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Post-antifungal effect and adhesion to buccal epithelial cells of oral Candida dubliniensis isolates subsequent to limited exposure to amphotericin B, ketoconazole and fluconazole

Authors

  • Arjuna N. B. Ellepola,

    Corresponding author
    1. Department of Bioclinical Sciences, Faculty of Dentistry, Health Sciences Center, Kuwait University, Jabriya, Kuwait
    • Correspondence

      Dr A. Ellepola, Department of Bioclinical Sciences, Faculty of Dentistry, Kuwait University, P.O. Box 24923, Safat 13110, Kuwait.

      Tel: 00965 24636714

      Fax: 00965 25326049

      Email: arjuna@hsc.edu.kw

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  • Rachel Chandy,

    1. Department of Microbiology, Faculty of Medicine, Health Sciences Center, Kuwait University, Jabriya, Kuwait
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  • Zia U. Khan

    1. Department of Microbiology, Faculty of Medicine, Health Sciences Center, Kuwait University, Jabriya, Kuwait
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Abstract

Aim

The post-antifungal effect (PAFE) of Candida and its adherence to oral mucosal surfaces are important determinants of candidal pathogenicity. Candida dubliniensis is allied with recurrent oral candidosis. Oral candidosis can be treated with amphotericin B, ketoconazole and fluconazole. There is no information on the PAFE and its impact on adhesion to oral buccal epithelial cells (BEC) of oral C. dubliniensis isolates. Therefore, the main objective was to reconnoiter the PAFE and adhesion to BEC of 20 C. dubliniensis isolates following brief exposure to aforementioned antimycotics.

Methods

After determining the minimum inhibitory concentration (MIC), C. dubliniensis isolates were exposed to sub-lethal concentrations of these drugs for 1 h. Following subsequent drug removal, the PAFE and adhesion to BEC, was determined by a turbidometric method, and an adhesion assay, respectively.

Results

Minimum inhibitory concentration (μg/mL) to amphotericin B, ketoconazole and fluconazole, ranged from 0.002 to 0.125, 0.002 to 0.012 and 0.016 to 0.38, respectively. Amphotericin B and ketoconazole induced mean PAFE (hours) were 2.21 and 0.6, respectively. Fluconazole failed to produce a detectable PAFE. Compared to controls, amphotericin B, ketoconazole and fluconazole suppressed the ability to adhere to BEC with a mean percentage reduction of 74.31%, 49.80% (P < 0.0001) and 29.36% (P < 0.05), respectively.

Conclusions

Brief exposure to sub-lethal concentrations of aforementioned drugs would exert an antifungal effect by modifying the growth and adhesion of C. dubliniensis isolates.

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