Adaptation to Sodium Hypochlorite and Potassium Permanganate May Lead to Their Ineffectiveness Against <i>Candida albicans</i>

<b>Background/Objectives:</b> Adaptation can reduce or completely eliminate the effectiveness of antibiotics and antiseptics at clinical concentrations. To our knowledge, no studies have examined fungal adaptation to antiseptics. This study aimed to preliminarily investigate the potentia...

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Main Authors: Tomasz M. Karpiński, Marzena Korbecka-Paczkowska, Marcin Ożarowski, Donald Włodkowic, Marzena Liliana Wyganowska, Agnieszka Seremak-Mrozikiewicz, Judyta Cielecka-Piontek
Format: Article
Language:English
Published: MDPI AG 2024-11-01
Series:Pharmaceuticals
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Online Access:https://www.mdpi.com/1424-8247/17/11/1544
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author Tomasz M. Karpiński
Marzena Korbecka-Paczkowska
Marcin Ożarowski
Donald Włodkowic
Marzena Liliana Wyganowska
Agnieszka Seremak-Mrozikiewicz
Judyta Cielecka-Piontek
author_facet Tomasz M. Karpiński
Marzena Korbecka-Paczkowska
Marcin Ożarowski
Donald Włodkowic
Marzena Liliana Wyganowska
Agnieszka Seremak-Mrozikiewicz
Judyta Cielecka-Piontek
author_sort Tomasz M. Karpiński
collection DOAJ
description <b>Background/Objectives:</b> Adaptation can reduce or completely eliminate the effectiveness of antibiotics and antiseptics at clinical concentrations. To our knowledge, no studies have examined fungal adaptation to antiseptics. This study aimed to preliminarily investigate the potential for <i>Candida albicans</i> adaptation to eight antiseptics. <b>Methods:</b> The minimal inhibitory concentration (MIC), drug susceptibility, adaptation to antiseptics, and Karpinski Adaptation Index (KAI) of <i>C. albicans</i> strains were assessed. <b>Results:</b> The antiseptics with the most effective MICs activity against <i>C. albicans</i> were octenidine dihydrochloride (OCT), chlorhexidine digluconate (CHX), and polyhexamethylene biguanide (polyhexanide, PHMB). Sodium hypochlorite (NaOCl) and ethacridine lactate (ET) demonstrated moderate activity, while boric acid (BA), povidone–iodine (PVI), and potassium permanganate (KMnO<sub>4</sub>) showed the weakest activity. The MIC values for NaOCl and KMnO<sub>4</sub> were close to or equal to the clinical concentrations used in commercial products. The studied strains were susceptible to econazole, miconazole, and voriconazole. Resistance to other drugs occurred in 10–30% of the strains. Antifungal resistance remained unchanged after antiseptic adaptation testing. The lowest KAI values, indicating very low resistance risk, were observed for CHX, OCT, and PHMB. PVI and BA presented a low risk, ET a moderate risk. KMnO<sub>4</sub> and NaOCl had the highest KAI values, indicating high and very high resistance risk in <i>Candida</i> yeasts. <b>Conclusions:</b> <i>C. albicans</i> strains can adapt to antiseptics to varying extents. For most antiseptics, adaptation does not significantly affect their clinical efficacy. However, due to adaptation, NaOCl and KMnO<sub>4</sub> may become ineffective against <i>C. albicans</i> strains even at clinical concentrations.
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spelling doaj-art-e7a0aa241b804c4cba8c5b31aff4620d2025-08-20T01:53:54ZengMDPI AGPharmaceuticals1424-82472024-11-011711154410.3390/ph17111544Adaptation to Sodium Hypochlorite and Potassium Permanganate May Lead to Their Ineffectiveness Against <i>Candida albicans</i>Tomasz M. Karpiński0Marzena Korbecka-Paczkowska1Marcin Ożarowski2Donald Włodkowic3Marzena Liliana Wyganowska4Agnieszka Seremak-Mrozikiewicz5Judyta Cielecka-Piontek6Chair and Department of Medical Microbiology, Poznań University of Medical Sciences, Rokietnicka 10, 60-806 Poznań, PolandChair and Department of Medical Microbiology, Poznań University of Medical Sciences, Rokietnicka 10, 60-806 Poznań, PolandDepartment of Biotechnology, Institute of Natural Fibres and Medicinal Plants—National Research Institute, Wojska Polskiego 71b, 60-630 Poznań, PolandThe Neurotox Lab, School of Science, RMIT University, Plenty Road, P.O. Box 71, Bundoora, VIC 3083, AustraliaDepartment of Dental Surgery, Periodontology and Oral Mucosa Diseases, Poznań University of Medical Sciences, Bukowska 70, 60-812 Poznań, PolandDivision of Perinatology, Poznan University of Medical Sciences, Polna 33, 60-535 Poznań, PolandDepartment of Pharmacognosy and Biomaterials, Poznań University of Medical Sciences, Rokietnicka 3, 60-806 Poznań, Poland<b>Background/Objectives:</b> Adaptation can reduce or completely eliminate the effectiveness of antibiotics and antiseptics at clinical concentrations. To our knowledge, no studies have examined fungal adaptation to antiseptics. This study aimed to preliminarily investigate the potential for <i>Candida albicans</i> adaptation to eight antiseptics. <b>Methods:</b> The minimal inhibitory concentration (MIC), drug susceptibility, adaptation to antiseptics, and Karpinski Adaptation Index (KAI) of <i>C. albicans</i> strains were assessed. <b>Results:</b> The antiseptics with the most effective MICs activity against <i>C. albicans</i> were octenidine dihydrochloride (OCT), chlorhexidine digluconate (CHX), and polyhexamethylene biguanide (polyhexanide, PHMB). Sodium hypochlorite (NaOCl) and ethacridine lactate (ET) demonstrated moderate activity, while boric acid (BA), povidone–iodine (PVI), and potassium permanganate (KMnO<sub>4</sub>) showed the weakest activity. The MIC values for NaOCl and KMnO<sub>4</sub> were close to or equal to the clinical concentrations used in commercial products. The studied strains were susceptible to econazole, miconazole, and voriconazole. Resistance to other drugs occurred in 10–30% of the strains. Antifungal resistance remained unchanged after antiseptic adaptation testing. The lowest KAI values, indicating very low resistance risk, were observed for CHX, OCT, and PHMB. PVI and BA presented a low risk, ET a moderate risk. KMnO<sub>4</sub> and NaOCl had the highest KAI values, indicating high and very high resistance risk in <i>Candida</i> yeasts. <b>Conclusions:</b> <i>C. albicans</i> strains can adapt to antiseptics to varying extents. For most antiseptics, adaptation does not significantly affect their clinical efficacy. However, due to adaptation, NaOCl and KMnO<sub>4</sub> may become ineffective against <i>C. albicans</i> strains even at clinical concentrations.https://www.mdpi.com/1424-8247/17/11/1544antimicrobial resistanceAMRfungipriority pathogensclinical concentrationclinical dose
spellingShingle Tomasz M. Karpiński
Marzena Korbecka-Paczkowska
Marcin Ożarowski
Donald Włodkowic
Marzena Liliana Wyganowska
Agnieszka Seremak-Mrozikiewicz
Judyta Cielecka-Piontek
Adaptation to Sodium Hypochlorite and Potassium Permanganate May Lead to Their Ineffectiveness Against <i>Candida albicans</i>
Pharmaceuticals
antimicrobial resistance
AMR
fungi
priority pathogens
clinical concentration
clinical dose
title Adaptation to Sodium Hypochlorite and Potassium Permanganate May Lead to Their Ineffectiveness Against <i>Candida albicans</i>
title_full Adaptation to Sodium Hypochlorite and Potassium Permanganate May Lead to Their Ineffectiveness Against <i>Candida albicans</i>
title_fullStr Adaptation to Sodium Hypochlorite and Potassium Permanganate May Lead to Their Ineffectiveness Against <i>Candida albicans</i>
title_full_unstemmed Adaptation to Sodium Hypochlorite and Potassium Permanganate May Lead to Their Ineffectiveness Against <i>Candida albicans</i>
title_short Adaptation to Sodium Hypochlorite and Potassium Permanganate May Lead to Their Ineffectiveness Against <i>Candida albicans</i>
title_sort adaptation to sodium hypochlorite and potassium permanganate may lead to their ineffectiveness against i candida albicans i
topic antimicrobial resistance
AMR
fungi
priority pathogens
clinical concentration
clinical dose
url https://www.mdpi.com/1424-8247/17/11/1544
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