Ocular infections caused by Candida species: Type of species, in vitro susceptibility and treatment outcome

Motukupally, SR; Nanapur, VR; Chathoth, Kanchana; Murthy, SI; Pappuru, RR; Mallick, Aparajita; Sharma, Savitri

doi:10.4103/0255-0857.167331

Cited by 26 publications

(10 citation statements)

References 23 publications

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“…Although the above mentioned Candida sp. have been isolated from the ocular surface of FK patients [ 50 ], the present finding of the ubiquitous presence of the two species of Candida in the gut of FK patients is interesting.…”

Section: Resultsmentioning

confidence: 82%

Alterations in the gut bacterial microbiome in fungal Keratitis patients

et al. 2018

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Dysbiosis in the gut microbiome has been implicated in several diseases including auto-immune diseases, inflammatory diseases, cancers and mental disorders. Keratitis is an inflammatory disease of the eye significantly contributing to corneal blindness in the developing world. It would be worthwhile to investigate the possibility of dysbiosis in the gut microbiome being associated with Keratitis. Here, we have analyzed fungal and bacterial populations in stool samples through high-throughput sequencing of the ITS2 region for fungi and V3-V4 region of 16S rRNA gene for bacteria in healthy controls (HC, n = 31) and patients with fungal keratitis (FK, n = 32). Candida albicans (2 OTUs), Aspergillus (1 OTU) and 3 other denovo-OTUs were enriched in FK samples and an unclassified denovo-OTU was enriched in HC samples. However, the overall abundances of these ‘discriminatory’ OTUs were very low (< 0.001%) and not indicative of significant dysbiosis in the fungal community inhabiting the gut of FK patients. In contrast, the gut bacterial richness and diversity in FK patients was significantly decreased when compared to HC. 52 OTUs were significantly enriched in HC samples whereas only 5 OTUs in FK. The OTUs prominently enriched in HC were identified as Faecalibacterium prausnitzii, Bifidobacterium adolescentis, Lachnospira, Mitsuokella multacida, Bacteroides plebeius, Megasphaera and Lachnospiraceae. In FK samples, 5 OTUs affiliated to Bacteroides fragilis, Dorea, Treponema, Fusobacteriaceae, and Acidimicrobiales were significantly higher in abundance. The functional implications are that Faecalibacterium prausnitzii, an anti-inflammatory bacterium and Megasphaera, Mitsuokella multacida and Lachnospira are butyrate producers, which were enriched in HC patients, whereas Treponema and Bacteroides fragilis, which are pathogenic were abundant in FK patients, playing a potential pro-inflammatory role. Heatmap, PCoA plots and functional profiles further confirm the distinct patterns of gut bacterial composition in FK and HC samples. Our study demonstrates dysbiosis in the gut bacterial microbiomes of FK patients compared to HC. Further, based on inferred functions, it appears that dysbiosis in the gut of FK subjects is strongly associated with the disease phenotype with decrease in abundance of beneficial bacteria and increase in abundance of pro-inflammatory and pathogenic bacteria.

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Section: Resultsmentioning

confidence: 82%

Alterations in the gut bacterial microbiome in fungal Keratitis patients

et al. 2018

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“…The MIC 90 of NT is reported to be in the range of 1.56 to 6.25 µg/mL against Fusarium species, 44 and 0.25 to 4.0 µg/mL against Candida species. 45 The data from the release studies reveal that within 30 min the NT concentration achieved from the NLC formulation (174 µg/mL), was higher than the MIC 90 against both fungal species. However, from the NLC-IG formulation, NT concentration (30 µg/mL) exceeded the MIC 90 values only after the third hour.…”

Section: Resultsmentioning

confidence: 93%

Dual Drug Loaded Lipid Nanocarrier Formulations for Topical Ocular Applications

Youssef¹,

Dudhipala²,

Majumdar³

2022

IJN

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Introduction Untreated ocular infections can damage the unique fine structures of the eye with possible visual impairments and blindness. Ciprofloxacin (CIP) ophthalmic solution is prescribed as first-line therapy in ocular bacterial infections. Natamycin (NT) ophthalmic suspension is one of the progenitors in ocular antifungal therapy. Nanostructured lipid carriers (NLCs) have been widely examined for ocular penetration enhancement and distribution to deeper ocular tissues. The objective of the current study was to prepare NLCs loaded with a combination of CIP and NT (CIP-NT-NLCs) and embed them in an in-situ gelling system (CIP-NT-NLCs-IG). This novel formulation will target the co-delivery of CIP and NT for the treatment of mixed ocular infections or as empirical treatment in case of limited access to healthcare diagnostic services. Methods CIP-NT-NLC and CIP-NT-NLC-IG formulations were evaluated based on physicochemical characteristics, in vitro release, and ex vivo transcorneal permeation studies and compared against commercial CIP and NT ophthalmic eye drops. Results and Discussion NLCs formulation (0.1% CIP and 0.3% NT) showed particle size, polydispersity index, and zeta potential of 196.2 ± 1.2 nm, 0.43 ± 0.06, and −28.1 ± 1.4 mV, respectively. Moreover, CIP-NT-NLCs showed entrapment efficiency of 80.9 ± 2.9 and 98.7 ± 1.9% for CIP and NT, respectively. CIP-NT-NLCs-IGformulation with 0.2% w/v gellan gum demonstrated the most favorable viscoelastic characteristics for ocular application. CIP-NT-NLCs and CIP-NT-NLCs-IG formulations exhibited a sustained release pattern for both drugs over 24 h. Moreover, CIP-NT-NLCs and CIP-NT-NLC-IG formulations showed 4.0- and 2.2-folds, and 5.0- and 2.5-folds enhancement in ex vivo transcorneal permeability of CIP and NT, respectively, compared to the control formulations. Conclusion The results suggest that this dual nanoparticulate-based in-situ gelling drug delivery system can serve as a promising topical delivery platform for the treatment of ocular infections.

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“…Patients most commonly present with gradual vision loss with or without ocular pain [ 4 , 5 ]. Although there is no established treatment protocol for candidal endogenous endophthalmitis, voriconazole is a new-generation triazole antifungal that has been shown to achieve therapeutic intraocular levels with oral administration, and systemic antifungal therapy alone is usually sufficient in the absence of vitritis [ 6 ]. In the presence of vitreal lesions or vitritis, intravitreal injection of antifungal agents is usually added to systemic antifungal treatment, and vitrectomy can be performed for persistent vitreal opacities, vitritis or nonclearing vitreous hemorrhage [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Brown Heroin-Associated <b><i>Candida albicans</i></b> Ventriculitis and Endopthalmitis Treated with Voriconazole

Elfiky¹,

Baldwin²

2016

Case Rep Neurol

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Chronic meningitis and ventriculitis are defined as inflammatory pleocytoses in the cerebrospinal fluid (CSF) and ependyma that persists for at least 1 month without spontaneous resolution. Because the CSF communicates directly with the posterior compartments of the eye, fungal infections in the brain often cause secondary ophthalmologic complications. We report a 23-year-old male who presented to the emergency room with progressive severe headaches associated with insidious monocular vision loss. After extensive workup and a multidisciplinary team effort, the patient was diagnosed with ventriculitis and endogenous endopthalmitis. The etiology is suspected to be due to brown heroin use with secondary disseminated Candida albicans.

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Ocular infections caused by Candida species: Type of species, in vitro susceptibility and treatment outcome

Abstract: Ocular candidiasis needs early and specific treatment for optimal results. Candida species continue to be susceptible to most commonly available antifungals including amphotericin B, voriconazole and natamycin.

Cited by 26 publications

References 23 publications

Alterations in the gut bacterial microbiome in fungal Keratitis patients

Alterations in the gut bacterial microbiome in fungal Keratitis patients

Dual Drug Loaded Lipid Nanocarrier Formulations for Topical Ocular Applications

Brown Heroin-Associated <b><i>Candida albicans</i></b> Ventriculitis and Endopthalmitis Treated with Voriconazole

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