Antifungal Activity of Carvacrol on Ergosterol Synthesis in Multidrug Resistant Candida albicans

Introduction: Greatly increased use of antifungal therapies has resulted in the development of multidrug resistant. The phenolic compound carvacrol have been reported to have anti-Candida activity. This work is an attempt to examine effect of carvacrol on ergosterol synthesis against multidrug resistant Candida albicans.Methods: This cross-sectional study has been conducted on ۳۰ immune-compromised patients from vagina, mouth and skin surfaces during ۲۰۱۶-۲۰۱۷. Colonizing clinical isolates of C. albicans were identified and drug resistant isolates detected using WHONET software. The susceptibility tests for carvacrol were carried out in terms of disk diffusion, broth microdilution and time kill assays against multidrug resistant C.albicans. The ability to change from yeast to hyphal morphology exploited using a lightmicroscopy. Ergosterol quantification has been investigated by spectrophotometricanalysis. The expression profile of ERG۱۱ gene was studied using quantitative real timeRT-PCR to admit the possibility of further associated ergosterol pathway. Statisticalanalysis was performed with SPSS ۲۱.۰. Comparisons were performed using one-wayANOVA, with Tukey’s tests.Results: Ten colonizing clinical isolates of C. albicans were identified. Multidrug resistant isolates of C. albicans were detected. Carvacrol was found to have MIC۹۰ of ۱۰۰-۲۰۰ μg/ml for multidrug drug resistant isolates of C. albicans. The time kill curve results show thatcarvacrol could significantly inhibit the growth of C. albicans (P≤۰.۰۵). In multidrugresistant C. albicans treated with carvacrol there was a marked reduction of the transitionof yeast cells to hyphal cells. Significant decrease of ergosterol content was noted inmultidrug resistant C. albicans treated with carvacrol. Furthermore, significant downregulationwas observed on ERG۱۱ gene in multidrug resistant C. albicans treated withcarvacrol (P≤۰.۰۵).Conclusion: Carvacrol show strong antifungal activity against multidrug resistant C. albicans. These results provide proof of concept for the implementation of carvacrol that may have potential applications in the treatment of drug resistance C. albicans infections.