Antifungal Susceptibility of Oral Candida Isolates from Mother-Infant Dyads to Nystatin, Fluconazole, and Caspofungin.

Content Provider	Europe PMC
Author	Alkhars, Naemah Gaca, Anthony Zeng, Yan Al-Jallad, Nisreen Rustchenko, Elena Wu, Tong Tong Eliav, Eli Xiao, Jin
Editor	Cannon, Richard D.
Copyright Year	2023
Abstract	The carriage of Candida albicans in children’s oral cavities is associated with a higher risk for early childhood caries, so controlling this fungus in early life is essential for preventing caries. In a prospective cohort of 41 mothers and their children from 0 to 2 years of age, this study addressed four main objectives: (1) Evaluate in vitro the antifungal agent susceptibility of oral Candida isolates from the mother-child cohort; (2) compare Candida susceptibility between isolates from the mothers and children; (3) assess longitudinal changes in the susceptibility of the isolates collected between 0 and 2 years; and (4) detect mutations in C. albicans antifungal resistance genes. Susceptibility to antifungal medications was tested by in vitro broth microdilution and expressed as the minimal inhibitory concentration (MIC). C. albicans clinical isolates were sequenced by whole genome sequencing, and the genes related to antifungal resistance, ERG3, ERG11, CDR1, CDR2, MDR1, and FKS1, were assessed. Four Candida spp. (n = 126) were isolated: C. albicans, C. parapsilosis, C. dubliniensis, and C. lusitaniae. Caspofungin was the most active drug for oral Candida, followed by fluconazole and nystatin. Two missense mutations in the CDR2 gene were shared among C. albicans isolates resistant to nystatin. Most of the children’s C. albicans isolates had MIC values similar to those from their mothers, and 70% remained stable on antifungal medications from 0 to 2 years. For caspofungin, 29% of the children’s isolates showed an increase in MIC values from 0 to 2 years. Results of the longitudinal cohort indicated that clinically used oral nystatin was ineffective in reducing the carriage of C. albicans in children; novel antifungal regimens in infants are needed for better oral yeast control.
Volume Number	9
PubMed Central reference number	PMC10219145
Issue Number	5
PubMed reference number	37233291
Journal	Journal of Fungi [J Fungi (Basel)]
e-ISSN	2309608X
DOI	10.3390/jof9050580
Language	English
Publisher	MDPI
Publisher Date	2023-05-17
Access Restriction	Open
Rights License	Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). © 2023 by the authors.
Subject Keyword	antifungal agent in vitro susceptibility oral Candida nystatin fluconazole caspofungin
Content Type	Text
Resource Type	Article
Subject	Plant Science Microbiology (medical) Ecology, Evolution, Behavior and Systematics