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Research Article

Reversal of fluconazole resistance induced by a synergistic effect with Acca sellowiana in Candida glabrata strains

, , , , , & show all
Pages 2410-2419 | Received 29 Dec 2015, Accepted 22 Feb 2016, Published online: 06 Apr 2016
 

Abstract

Context: The increased incidence of non-albicans Candida (NAC) resistant to fluconazole (FLZ) makes it necessary to use new therapeutic alternatives. Acca sellowiana (O.berg) Burret (Myrtaceae) is a guava with several proven biological activities. The interaction with fluconazole can be a feasible alternative to overcome this resistance.

Objective: This study evaluates the in vitro antifungal activity of fractions obtained from the lyophilized aqueous extract of the leaves of A. sellowiana against resistant strains of NAC.

Materials and methods: The antifungal activity of the fractions was evaluated at 500 μg/mL by microdilution method. Checkerboard assay was performed to determine the effect of the combination of the F2 fraction and antifungal at concentrations: MIC/4, MIC/2, MIC, MIC × 2 and MIC × 4.

Results: Candida glabrata showed the lowest MIC values (500–3.90 μg/mL) and the F2 active fraction was the most effective. The association of F2 with FLZ showed a strong synergistic effect (FICI ≤ 0.5) against 100% of C. glabrata resistant isolates. Moreover, the F2 active fraction has demonstrated that probably acts in the cell wall of these yeasts. There was no observed acute dermal toxicity of lyophilized aqueous extract of leaves of A. sellowiana on pig ear skin cells.

Discussion and conclusion: The interaction between substances present in the F2 active fraction is possibly responsible for the antifungal activity presented by this fraction. This study is unprecedented and suggests that the combination of F2 active fraction and FLZ might be used as an alternative treatment for mucocutaneus infections caused by C. glabrata resistant.

Acknowledgements

The authors would like to acknowledge the assistance of Gregory Svetlichny for SEM images.

Disclosure statement

All authors declare to have no conflict of interest.

Funding information

This study received financial support from the National Council of Technological and Scientific Development (CNPq), Brazil

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