dubliniensis isolates obtained from AIDS patients and stable fluconazole resistance can be readily induced in C. dubliniensis following exposure to the drug in vitro. Furthermore, a breakthrough in C. dubliniensis fungemia occurred in a patient during prolonged exposure to voriconazole  and it has been revealed that C. dubliniensis isolates from HIV-infected patients may acquire itraconazole resistance, even in the absence of prior azole therapy. Development of such resistance may have important implications for antifungal therapy and indicates the
need for possible alternative therapies, which may facilitate the management of oral candidosis. Lapatinib nmr In this context, this study clearly reveals that exposure to nystatin, a commonly used topical antifungal drug is capable of inducing a PAFE and thereby plummeting C. dubliniensis adhesion to BEC, its GT formation as well as its CSH to varying degrees during the PAFE period, which appear to be an unrecognised, yet a salutary feature Gefitinib purchase potentiating the action of nystatin. Furthermore, it contributes to broadening the understanding of the effectiveness of nystatin against these colonisation attributes incriminated in the pathogenesis
of C. dubliniensis as well it’s PAFE. Thus, the information provided lends further credence to the use of topical nystatin in the management of oral candidosis and in clinical rapports it appears that, even a short exposure to subtherapeutic
concentrations of nystatin, a situation all too acquainted in the niches of the oral cavity, would endure to wield an antifungal effect by suppressing the potency of the pathogen. Though there have been previous studies on nystatin as well as other antimycotic-induced PAFE’s and its impact on various pathogenic attributes of Candida, mainly on C. albicans,[18-20, 23-25] the methodological differences between researchers, in addition to variations in the concentrations of the drugs used, number and the types of Candida species engaged and exposure time of the drug, make comparisons Urease arduous between this study with previously studies. Nevertheless, to our knowledge this study is the first to document the suppression of adhesion to BEC, GT formation, relative CSH and the PAFE induced by nystatin, covering the largest number of oral C. dubliniensis isolates obtained from a single geographic location. However, testing with a larger number of isolates obtained from diverse categories of individuals and varied geographic locations is warranted to further magnify the current findings. The work was supported by Kuwait University Research Grant No. DB 01/11 and DB 02/11 and the General Facility Project Grant No. GD 01/11. The technical support from Ms. Leeba Philip, Ministry of Health, Kuwait and Ms. Preethi John, Faculty of Dentistry, Kuwait University are appreciated and thankfully acknowledged.