RESUMEN

Patients with orofacial clefts are more likely to develop oral fungal diseases due to anatomo-physiological changes and surgical rehabilitation treatment. This case-series study evaluated the genetic diversity and dynamics of oral colonization and spread of C. albicans and C. tropicalis in four patients with orofacial clefts, from the time of hospital admission, perioperative and outpatient follow-up, with specialized physician. Candida biotypes previously identified by CHROMagar Candida and PCR methods were studied by MALDI-TOF MS assays and clustering analyses. Possible correlations with pathogenicity characteristics were observed, including production of hydrolytic exoenzymes and the antifungal sensitivity profiles. Amphotericin B-sensitive and fluconazole-resistant (low frequency) C. tropicalis and C. albicans, including clinically compatible MIC of nystatin, were found in the oral cavity of these patients. Clusters of isolates revealed phenomena of (i) elimination in the operative phase, (ii) maintenance or (iii) acquisition of oral C. tropicalis in the perioperative period and specialized outpatient and medical follow-up. For C. albicans, these phenomena included (i) elimination in the operative phase, (ii) acquisition in the operative phase and propagation from the hospital environment, and (iii) maintenance during hospitalization and operative phase. Amphotericin B and nystatin were shown to be effective in cases of clinical treatment and/or prophylaxis, especially considering the pre-existence of fluconazole-resistant strains. This study confirmed the phenomena of septic maintenance, septic neocolonization and septic elimination involving the opportunistic pathogens. MALDI-TOF MS associated with clustering analysis may assist the monitoring of clinical isolates or groups of epidemiologically important microbial strains in the hospital setting.

Asunto(s)

Anfotericina B , Antifúngicos , Candida albicans , Candida tropicalis , Farmacorresistencia Fúngica , Genotipo , Pruebas de Sensibilidad Microbiana , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción , Humanos , Candida tropicalis/efectos de los fármacos , Candida tropicalis/aislamiento & purificación , Candida tropicalis/genética , Antifúngicos/farmacología , Antifúngicos/uso terapéutico , Candida albicans/genética , Candida albicans/efectos de los fármacos , Candida albicans/aislamiento & purificación , Anfotericina B/farmacología , Anfotericina B/uso terapéutico , Masculino , Femenino , Boca/microbiología , Niño , Fluconazol/farmacología , Fluconazol/uso terapéutico , Candidiasis Bucal/microbiología , Nistatina/farmacología , Nistatina/uso terapéutico , Técnicas de Tipificación Micológica , Fisura del Paladar/cirugía , Labio Leporino/cirugía , Adolescente , Análisis por Conglomerados , Preescolar

RESUMEN

OBJECTIVES: This study evaluated the incidence of Candida species, and the genetic diversity and virulence of C. albicans of the oral cavity from patients with cleft lip and palate (CLP). MATERIALS AND METHODS: Oral samples were investigated by microbiological and species-specific PCR methods. The genetic diversity of C. albicans was established using isoenzyme markers, Nei's statistics, and clustering analysis. Hydrolytic enzymes (SAPs and PLs) were analyzed in vitro. RESULTS: Oral colonization by Candida species was observed in 29 patients with CLP (65.9%), and C. albicans was highly prevalent. SAP and PL activities were observed in 100% and 51.9% of isolates, respectively. High genetic diversity and patterns of monoclonal and polyclonal oral colonization by C. albicans were observed among patients with CLP. Two major polymorphic taxa (A and B) and other minor polymorphic taxa (C to J) were identified. Only one of the 16 clusters (taxon A) harbored strains from patients with and without CLP, whereas other clusters harbored strains exclusively from CLP patients. CONCLUSIONS: The anatomical conditions of the oral cavity of patients with CLP contribute to the high incidence of Candida species (C. albicans, C. krusei, C. tropicalis, and/or Candida spp.). Data suggest high genetic diversity of potentially virulent C. albicans strains in the oral cavity of CLP patients. CLINICAL RELEVANCE: Microbiological niches in orofacial clefts can contribute to the emergence of a relative clinical genotypic identity of C. albicans. However, orofacial rehabilitation centers can contribute to the direct and indirect sources of transmission and propagation of Candida species.

Asunto(s)

Candidiasis Bucal , Labio Leporino , Fisura del Paladar , Candida , Candida albicans , Candidiasis Bucal/microbiología , Humanos

RESUMEN

BACKGROUND: Sedum praealtum has been used for a long time in traditional medicine as an analgesic and anti-inflammatory agent. Its beneficial effects have been known since ancient times, when Latinos used it to treat sore and swollen eyes. This research evaluated the antimicrobial potential, the cytotoxic and genotoxic effects, and some chromatographic profiles of the hydroethanolic extract of leaves, stems and roots of S. praealtum. METHODS: The antimicrobial activities were carried out by broth microdilution and agar diffusion. In vitro cytotoxicity was evaluated by cell cultures of Aedes albopictus and the selectivity index (SI) was estimated: SI=CI50/MIC. Genotoxic and systemic toxic effects of S. praealtum leaves were analyzed by micronucleus assay in mice bone marrow. Chromatographic profiles and mass spectra were investigated by GC-MS. RESULTS: Gram-positive (B. subtilis, B. cereus, M. luteus, E. faecalis and S. aureus) and gram-negative (E. coli, E. aerogenes, S. marcescens, P. aeruginosa, P. mirabilis and S. typhimurium) bacteria exhibited MICs ranging from 12.5-50 and 0-50 mg/ml, respectively. Sedum praealtum showed no efficacy against M. tuberculosis and M. bovis. Cytotoxicity (CI50) of S. praealtum was 4.22 and 5.96 mg/ml for leaves and stems, respectively, while its roots showed no cytotoxicity. Micronucleated polychromatic erythrocytes (MNPCEs) analyzes showed no differences between treatment doses (0.5-2 g/kg) and negative control (NaCl), but the PCE/NCE ratio (polychromatic erythrocyte/normochromatic erythrocyte) showed significant differences. Phytochemical screening identified thirteen compounds in the leaves, stems and roots of S. praealtum potentially associated with their biological activities. CONCLUSIONS: This research comprises a first scientific study on genotoxicity, cytotoxicity and antimicrobial effects of S. praealtum (Balsam), and it provides an initial theoretical foundation for its comprehensive use. Results showed antibacterial action of S. praealtum against gram-positive bacteria and some gram-negative species (depending on the plant anatomical part), but ineffective antimycobacterial action. However, S. praealtum leaves and stems display potential cytotoxicity, contributing to the SI < 1 values. In addition, S. praealtum leaves exhibit no clastogenic and/or aneugenic effects, but it has systemic toxicity dose-independent.

Asunto(s)

Bacterias/efectos de los fármacos , Candida albicans/efectos de los fármacos , Extractos Vegetales/toxicidad , Saccharomyces cerevisiae/efectos de los fármacos , Sedum , Aedes , Animales , Brasil , Ratones , Pruebas de Mutagenicidad , Extractos Vegetales/química

RESUMEN

The aim of this study was to evaluate the mutagenicity (clastogenicity/aneugenicity) of a glycolic extract of Ziziphus joazeiro bark (GEZJ) by the micronucleus assay in mice bone marrow. Antimutagenic activity was also assessed using treatments associated with GEZJ and doxorubicin (DXR). Mice were evaluated 24-48 h after exposure to positive (N-nitroso-N-ethylurea, NEU - 50 mg.kg(-1) and DXR - 5 mg.kg(-1)) and negative (150 mM NaCl) controls, as well as treatment with GEZJ (0.5-2 g.kg(-1)), GEZJ (2 g.kg(-1)) + NEU and GEZJ (2 g.kg(-1)) + DXR. There were no significant differences in the frequencies of micronucleated polychromatic erythrocytes in mice treated with GEJZ and GEJZ + DXR compared to the negative controls, indicating that GEZJ was not mutagenic. Analysis of the polychromatic:normochromatic erythrocyte ratio revealed significant differences in the responses to doses of 0.5 g.kg(-1) and 1-2 g.kg(-1) and the positive control (NEU). These results indicated no systemic toxicity and moderate toxicity at lower and higher doses of GEZJ. The lack of mutagenicity and systemic toxicity in the antimutagenic assays, especially for treatment with GEZJ + DXR, suggested that phytochemical compounds in Z. joazeiro bark attenuated DXR-induced mutagenicity and the moderate systemic toxicity of a high dose of Z. joazeiro bark (2 g.kg(-1)). Further studies on the genotoxicity of Z. joazeiro extracts are necessary to establish the possible health risk in humans and to determine the potential as a chemopreventive agent for therapeutic use.