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Evaluation of antifungal activity of Terminalia subspathulata bark and fruit extracts against azole-resistant Candida isolates


 
 Emerging resistant Candida species become a severe problem for public health. The study aims to examine the efficacy of Terminalia subspathulata bark and fruit extracts as an alternative source of antifungals for resistant strains of Candida species.
 
 
 
 
 Candida albicans was isolated between 4–5th interdigital foot space and C. parapsilosis were isolated from the left-hand third finger of male patients. Morphological and molecular methods identified the isolates. Antifungal susceptibility testing (AFST) was determined using azole derivatives, amphotericin B (AmpB) and echinocandins based on E-test and broth microdilution (BMD) methods. The AFST activity of the 10 μL methanolic extracts with concentrations between 1.25–10 mg/mL was assessed by disk diffusion method according to CLSI guidelines.
 
 
 
 The AFST results showed total resistance to all azoles (FLU, MIC ≥ 256 μg/ml and VOR, ITR and POS each with MIC ≥ 32 μg/ml). The BMD method agreed with E-test MICs. The T. subspathulata bark extract tested indicated activity on the C. albicans lawn with the zone of inhibition between 9–13 mm. The fruit extract indicated zone between 8–10 mm. Candida parapsilosis indicated susceptibility to bark extract with the zone of inhibition between 10–15 mm, while the fruit extract showed zone between 8–13 mm.
 
 
 
 Despite azole resistance, the extracts showed good activity against the isolates. Findings showed alternatives to AmpB and echinocandins because of toxicity and parenteral administration, respectively. Based on our findings, our study first reports the medicinal value of T. subspathulata.
