Khalandi Halala, Masoori Leila, Farahyar Shirin, Delbandi Ali Akbar, Raiesi Omid, Farzanegan Ali, Khalandi Ghafour, Mahmoudi Shahram, Erfanirad Tayebeh, Falahati Mehraban
Department of Medical Parasitology and Mycology, School of Medicine, Iran University of Medical Science, Tehran, Iran.
Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran.
Assay Drug Dev Technol. 2020 May/Jun;18(4):195-201. doi: 10.1089/adt.2020.971. Epub 2020 May 11.
Due to the increasing resistance of various species to azole drugs, particularly fluconazole, it would be of significant importance to look for alternative therapies. The aim of this study was to investigate the antifungal activity of capric acid and its interactions with nystatin and fluconazole against isolates. A total of 40 isolates (, 36; , 2; , 1; , 1) collected from the oral cavity of neonates with oropharyngeal candidiasis and a reference strain of (ATCC 10231) were used in this study. Antifungal activity of capric acid and two comparator antifungal drugs, namely fluconazole and nystatin, was tested according to CLSI M27-A3/M60 method. The interaction between capric acid with fluconazole and nystatin was determined following a checkerboard method and results were interpreted using fractional inhibitory concentration index. Nystatin had the lowest minimum inhibitory concentrations (range, 0.125-8 μg/mL; geometric mean [GM], 0.6229 μg/mL) followed by fluconazole (range, 0.5-16 μg/mL; GM, 1.9011 μg/mL) and capric acid (range, 128-2,048 μg/mL; GM, 835.9756 μg/mL). When tested in combination, capric acid with fluconazole demonstrated synergistic, indifferent, and antagonistic interactions in 3 (7.317%), 24 (58.536%), and 14 (34.146%) cases, respectively. For combination of capric acid with nystatin, synergistic, indifferent, and antagonistic interactions were observed in 1 (2.439%), 19 (46.341%), and 21 (51.219%) cases, respectively. All cases of synergistic interactions were against resistant or susceptible dose-dependent isolates. Fluconazole, nystatin, and capric acid seem to be more effective when they are used alone compared with their combination. However, their combination might be effective on resistant isolates.
由于各种真菌对唑类药物，尤其是氟康唑的耐药性不断增加，寻找替代疗法具有重要意义。本研究的目的是研究癸酸的抗真菌活性及其与制霉菌素和氟康唑对分离株的相互作用。本研究共使用了40株从患有口腔念珠菌病的新生儿口腔中分离出的菌株（白色念珠菌36株；近平滑念珠菌2株；热带念珠菌1株；光滑念珠菌1株）以及一株白色念珠菌参考菌株（ATCC 10231）。根据CLSI M27-A3/M60方法检测癸酸和两种对照抗真菌药物（即氟康唑和制霉菌素）的抗真菌活性。采用棋盘法测定癸酸与氟康唑和制霉菌素之间的相互作用，并使用分数抑菌浓度指数解释结果。制霉菌素的最低抑菌浓度最低（范围为0.125 - 8μg/mL；几何平均数[GM]为0.6229μg/mL），其次是氟康唑（范围为0.5 - 16μg/mL；GM为1.9011μg/mL）和癸酸（范围为128 - 2048μg/mL；GM为835.9756μg/mL）。联合检测时，癸酸与氟康唑分别在3例（7.317%）、24例（58.536%）和14例（34.146%）中表现出协同、无关和拮抗相互作用。对于癸酸与制霉菌素的联合使用，分别在1例（2.439%）、19例（46.341%）和21例（51.219%）中观察到协同、无关和拮抗相互作用。所有协同相互作用的病例均针对耐药或剂量依赖性敏感分离株。与联合使用相比，氟康唑、制霉菌素和癸酸单独使用时似乎更有效。然而，它们的联合使用可能对耐药分离株有效。
