Synergistic antifungal activity of minocycline as an effective augmenting agent of fluconazole against drug-resistant Candida tropicalis

ABSTRACT Invasive candidiasis has emerged as a significant healthcare challenge, with a rising incidence rate attributed to the widespread use of organ transplantation, chemotherapy, immunosuppressants, and broad-spectrum antibiotics. The increasing prevalence of drug-resistant strains, particularly...

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Main Authors: Yun-Zhu Zhu, Xiang Li, Qing-Yue Zhang, Ning Yang, Ping Tian, Ding Zhang, Yi Yang, Liang Yu, Yan-Yan Liu, Ying Ye, Ya-Sheng Li, Jia-Bin Li
Format: Article
Language:English
Published: American Society for Microbiology 2025-05-01
Series:Microbiology Spectrum
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Online Access:https://journals.asm.org/doi/10.1128/spectrum.03185-24
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author Yun-Zhu Zhu
Xiang Li
Qing-Yue Zhang
Ning Yang
Ping Tian
Ding Zhang
Yi Yang
Liang Yu
Yan-Yan Liu
Ying Ye
Ya-Sheng Li
Jia-Bin Li
author_facet Yun-Zhu Zhu
Xiang Li
Qing-Yue Zhang
Ning Yang
Ping Tian
Ding Zhang
Yi Yang
Liang Yu
Yan-Yan Liu
Ying Ye
Ya-Sheng Li
Jia-Bin Li
author_sort Yun-Zhu Zhu
collection DOAJ
description ABSTRACT Invasive candidiasis has emerged as a significant healthcare challenge, with a rising incidence rate attributed to the widespread use of organ transplantation, chemotherapy, immunosuppressants, and broad-spectrum antibiotics. The increasing prevalence of drug-resistant strains, particularly among Candida tropicalis, has necessitated the exploration of novel therapeutic strategies. Our study investigated the synergistic effects of minocycline (MIN) combined with fluconazole (FLC) against FLC-resistant C. tropicalis, both in vitro and in vivo. The in vitro synergistic activity of MIN and FLC was evaluated using checkerboard titration and time-kill assays. The Galleria mellonella larvae and mouse model were employed to assess in vivo efficacy, with histopathological examination and fungal burden quantification. Whole-genome and RNA sequencing elucidated the synergistic mechanisms observed. The FLC/MIN combination significantly lowered the minimum inhibitory concentration (MIC) and improved fungicidal activity, as evidenced by enhanced survival rates and reduced fungal burden in G. mellonella larvae and mouse models. Histopathological analysis confirmed less tissue damage and fungal load with combination therapy. RNA sequencing analysis suggested that the impact of MIN on amino acid metabolism contributes to the synergistic effects. This approach holds promise for treating FLC-resistant C. tropicalis by increasing antifungal efficacy and reducing drug resistance risks, warranting further clinical exploration.IMPORTANCEThis study highlights the potential of minocycline and fluconazole combination therapy in combating drug-resistant Candida tropicalis. It shows promising in vitro and in vivo synergistic effects, reducing MIC and enhancing fungicidal activity. Further clinical trials are needed to validate its efficacy in treating FLC-resistant C. tropicalis infections.
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spelling doaj-art-ffb2d915d59e48bb8eb5bb50677a132f2025-08-20T02:11:31ZengAmerican Society for MicrobiologyMicrobiology Spectrum2165-04972025-05-0113510.1128/spectrum.03185-24Synergistic antifungal activity of minocycline as an effective augmenting agent of fluconazole against drug-resistant Candida tropicalisYun-Zhu Zhu0Xiang Li1Qing-Yue Zhang2Ning Yang3Ping Tian4Ding Zhang5Yi Yang6Liang Yu7Yan-Yan Liu8Ying Ye9Ya-Sheng Li10Jia-Bin Li11Department of Infectious Diseases & Anhui Province Key Laboratory of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, ChinaDepartment of Infectious Diseases & Anhui Province Key Laboratory of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, ChinaDepartment of Infectious Diseases & Anhui Province Key Laboratory of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, ChinaDepartment of Infectious Diseases & Anhui Province Key Laboratory of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, ChinaDepartment of Gastroenterology, Linyi People’s Hospital, Linyi, Shandong, ChinaDepartment of Infectious Diseases & Anhui Province Key Laboratory of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, ChinaDepartment of Infectious Diseases & Anhui Province Key Laboratory of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, ChinaDepartment of Infectious Diseases & Anhui Province Key Laboratory of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, ChinaDepartment of Infectious Diseases & Anhui Province Key Laboratory of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, ChinaDepartment of Infectious Diseases & Anhui Province Key Laboratory of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, ChinaDepartment of Infectious Diseases & Anhui Province Key Laboratory of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, ChinaDepartment of Infectious Diseases & Anhui Province Key Laboratory of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, ChinaABSTRACT Invasive candidiasis has emerged as a significant healthcare challenge, with a rising incidence rate attributed to the widespread use of organ transplantation, chemotherapy, immunosuppressants, and broad-spectrum antibiotics. The increasing prevalence of drug-resistant strains, particularly among Candida tropicalis, has necessitated the exploration of novel therapeutic strategies. Our study investigated the synergistic effects of minocycline (MIN) combined with fluconazole (FLC) against FLC-resistant C. tropicalis, both in vitro and in vivo. The in vitro synergistic activity of MIN and FLC was evaluated using checkerboard titration and time-kill assays. The Galleria mellonella larvae and mouse model were employed to assess in vivo efficacy, with histopathological examination and fungal burden quantification. Whole-genome and RNA sequencing elucidated the synergistic mechanisms observed. The FLC/MIN combination significantly lowered the minimum inhibitory concentration (MIC) and improved fungicidal activity, as evidenced by enhanced survival rates and reduced fungal burden in G. mellonella larvae and mouse models. Histopathological analysis confirmed less tissue damage and fungal load with combination therapy. RNA sequencing analysis suggested that the impact of MIN on amino acid metabolism contributes to the synergistic effects. This approach holds promise for treating FLC-resistant C. tropicalis by increasing antifungal efficacy and reducing drug resistance risks, warranting further clinical exploration.IMPORTANCEThis study highlights the potential of minocycline and fluconazole combination therapy in combating drug-resistant Candida tropicalis. It shows promising in vitro and in vivo synergistic effects, reducing MIC and enhancing fungicidal activity. Further clinical trials are needed to validate its efficacy in treating FLC-resistant C. tropicalis infections.https://journals.asm.org/doi/10.1128/spectrum.03185-24Candida tropicalisfluconazole resistanceminocyclinesynergistic effectantifungal therapyRNA sequencing
spellingShingle Yun-Zhu Zhu
Xiang Li
Qing-Yue Zhang
Ning Yang
Ping Tian
Ding Zhang
Yi Yang
Liang Yu
Yan-Yan Liu
Ying Ye
Ya-Sheng Li
Jia-Bin Li
Synergistic antifungal activity of minocycline as an effective augmenting agent of fluconazole against drug-resistant Candida tropicalis
Microbiology Spectrum
Candida tropicalis
fluconazole resistance
minocycline
synergistic effect
antifungal therapy
RNA sequencing
title Synergistic antifungal activity of minocycline as an effective augmenting agent of fluconazole against drug-resistant Candida tropicalis
title_full Synergistic antifungal activity of minocycline as an effective augmenting agent of fluconazole against drug-resistant Candida tropicalis
title_fullStr Synergistic antifungal activity of minocycline as an effective augmenting agent of fluconazole against drug-resistant Candida tropicalis
title_full_unstemmed Synergistic antifungal activity of minocycline as an effective augmenting agent of fluconazole against drug-resistant Candida tropicalis
title_short Synergistic antifungal activity of minocycline as an effective augmenting agent of fluconazole against drug-resistant Candida tropicalis
title_sort synergistic antifungal activity of minocycline as an effective augmenting agent of fluconazole against drug resistant candida tropicalis
topic Candida tropicalis
fluconazole resistance
minocycline
synergistic effect
antifungal therapy
RNA sequencing
url https://journals.asm.org/doi/10.1128/spectrum.03185-24
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