation (Kanafani and Perfect 2008).
Microbiological Diagnosis of Fungal Keratitis
Published in Mahendra Rai, Marcelo Luís Occhiutto, Mycotic Keratitis, 2019
Antifungal resistance is emerging and may limit the number of treatment options available. Molecular techniques have the potential to identify resistance, even without the need for a cultured organism. Emergence of azole resistance in Aspergillus fumigatus is clinically significant. Molecular assays have been used to detect specific mutations that confers resistance. These assays may be designed to identify a causative agent at species level and to amplfy specific regions associated with antifungal resistance in the same run (Shankland 2018).
Antifungal drug resistance: Significance and mechanisms
Published in Mahmoud A. Ghannoum, John R. Perfect, Antifungal Therapy, 2019
Sharvari Dharmaiah, Rania A. Sherif, Pranab K. Mukherjee
Resistance to commonly used antifungals (e.g., azoles, polyenes, echinocandins, allylamines) is a significant problem in nosocomial infections (including invasive and superficial mycoses), as well as those associated with indwelling devices like central venous catheters, urinary catheters, and contact lenses (fungal keratitis). Fungal resistance has been reported even for newer antifungals, such as the echinocandins, underscoring the importance of gaining insight into the mechanisms of antifungal resistance. This chapter briefly describes the methods used to evaluate antifungal susceptibility of fungi, reviews the significance of antifungal resistance, and summarizes recent advances in identification of the underlying mechanisms.
Will invasive fungal infections be The Last of Us? The importance of surveillance, public-health interventions, and antifungal stewardship
Published in Expert Review of Anti-infective Therapy, 2023
Roxana M. Rodríguez Stewart, Jeremy A.W. Gold, Tom Chiller, D. Joseph Sexton, Shawn R. Lockhart
Each year, IFIs are responsible for over 1.5 million deaths globally and, in the United States alone, impose health-care costs ranging from five to seven billion dollars [1,2]. During the COVID-19 pandemic, rates of death from fungal infections have increased [3], and the burden of IFIs is poised to grow given the expanding population of patients living with immunosuppressive conditions (e.g. solid organ and stem cell transplantation), increasing antifungal resistance, and potential climate-change related expansion of the geographic ranges in which pathogenic fungi live. Despite the morbidity and mortality associated with fungal infections and their growing public health importance, we still have much to learn about their diagnosis and management. In this review, we discuss gaps and global disparities in fungal laboratory capacity including antifungal susceptibility testing, the paucity of fungal surveillance, and the importance of antifungal stewardship, all against the backdrop of increasing antifungal resistance and a limited armamentarium of antifungal therapies.
Evolution of antifungals for invasive mold infections in immunocompromised hosts, then and now
Published in Expert Review of Anti-infective Therapy, 2023
Zoe Freeman Weiss, Jessica Little, Sarah Hammond
Invasive mold infections (IMI) are a significant cause of morbidity and mortality, particularly among immunocompromised hosts. As novel immunotherapies, cellular therapies, and organ transplantation programs are developed, the patient population at risk for severe invasive fungal infections (IFI) grows. Simultaneously, rising global temperatures have expanded endemic regions and the burden of fungal pathogens [1]. Antifungal resistance is becoming an increasing problem, linked to widespread use of antifungals for treatment and prophylaxis in healthcare settings, and to environmental exposures to antifungals in chemicals and pesticides [2]. Current antifungal agents are insufficient to address this growing problem. Despite the development of several mold-active agents in the last 20 years, significant challenges in treating IMI remain including the limited number of antifungal treatment options, toxicities, drug interactions, high costs, and difficulties in performing antifungal susceptibility testing. We review the history and evolving landscape of anti-mold therapeutics and explore emerging therapeutic options.
In vitro and in vivo anti-Candida activity of citral in combination with fluconazole
Published in Journal of Oral Microbiology, 2022
Katherine Miranda-Cadena, Cristina Marcos-Arias, Aitzol Perez-Rodriguez, Iván Cabello-Beitia, Estibaliz Mateo, Elena Sevillano, Lucila Madariaga, Guillermo Quindós, Elena Eraso
With regard to the involvement of citral in the expression of the ERG11 gene, our findings were not conclusive. The relative changes in expression were not significant in any case, despite the fact that a slight ERG11 upregulation was observed. This could be due to the low concentrations of fluconazole used in this study [47]. However, in a previous study using carvacrol, down-regulated expression of ERG3 and ERG11 was described at different concentrations (IC, 25 mg/L, and 0.5× IC) [48]. Although ERG11 encodes an essential enzyme in the C. albicans pathway and the Hot-spot mutations and its overexpression are associated with fluconazole resistance, there are about 20 genes involved in the ergosterol biosynthesis, which have not been included in this study. Hence, if citral interferes with the ergosterol pathway, it should be independent to ERG11 or likely dose dependent, and other ERG genes should be considered. In addition, it is relevant to note that antifungal resistance is often the result of the sum of several mechanisms, and further study would be necessary for a better understanding.