Biomaterials for the Prevention of Oral Candidiasis Development

Thousands of microorganisms coexist within the human microbiota. However, certain conditions can predispose the organism to the overgrowth of specific pathogens that further lead to opportunistic infections. One of the most common such imbalances in the normal oral flora is the excessive growth of Candida spp, which produces oral candidiasis. In immunocompromised individuals, this fungal infection can reach the systemic level and become life-threatening. Hence, prompt and efficient treatment must be administered. Traditional antifungal agents, such as polyenes, azoles, and echinocandins, may often result in severe adverse effects, regardless of the administration form. Therefore, novel treatments have to be developed and implemented in clinical practice. In this regard, the present paper focuses on the newest therapeutic options against oral Candida infections, reviewing compounds and biomaterials with inherent antifungal properties, improved materials for dental prostheses and denture adhesives, drug delivery systems, and combined approaches towards developing the optimum treatment.

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Microbial interactions and immunity response in oral Candida species

Future Microbiology ◽

10.2217/fmb-2020-0113 ◽

2020 ◽

Vol 15 (17) ◽

pp. 1653-1677

Author(s):

Lucia Černáková ◽

Célia F Rodrigues

Keyword(s):

Immune Responses ◽

Literature Search ◽

Oral Candidiasis ◽

Host Immunity ◽

Microbial Interactions ◽

Noncommunicable Diseases ◽

Candida Spp ◽

Immunity Response ◽

Oral Candida ◽

Antimicrobial Treatments

Oral candidiasis are among the most common noncommunicable diseases, related with serious local and systemic illnesses. Although these infections can occur in all kinds of patients, they are more recurrent in immunosuppressed ones such as patients with HIV, hepatitis, cancer or under long antimicrobial treatments. Candida albicans continues to be the most frequently identified Candida spp. in these disorders, but other non- C. albicans Candida are rising. Understanding the immune responses involved in oral Candida spp. infections is a key feature to a successful treatment and to the design of novel therapies. In this review, we performed a literature search in PubMed and WoS, in order to examine and analyze common oral Candida spp.–bacteria/ Candida–Candida interactions and the host immunity response in oral candidiasis.

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Micafungin Is an Efficient Treatment of Multi Drug-Resistant Candida glabrata Urosepsis: A Case Report

Journal of Fungi ◽

10.3390/jof7100800 ◽

2021 ◽

Vol 7 (10) ◽

pp. 800

Author(s):

Zuzana Javorova Rihova ◽

Lubica Slobodova ◽

Anna Hrabovska

Keyword(s):

Drug Resistance ◽

Urinary Tract ◽

Candida Glabrata ◽

Multi Drug Resistance ◽

Drug Resistant ◽

Candida Spp ◽

Efficient Treatment ◽

Pharmacokinetic Properties ◽

Life Threatening ◽

Low Levels

Candiduria is a common nosocomial infection in hospitalized patients, which may progress into life-threatening candidemia. Successful treatment of urosepsis requires early and effective antifungal therapy, while the available agents within three pharmacological classes each have characteristic pharmacokinetics and side effect profiles. Moreover, treatment of Candida spp. infections is becoming challenging due to increasing multi drug-resistance. Here, we present a case of candidemia resulting from a multi drug-resistant C. glabrata infection of the urinary tract. Due to resistance to fluconazole and a contraindication for amphotericin B, micafungin was used in the treatment, regardless of its unfavorable pharmacokinetic properties. Our study showed that despite the expected low levels in the urinary tract, micafungin was successful in the eradication of C. glabrata allowing full recovery of the patient. Thus, micafungin should be considered in the management of urosepsis caused by sensitive Candida spp.

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Anti–IFN-γ autoantibodies underlie disseminated Talaromyces marneffei infections

Journal of Experimental Medicine ◽

10.1084/jem.20190502 ◽

2020 ◽

Vol 217 (12) ◽

Author(s):

Jing Guo ◽

Xin-Qiang Ning ◽

Jing-Ya Ding ◽

Yan-Qing Zheng ◽

Na-Na Shi ◽

...

Keyword(s):

Southeast Asia ◽

Opportunistic Infections ◽

Talaromyces Marneffei ◽

Novel Treatments ◽

Immunodeficiency Virus ◽

High Prevalence ◽

Life Threatening ◽

Acquired Immunodeficiency ◽

Ifn Γ ◽

Hiv Negative

Talaromyces marneffei causes life-threatening opportunistic infections, mainly in Southeast Asia and South China. T. marneffei mainly infects patients with human immunodeficiency virus (HIV) but also infects individuals without known immunosuppression. Here we investigated the involvement of anti–IFN-γ autoantibodies in severe T. marneffei infections in HIV-negative patients. We enrolled 58 HIV-negative adults with severe T. marneffei infections who were otherwise healthy. We found a high prevalence of neutralizing anti–IFN-γ autoantibodies (94.8%) in this cohort. The presence of anti–IFN-γ autoantibodies was strongly associated with HLA-DRB1*16:02 and -DQB1*05:02 alleles in these patients. We demonstrated that adult-onset acquired immunodeficiency due to autoantibodies against IFN-γ is the major cause of severe T. marneffei infections in HIV-negative patients in regions where this fungus is endemic. The high prevalence of anti–IFN-γ autoantibody–associated HLA class II DRB1*16:02 and DQB1*05:02 alleles may account for severe T. marneffei infections in Southeast Asia. Our findings clarify the pathogenesis of T. marneffei infection and pave the way for developing novel treatments.

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MULTICENTER STUDY OF CANDIDA SPECIES IN ORAL MUCOSA OF DIFFERENT PATIENTS: ANALYSIS OF 711 STRAINS AND LITERATURE REVIEW

Revista de Patologia Tropical / Journal of Tropical Pathology ◽

10.5216/rpt.v49i2.63481 ◽

2020 ◽

Vol 49 (2) ◽

pp. 105-119

Author(s):

Rennan Luiz Oliveira dos Santos ◽

Luciana Da Silva Ruiz ◽

Marcos Ereno Auler ◽

Jorge Kleber Chavasco ◽

Débora Moreira ◽

...

Keyword(s):

Literature Review ◽

Oral Mucosa ◽

Candida Species ◽

Oral Candidiasis ◽

Molecular Methods ◽

Future Research ◽

Correct Identification ◽

Candida Spp ◽

Culture Collections ◽

Oral Candida

This study aimed to identify Candida spp. collected from oral mucosa and maintained in culture collections, correlating the findings with the medical history of patients and comparing with data from the literature over the past five years. Seven hundred and eleven oral Candida spp. isolates, collected between 2013 and 2017, were selected and identified using traditional and molecular methods. In addition, a literature review was performed with the key words: “Oral”, “Candida” and “Yeast”. Seven species of the genus Candida: were identified C. albicans (73.3%); C. tropicalis (9.3%); C. parapsilosis (8.2%); C. glabrata (3.9%); C. guilliermondii(2.8%); C. krusei (1.7%) and C. lusitaniae (0.3%). The strains identified as C. albicans were submitted to molecular methods using specific primers and of these, 5.8% were identified as C. dubliniensis strains. The greatest diversity of strains was found in patients presenting no systemic diseases or HIV +, while the highest percentage of strains of Candida non-albicans were observed in cancer patients. This study reports a representative distribution of Candida species among individuals exhibiting distinct clinical conditions, in order to contribute to the design of future research on details of aspects involved in the infections caused by thesemicroorganisms. The correct identification of oral Candida strains contributes to a realistic epidemiological approach and future clinical protocols against these pathogens.KEY WORDS: Candida; oral candidiasis; dentistry; yeasts; HIV; co-infection

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Prevalência de Candida spp. em biofilme dentário de usuários de aparelhos ortodônticos fixos

Revista da Faculdade de Odontologia de Porto Alegre ◽

10.22456/2177-0018.32965 ◽

2012 ◽

Vol 53 (2) ◽

pp. 5-10

Author(s):

Michele Mezzari ◽

Amanda Gomes Faria ◽

Igor Palagi De Souza ◽

Ernani Marchioro ◽

Alexandre Meneghello Fuentefria ◽

...

Keyword(s):

Dental Plaque ◽

Antifungal Agents ◽

Oral Candidiasis ◽

Control Group ◽

Orthodontic Appliances ◽

Candida Spp ◽

Mycological Diagnosis ◽

Appropriate Treatment ◽

Fixed Orthodontic Appliances ◽

Oral Candida

OBJETIVOS: O presente estudo tem como objetivo avaliar a prevalência de Candida spp. em biofilme dentário de usuários de aparelhos ortodônticos fixos (AOF) e relacionar com seus hábitos e características. MATERIAIS E MÉTODOS: Foram isolados e identificados cepas de Candida em amostras de saliva em indivíduos usuários de AOF com presença de biofilme microbiano e indivíduos usuários de AOF mas sem presença de biofilme (grupo controle), a partir do cultivo em laboratório. RESULTADOS: Neste estudo foram analisadas 108 amostras de indivíduos com biofilme, e 51 indivíduos no grupo controle. Das 108 amostras analisadas, 52 (48,1%) foram negativas para o gênero Candida e 56 (55,2%) foram positivas, sendo que em oito pacientes foram isolados duas espécies de Candida, quatro pacientes com C. albicans e C. krusei, um com C. albicans e C. tropicalis, um com C. albicans e C. glabrata, um com C. tropicalis e C. glabrata e um com C. tropicalis e C. krusei. No grupo controle 33,3% apresentaram isolamento de Candida, mesmo não apresentando biofilme. CONCLUSÃO: Foram detectadas espécies de Candida patogênicas e intrinsicamente resistentes aos convencionais antifúngicos, ressaltando a importância do diagnóstico micológico para um tratamento adequado das infecções causadas por este grupo de fungos presentes na cavidade oral dos indivíduos. Palavras-chave: Candidíase oral, Candida spp., aparelho ortodôntico fixo. ____________________________________________________ ABSTRACT OBJECTIVES: This study aims to evaluate the prevalence of Candida spp. in dental plaque of users of fixed orthodontic appliances (FOA) and relate to their habits and characteristics. MATERIALS AND METHODS: We isolated and identified strains of Candida in saliva samples from individuals using FOA with the presence of microbial biofilm and individuals without the presence of biofilm (control group) in the laboratory cultivation. RESULTS: We analyzed 108 samples from individuals with biofilm and 51 individuals in the control group. Of the 108 samples analyzed, 52 (48.1%) were negative for Candida and 56 (55.2%) were positive, with eight patients were isolated two species of Candida, four patients with C. albicans and C. krusei, with one C. albicans and C. tropicalis, with one C. albicans and C. glabrata, with one C. tropicalis and C. glabrata and with one C. tropicalis and C. krusei. In the control group 33.3% had isolated Candida, even showing no biofilm. CONCLUSION: Were detected and pathogenic Candida species intrinsically resistant to conventional antifungal agents, emphasizing the importance of mycological diagnosis for appropriate treatment of infections caused by this group of fungi present in the oral cavity of individuals. Key-words: Oral Candidiasis, Candida spp., fixed orthodontic braces. ____________________________________________________

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A prospective randomized trial to reduce oral Candida spp. colonization in patients with hyposalivation

Brazilian Oral Research ◽

10.1590/s1806-83242007000200015 ◽

2007 ◽

Vol 21 (2) ◽

pp. 182-187 ◽

Cited By ~ 17

Author(s):

Sandra Regina Torres ◽

Camila Bernardo Peixoto ◽

Daniele Manhães Caldas ◽

Tiyomi Akiti ◽

Maria Glória Carvalho Barreiros ◽

...

Keyword(s):

Oral Candidiasis ◽

Salivary Flow ◽

Candida Spp ◽

Flow Rates ◽

Mouth Rinses ◽

Whole Saliva ◽

The Difference ◽

Group 2 ◽

Oral Candida ◽

Group 1

Low salivary flow rates are associated with higher oral Candida spp. counts, which may predispose to oral candidiasis. The aim of this study was to compare the effect of stimulating salivary flow rates with that of a regimen of chlorhexidine mouth rinse on the intensity of Candida colonization in patients with reduced salivary flow rates. Thirty-one outpatients were randomized to stimulate salivary output (group 1) or to receive chlorhexidine mouth rinses (group 2). Evaluations were performed at baseline (T0), at end of treatment (T1), and 15 days after last day of treatment (T2). Chewing-stimulated whole saliva samples were collected at each visit. Group 1 showed a constant reduction in median cfu counts, although the difference was significant only between T0 and T2 (p = 0.004). Group 2 showed a reduction in median Candida cfu counts between T0 and T1 (p = 0.01), but the counts increased at T2 (p = 0.01), and the difference between T0 and T2 was not significant (p = 0.8). In conclusion, patients who received salivary stimulation showed reductions of Candida cfu counts in saliva and a trend for increasing salivary flow rates between baseline and end of study evaluations. The use of chlorhexidine mouth rinses dramatically reduced Candida cfu counts, but when patients discontinued treatment, intensity of colonization rose again.

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Opportunistic infections among people living with HIV at reference health care centers in Morocco, 2015 (Preprint)

10.2196/preprints.14229 ◽

2019 ◽

Author(s):

Noureddine Sakhri ◽

Fatima Zahra Meski ◽

SOUMIA TRIKI

Keyword(s):

Health Care ◽

Opportunistic Infections ◽

Oral Candidiasis ◽

Clinical Stage ◽

Bivariate Analysis ◽

People Living With Hiv ◽

Cross Sectional Survey ◽

Pneumocystis Jiroveci ◽

Cross Sectional ◽

Health Care Centers

BACKGROUND Morbidity and mortality in HIV disease is due to immune-suppression leading to life-threatening opportunistic infections (OIs) during the natural course of the disease. In 2015, the HIV prevalence is low in general population and concentrated among key populations. OBJECTIVE This study aimed to assess the prevalence and CD4 correlates of OIs among adult HIV-infected patients attending antiretroviral health care in Morocco, during 2015. METHODS We conducted a cross-sectional survey among all adult PLHIV for admitted in the health care centers during 2015, who had acquired infection disease. Patients’ opportunistic infection status was determined through clinical diagnosis and laboratory investigations. CD4 count was determined using flow cytometry technique. The clinical stage of HIV was identified by the classification of Centers for Disease Control and Prevention (CDC). We collected Socio-demographic and clinical data from patients’ medical records. We performed statistical analysis by using Epi-Info 7.2.0.1 software. The appropriate test was applied, bivariate analysis was made and the differences were significant when p<.05. RESULTS 299 HIV-infected cases were included; 53% were males. The most represented age group was 25-34 years (36.1%). The mean age of the cases was 38.7 ± 16.8. The prevalence of OIs was 47.8%. Tuberculosis (65/299, 21.7%), Pneumocystis jiroveci pneumonia (40/299, 13.4%) and Oral candidiasis (22/299, 7.4%) were the most frequently observed OIs. CONCLUSIONS Tuberculosis, pneumocystis and oral candidacies were the leading OIs, encountered by HIV-infected cases. Preventive measures and early diagnosis of HIV associated to OIs are crucial.

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Orodispersible Film Loaded with Enterococcus faecium CRL183 Presents Anti-Candida albicans Biofilm Activity In Vitro

Pharmaceutics ◽

10.3390/pharmaceutics13070998 ◽

2021 ◽

Vol 13 (7) ◽

pp. 998

Author(s):

Virgínia Barreto Lordello ◽

Andréia Bagliotti Meneguin ◽

Sarah Raquel de Annunzio ◽

Maria Pía Taranto ◽

Marlus Chorilli ◽

...

Keyword(s):

Candida Albicans ◽

Antifungal Activity ◽

Enterococcus Faecium ◽

Potato Starch ◽

Oral Candidiasis ◽

Candida Spp ◽

Sem Images ◽

Control Film ◽

In Vitro Antifungal Activity

Background: Probiotic bacteria have been emerging as a trustworthy choice for the prevention and treatment of Candida spp. infections. This study aimed to develop and characterize an orodispersible film (ODF) for delivering the potentially probiotic Enterococcus faecium CRL 183 into the oral cavity, evaluating its in vitro antifungal activity against Candida albicans. Methods and Results: The ODF was composed by carboxymethylcellulose, gelatin, and potato starch, and its physical, chemical, and mechanical properties were studied. The probiotic resistance and viability during processing and storage were evaluated as well as its in vitro antifungal activity against C. albicans. The ODFs were thin, resistant, and flexible, with neutral pH and microbiologically safe. The probiotic resisted the ODF obtaining process, demonstrating high viability (>9 log10 CFU·g−1), up to 90 days of storage at room temperature. The Probiotic Film promoted 68.9% of reduction in fungal early biofilm and 91.2% in its mature biofilm compared to the group stimulated with the control film. Those results were confirmed through SEM images. Conclusion: The probiotic ODF developed is a promising strategy to prevent oral candidiasis, since it permits the local probiotic delivery, which in turn was able to reduce C. albicans biofilm formation.

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Penetration of Isavuconazole in Ascites Fluid of Critically Ill Patients

Journal of Fungi ◽

10.3390/jof7050376 ◽

2021 ◽

Vol 7 (5) ◽

pp. 376

Author(s):

Tobias Lahmer ◽

Gonzalo Batres Baires ◽

Roland M. Schmid ◽

Johannes R. Wiessner ◽

Jörg Ulrich ◽

...

Keyword(s):

Critically Ill ◽

Critically Ill Patients ◽

Ascites Fluid ◽

Candida Spp ◽

Fungal Peritonitis ◽

Penetration Ratio ◽

Threatening Condition ◽

Liquid Chromatography Tandem Mass ◽

Life Threatening ◽

Fluid Levels

Fungal peritonitis is a life-threatening condition which is not only difficult to diagnose, but also to treat. Following recent guidelines, echinocandins and azoles are the recommended antimycotics for the management of intra-abdominal Candida spp. infections, with a favor for echinocandins in critically ill patients. However, the new extended spectrum triazole isavuconazole also has a broad spectrum against Candida spp. Data on its target-site penetration are sparse. Therefore, we assessed isavuconazole concentrations and penetration ratios in ascites fluid of critically ill patients. Obtaining of Isavuconazole plasma and ascites fluid levels as well penetration ratios using paracentesis in critically ill patients. Isavuconazole concentrations were quantified in human plasma and ascites by a liquid chromatography/tandem mass spectrometry (LC-MS/MS) method. Isavuconazole concentrations in plasma and ascites fluid were measured in sixteen critically ill patients. Isavuconazol levels in ascites fluid (1.06 µg/mL) were lower than plasma levels (3.08 µg/mL). Penetration ratio was 36%. In two out of sixteen patients, Candida spp., in detail C. glabrata and C. tropicalis, could be isolated. Cmax/MIC Ratio in plasma of 560 for C. glabrata and 2166 for C. tropicalis could be observed. Following our results, isavuconazole penetrates into ascites. Successful treatment in Candida spp. peritonitis depends on pathogen susceptibility.

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Therapeutic Antibodies for the Treatment of Respiratory Tract Infections—Current Overview and Perspectives

Vaccines ◽

10.3390/vaccines9020151 ◽

2021 ◽

Vol 9 (2) ◽

pp. 151

Author(s):

Alexie Mayor ◽

Adélaïde Chesnay ◽

Guillaume Desoubeaux ◽

David Ternant ◽

Nathalie Heuzé-Vourc’h ◽

...

Keyword(s):

Respiratory Tract Infections ◽

Inflammatory Diseases ◽

Treatment Strategies ◽

Candida Spp ◽

Medical Needs ◽

Life Threatening ◽

Rsv Infection ◽

Syncytial Virus ◽

Tract Infections ◽

Unmet Medical Needs

Respiratorytract infections (RTIs) are frequent and life-threatening diseases, accounting for several millions of deaths worldwide. RTIs implicate microorganisms, including viruses (influenza virus, coronavirus, respiratory syncytial virus (RSV)), bacteria (Pseudomonas aeruginosa, Streptococcus pneumoniae, Staphylococcus aureus and Bacillus anthracis) and fungi (Pneumocystis spp., Aspergillus spp. and very occasionally Candida spp.). The emergence of new pathogens, like the coronavirus SARS-CoV-2, and the substantial increase in drug resistance have highlighted the critical necessity to develop novel anti-infective molecules. In this context, antibodies (Abs) are becoming increasingly important in respiratory medicine and may fulfill the unmet medical needs of RTIs. However, development of Abs for treating infectious diseases is less advanced than for cancer and inflammatory diseases. Currently, only three Abs have been marketed for RTIs, namely, against pulmonary anthrax and RSV infection, while several clinical and preclinical studies are in progress. This article gives an overview of the advances in the use of Abs for the treatment of RTIs, based on the analysis of clinical studies in this field. It describes the Ab structure, function and pharmacokinetics, and discusses the opportunities offered by the various Ab formats, Ab engineering and co-treatment strategies. Including the most recent literature, it finally highlights the strengths, weaknesses and likely future trends of a novel anti-RTI Ab armamentarium.

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