Candida krusei izolatlarına karşı karanfil tomurcuğu esansiyel yağı ve mikafungin kombinasyonunun sinerjik etkisinin araştırılması

Öz

Amaç: Artan antifungal direnç, özellikle Candida krusei'nin intrinsik flukonazol direnci, mevcut tedavi stratejilerinin geliştirilmesini gerekli kılmaktadır. Bu çalışmada, karanfil tomurcuğu uçucu yağı (KTUY) ile mikafungin (MFG) kombinasyonunun Candida krusei izolatları üzerindeki sinerjistik etkisinin araştırılması amaçlanmıştır. Yöntem: Çalışmaya beş klinik C. krusei izolatı ve bir referans suşu (ATCC 6258) dahil edilmiştir. KTUY'nin ana bileşeni gaz kromatografisi-kütle spektrometrisi (GC-MS) analizi ile belirlenmiştir. KTUY ve MFG'nin antifungal aktivitesi sıvı mikrodilüsyon yöntemi kullanılarak değerlendirilmiştir. KTUY-MFG kombinasyonunun sinerjistik aktivitesi dama tahtası yöntemi ile araştırılmıştır. Bulgular: GC-MS analizi ile KTUY'nin ana bileşeninin öjenol (%72,3) olduğu, ayrıca kariofilen (%12,5), öjenil asetat (%5,34) ve α-humulen (%2,3) gibi minör bileşenler içerdiği belirlenmiştir. KTUY'nin MİK değerleri %0,004 ile %0,06 (v/v) arasında değişirken, MFG'nin MİK değerleri 0,002 ile 0,03 µg/mL arasında değişmiştir. Üç izolatta (%50) sinerjistik etki, bir izolatta (%16,7) additif etki, iki izolatta (%33,3) indiferan etki gözlenmiştir; antagonistik etki saptanmamıştır. Sonuç: KTUY ve MFG kombinasyonu, C. krusei izolatlarının bir alt kümesinde sinerjik aktivite göstermiştir. Bu bulgular, farklı etki mekanizmalarına sahip ajanların birleştirilmesinin antifungal etkinliği artırabileceğini ve kombinasyon tedavisi için potansiyel bir yaklaşım sunabileceğini düşündürmektedir. Özellikle, antifungal ajanlarla birlikte uçucu yağ bileşenlerinin kullanımı, tedavi etkinliğini artırabilir ve dirençli enfeksiyonların yönetimi için alternatif bir strateji sağlayabilir. Bununla birlikte, bu bulguların klinik ortamlarda doğrulanması için daha fazla çalışmaya ihtiyaç vardır.

Anahtar Kelimeler

• Candida krusei
• Karanfil Tomurcuğu Esansiyel Yağı
• Micafungin
• Antifungal Sinerji

Destekleyen Kurum

Kocaeli Üniversitesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu

Etik Beyan

Bu çalışma Kocaeli Üniversitesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu tarafından onaylanmıştır (Karar No: KÜ GOKAEK-2026/14/40, Proje No: 2026/444, Onay Tarihi: 23 Temmuz 2026). Klinik izolatlar anonim olarak kullanılmış olup, hastaya ait tanımlanabilir hiçbir bilgi dahil edilmemiştir. Çalışma, Helsinki Bildirgesi'nin etik ilkelerine uygun olarak yürütülmüştür.

INVESTIGATION OF THE SYNERGISTIC EFFECT OF CLOVE (SYZYGIUM AROMATICUM) BUD ESSENTIAL OIL AND MICAFUNGIN COMBINATION AGAINST CANDIDA KRUSEI (PICHIA KUDRIAVZEVII) ISOLATES

Öz

Objective: Increasing antifungal resistance, particularly the intrinsic fluconazole resistance of Candida krusei, necessitates the enhancement of current therapeutic strategies. This study aimed to investigate the synergistic effect of clove bud essential oil (CBEO) and micafungin (MFG) combination against C. krusei isolates. Methods: Five clinical C. krusei isolates and one reference strain (ATCC 6258) were included in the study. The major component of CBEO was identified by gas chromatography–mass spectrometry (GC-MS) analysis. The antifungal activity of CBEO and MFG was determined using the broth microdilution method. The synergistic activity of the CBEO–MFG combination was evaluated using the checkerboard method. Results: GC-MS analysis determined that the main component of CBEO is eugenol (72.3%), and it also contains minor components such as caryophyllene (12.5%), eugenyl acetate (5.34%), and α-humulene (2.3%). The MIC values of CBEO ranged from 0.004% to 0.06% (v/v), while the MIC values of MFG ranged from 0.002 to 0.03 µg/mL. Synergistic effects were observed in three isolates (50%), additive effects in one isolate (16.7%), and ineffective effects in two isolates (33.3%); no antagonistic effects were detected. Conclusion: The combination of CBEO and MFG demonstrated synergistic activity in a subset of C. krusei isolates. These findings suggest that combining agents with different mechanisms of action may enhance antifungal efficacy and offer a potential approach for combination therapy. In particular, the use of essential oil components alongside antifungal agents may improve treatment effectiveness and provide an alternative strategy for the management of resistant infections. However, further studies are required to validate these findings in clinical settings.

Anahtar Kelimeler

• Candida krusei
• Clove Bud Essential Oil
• Micafungin
• Antifungal Synergy

Destekleyen Kurum

Kocaeli University Non-Interventional Clinical Research Ethics Committee

Etik Beyan

This study was approved by the Kocaeli University Non-Interventional Clinical Research Ethics Committee (Decision No: KÜ GOKAEK-2026/14/40, Project No: 2026/444, Approval Date: July 23, 2026). Clinical isolates were used anonymously, and no identifiable patient information was included. The study was conducted in accordance with the ethical principles of the Declaration of Helsinki.

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