Impact of Brief Exposure to Drugs with Antifungal Properties on the Susceptibility of Oral Candida dubliniensis Isolates to Lysozyme and Lactoferrin

Arjuna Nishantha B. Ellepola, Ranil Samantha Dassanayake, Ziauddin Khan
2018 Medical Principles and Practice  
Significance of the Study • Lysozyme and lactoferrin are salivary constituents with anti-candidal activity. Candida infections are managed with antimycotic drugs; there is no information on the impact of these drugs (i.e., synergism or antagonism) on the susceptibility of Candida dubliniensis to lysozyme and lactoferrin. This study reveals that exposure to antifungal drugs increases the susceptibility of C. dubliniensis to lysozyme and lactoferrin. Abstract Objective: Lysozyme and lactoferrin
more » ... e and lactoferrin have anti-candidal activity. Candida dubliniensis is associated with oral candidiasis. Candida infections are managed with nystatin, amphotericin B, caspofungin, ketoconazole, fluconazole, and chlorhexidine. Candida species undergo a brief exposure to therapeutic agents in the mouth. There is no data on the influence of limited exposure to antimycotics on the sensitivity of C. dubliniensis to lactoferrin and lysozyme. Hence, this study observed the changes in the sensitivity of C. dubliniensis to anticandidal action of lactoferrin and lysozyme after transitory exposure to sub-lethal concentrations of antifungals. Materials and Methods: After determination of the minimum inhibitory concentration (MIC), 20 C. dubliniensis isolates were exposed to twice the concentration of MIC of nystatin, amphotericin B, caspofungin, ketoconazole, fluconazole, and chlorhexidine for 1 h. Drugs were removed by dilution and thereafter the susceptibility of these isolates to lysozyme and lactoferrin was determined by colony-forming unit quantification assay. Results: Exposure of C. dubliniensis to nystatin, amphotericin B, caspofungin, ketoconazole, fluconazole, and chlorhexidine resulted in an increase in susceptibility to lysozyme by 9. 45, 30.82, 30.04, 50.64, 55.60, and 50.18%, respectively (p < 0.05 to p < 0.001). Exposure of C. dubliniensis to nystatin, amphotericin B, caspofungin, ketoconazole, fluconazole, and chlorhexidine resulted in an increase in susceptibility to lactoferrin by 13.54, 16.43, 17.58, 19.60, 21.32, and 18.73, respectively (p < 0.05 to p < 0.001). Conclusion: Brief exposure to nystatin, amphotericin B, caspofungin, ketoconazole, fluconazole, and chlorhexidine enhances the antifungal effect of lysozyme and lactoferrin on C. dubliniensis isolates in vitro.
doi:10.1159/000493391 pmid:30173211 fatcat:valkybx6mrbudkjzktb3sc7g4u