Evaluation of antifungal activity of Origanum vulgare essential oil and detection of its influence on CDR1 gene expression among Candida albicans in vulvovaginal candidiasis

Document Type : Original Article

Authors

1 Medical Microbiology and Immunology, Faculty of Medicine, Ain Shams University, Egypt

2 Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Egypt

Abstract

Background: The most prevalent mycosis in women with complex recurrence and tolerance to antifungals is vulvovaginal candidiasis (VVC), so more efficient therapies are needed. This study evaluated the antifungal efficiency of Origanum vulgare essential oil (O. vulgare EO) and its genetic influence on CDR1 efflux pump gene among azole resistant Candida albicans (C. albicans). Methods: C. albicans was isolated from vaginal swabs. Antifungal effect of O. vulgare EO was determined in comparison to azole anti-fungal drugs against 30 vaginal C. albicans isolates using disk diffusion method. The MIC of fluconazole and O. vulgare EO was determined by microdilution method, while overexpression of efflux pump CDR1 gene among azole resistant C. albicans and effect of O. vulgare EO on gene expression was detected by quantitative real time PCR. Results: C. albicans accounted for (76.9%) of the isolated species, with C. glabrata following with (7.7%). Of all cases, (34%) were recurrent VVC, of which (53.8%) were non-albicans candida. (36.7%) of C. albicans isolates were resistant to one or more member of antifungal azoles, including (10%) isolates were resistant to all tested antifungal azoles. Regarding the group of tested azoles, resistant isolates were 16.7%, 13.4% and 10% for clotrimazole, itraconazole and fluconazole, respectively. (16.7%) of C. albicans were found to be resistant to fluconazole using the broth microdilution method. Disk diffusion testing revealed that all C. albicans isolates were sensitive to O. vulgare EO, with MIC values ranging from 0.125 to 0.007% v/v. (73%) of the isolates of azole-resistant C. albicans had overexpressed the CDR1 gene. In all azole-resistant C. albicans isolate with CDR1 gene over-expression, O. vulgare EO significantly reduced CDR1 gene expression (P-value=0.012). Conclusion: O. vulgare EO could act as an effective natural antifungal with potential utilization in the combat against azole resistant C. albicans.

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