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Published on: September 16, 2022
Preventive activity of promethazine against fluconazole-resistant Candida spp. biofilms fixed on urinary catheters
Cecília Rocha da Silva1,2, João Batista de Andrade Neto1,2,3, Vitória Pessoa de Farias Cabral1,2,3
1Laboratory for Bioprospection of Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, Brazil.
Abstract:
Catheter-associated urinary tract infections (CA-UTI) are among the most prevalent infections, affecting over 150 million individuals worldwide annually. Candida is the most common fungal genus causing urinary infections, representing a significant medical challenge, particularly in patients undergoing prolonged catheterization-a risk factor that exacerbates clinical conditions by promoting the formation of resistant biofilms. In this context, the coating of catheters with antimicrobial substances combined with drug repositioning is an innovative alternative. In this study, we evaluated the activity of promethazine (PMT), a first-generation antihistamine, against the formation of Candida spp. biofilms on urinary catheter fragments. Broth microdilution, impregnation of urinary catheter fragments, and scanning electron microscopy (SEM) were the exploratory techniques employed. PMT proved to be an effective agent in inhibiting biofilm formation, achieving a 50% reduction in colony-forming units (CFU/mL). The results indicated that PMT exhibits high potential as an antifungal agent, with promising applications in coatings aimed at preventing Candida spp. infections associated with long-term urinary devices.
Insights
Promethazine (PMT) effectively inhibits Candida biofilms on urinary catheters, reducing infection risk. This antihistamine shows promise for coating medical devices to prevent catheter-associated urinary tract infections (CA-UTI).
Area of Science:
- Mycology
- Infectious Diseases
- Biomaterials
Background:
- Catheter-associated urinary tract infections (CA-UTI) are a major global health concern, affecting millions annually.
- Candida species form resistant biofilms on urinary catheters, complicating treatment and prolonging illness.
- Antimicrobial catheter coatings and drug repositioning offer innovative strategies to combat CA-UTI.
Purpose of the Study:
- To investigate the efficacy of promethazine (PMT), an antihistamine, in preventing Candida spp. biofilm formation on urinary catheter fragments.
- To assess PMT's potential as an antifungal agent for medical device coatings.
Main Methods:
- Broth microdilution assays were used to determine PMT's antifungal activity.
- Urinary catheter fragments were impregnated with PMT for biofilm inhibition testing.
- Scanning electron microscopy (SEM) visualized biofilm formation and reduction.
Main Results:
- Promethazine demonstrated significant effectiveness in inhibiting Candida spp. biofilm formation.
- A 50% reduction in colony-forming units (CFU/mL) was achieved with PMT treatment.
- SEM analysis confirmed the anti-biofilm properties of PMT.
Conclusions:
- Promethazine exhibits potent antifungal activity against Candida spp. biofilms.
- PMT is a promising candidate for developing antimicrobial coatings on urinary catheters.
- This research supports the repositioning of PMT for preventing CA-UTI in patients with long-term urinary devices.
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