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Combination of Farnesol with Common Antifungal Drugs: Inhibitory Effect against <i>Candida</i> Species Isolated from Women with RVVC
oleh: Fatemeh Nikoomanesh, Mahsa Falahatinejad, Lucia Černáková, André Luis Souza dos Santos, Shahla Roudbar Mohammadi, Mitra Rafiee, Célia Fortuna Rodrigues, Maryam Roudbary
Format: | Article |
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Diterbitkan: | MDPI AG 2023-04-01 |
Deskripsi
<i>Background and Objectives</i>: Vulvovaginal candidiasis (VVC) is a mucous membrane infection, with an increased rate of antifungal resistance of <i>Candida</i> species. In this study, the in vitro efficacy of farnesol alone or in combination with traditional antifungals was assessed against resistant <i>Candida</i> strains recovered from women with VVC. <i>Materials and Methods</i>: Eighty <i>Candida</i> isolates were identified by multiplex polymerase chain reaction (PCR), and the antifungal susceptibility to amphotericin B (AMB), fluconazole (FLU), itraconazole (ITZ), voriconazole (VOR), clotrimazole (CTZ), and farnesol was tested by the standard microdilution method. The combinations of farnesol with each antifungal were calculated based on the fractional inhibitory concentration index (FICI). <i>Result: Candida glabrata</i> was the predominant species (48.75%) isolated from vaginal discharges, followed by <i>C. albicans</i> (43.75%), <i>C. parapsilosis</i> (3.75%), a mixed infection of <i>C. albicans</i> and <i>C. glabrata</i> (2.5%) and <i>C. albicans</i> and <i>C. parapsilosis</i> (1%). <i>C. albicans</i> and <i>C. glabrata</i> isolates had lower susceptibility to FLU (31.4% and 23.0%, respectively) and CTZ (37.1% and 33.3%, respectively). Importantly, there was “synergism” between farnesol–FLU and farnesol–ITZ against <i>C. albicans</i> and <i>C. parapsilosis</i> (FICI = 0.5 and 0.35, respectively), reverting the original azole-resistant profile. <i>Conclusion</i>: These findings indicate that farnesol can revert the resistance profile of azole by enhancing the activity of FLU and ITZ in resistant <i>Candida</i> isolates, which is a clinically promising result.