Ibuprofen-Mediated Reversal of Fluconazole Resistance in Clinical Isolates of Candida
Published: January 1, 2015 | DOI: https://doi.org/10.7860/JCDR/2015/.5494
Monika Sharma, Debasis Biswas, Aarti Kotwal, Bhaskar Thakuria, Barnali Kakati, Bhupendra Singh Chauhan, Abhishek Patras
1.
Senior Resident, Department of Microbiology, Govt. Medical College, Jammu, Jammu & Kashmir, India.
2.
Professor, Department of Microbiology, AIIMS Bhopal, Bhopal, India.
3.
Associate Professor, Department of Microbiology, Himalayan Institute of Medical Sciences, Jolly Grant, Dehradun, India.
4.
Associate Professor, Department of Microbiology, Subharti Medical College, Meerut, Uttar Pradesh, India.
5.
Associate Professor, Department of Microbiology, Himalayan Institute of Medical Sciences,Jolly Grant, Dehradun, India.
6.
Lab Technician, Department of Microbiology, Himalayan Institute of Medical Sciences, Jolly Grant, Dehradun, India.
7.
Lab Technician, Department of Microbiology, Himalayan Institute of Medical Sciences, Jolly Grant, Dehradun, India.
Correspondence
Dr. Debasis Biswas,
Professor, Department of Microbiology, AIIMS Bhopal, Bhopal-402624, India.
E-mail : dbiswas71@rediffmail.com
Introduction: In view of the increasing prevalence of invasive Candidiasis in today’s health-care scenario and the emergence of fluconazole resistance among clinical isolates of Candida , we sought to determine if Ibuprofen could elicit a reversal of fluconazole resistance and thereby offer a potential therapeutic breakthrough in fluconazole-resistant Candidiasis.
Materials and Methods: We selected 69 clinical isolates of Candida , which demonstrated an MIC of >32 µg/ml for fluconazole, and subjected them to broth microdilution in presence and absence of Ibuprofen.
Results: Forty two of the 69 isolates (60.9%) demonstrated reversal of Fluconazole resistance with concomitant use of Ibuprofen. This was characterized by significant species-wise variation (p=0.00008), with all the C. albicans isolates and none of the C. glabrata isolates demonstrating such reversal. Only 22.2% and 37.7% of C. krusei and C. tropicalis isolates respectively showed Ibuprofen-mediated reversal of Fluconazole resistance.
Conclusion: Since Ibuprofen is a known efflux pump inhibitor, our findings hint at the possible mechanism of Fluconazole resistance in most of our Candida isolates and suggest a potential therapeutic alternative that could be useful in the majority of Fluconazole-resistant clinical isolates of Candida .
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