title: Impact of short-term exposure of antifungal agents on hemolysin activity of oral Candida dubliniensis isolates from Kuwait and Sri Lanka.
abstract: OBJECTIVE
  Ability to produce hemolysin by Candida species is an important determinant of its pathogenicity. Candida dubliniensis is implicated in the causation of oral candidosis, which can be treated with polyene, echinocandin, and azole groups of antifungal agents as well as chlorhexidine. After oral application, however, the concentrations of these agents tend to decrease quickly to subtherapeutic levels due to the peculiarity of the oral environment. In this study, we have evaluated the effect of short-term exposure of sublethal concentrations of these drugs on hemolysin production by oral C. dubliniensis isolates obtained from two different geographical locale.
  
  
  METHODS
  Twenty C. dubliniensis oral isolates obtained from Kuwait and Sri Lanka were exposed to sublethal concentrations of nystatin, amphotericin B, caspofungin, ketoconazole, fluconazole, and chlorhexidine for 1 h. Thereafter, the drugs were removed by dilution and the hemolysin production determined by a previously described plate assay.
  
  
  RESULTS
  Hemolysin production of these isolates was significantly suppressed with a percentage reduction of 17.09, 16.45, 17.09, 11.39, 8.23 and 12.03 following exposure to nystatin, amphotericin B, caspofungin, ketoconazole, fluconazole, and chlorhexidine, respectively.
  
  
  CONCLUSIONS
  Brief exposure to sublethal concentrations of drugs with antifungal properties appears to reduce the pathogenic potential of C. dubliniensis isolates by suppressing hemolysin production.
authors.affiliation: Faculty of Dentistry, Health Sciences Center, Kuwait University, Jabriya, Kuwait. arjuna@hsc.edu.kw.
authors.forename: Arjuna N B
authors.initials: AN
authors.lastname: Ellepola
authors.affiliation: Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka.
authors.forename: J A M Sumedha
authors.initials: JA
authors.lastname: Jayathilake
authors.affiliation: Faculty of Medicine, Health Sciences Center, Kuwait University, Jabriya, Kuwait.
authors.forename: Prem N
authors.initials: PN
authors.lastname: Sharma
authors.affiliation: Faculty of Medicine, Health Sciences Center, Kuwait University, Jabriya, Kuwait.
authors.forename: Zia U
authors.initials: ZU
authors.lastname: Khan
mesh_terms: D000666:Amphotericin B / Q000008:administration & dosage / Q000494:pharmacology; D000935:Antifungal Agents / Q000008:administration & dosage* / Q000494:pharmacology*; D002175:Candida / Q000187:drug effects / Q000302:isolation & purification / Q000378:metabolism* / Q000472:pathogenicity; D002180:Candidiasis, Oral / Q000382:microbiology; D000077336:Caspofungin; D002710:Chlorhexidine / Q000008:administration & dosage / Q000494:pharmacology; D054714:Echinocandins / Q000008:administration & dosage / Q000494:pharmacology; D015725:Fluconazole / Q000008:administration & dosage / Q000494:pharmacology; D006460:Hemolysin Proteins / Q000032:analysis / Q000096:biosynthesis* / Q000187:drug effects*; D006801:Humans; D007654:Ketoconazole / Q000008:administration & dosage / Q000494:pharmacology; D007730:Kuwait; D055666:Lipopeptides / Q000008:administration & dosage / Q000494:pharmacology; D008826:Microbial Sensitivity Tests; D009761:Nystatin / Q000008:administration & dosage / Q000494:pharmacology; D013188:Sri Lanka; D013997:Time Factors
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D006460:Hemolysin Proteins; D055666:Lipopeptides; D009761:Nystatin; D000666:Amphotericin B; D015725:Fluconazole; D000077336:Caspofungin; D002710:Chlorhexidine; D007654:Ketoconazole
keywords: 
  Candida dubliniensis
  ; antifungal drugs; hemolysin