The increasing incidence of antifungal resistance represents a great challenge in the medical area and, for this reason, new therapeutic alternatives for the treatment of fungal infections are urgently required. Cold atmospheric plasma (CAP) has been proposed as a promising alternative technique for the treatment of superficial candidiasis, with inhibitory effect both in vitro and in vivo. However, little is known on the association of CAP with conventional antifungals. The aim of this study was to evaluate the effects of the association between CAP and conventional polyene antifungals on Candida albicans biofilms. C. albicans SC 5314 and a clinical isolate were used to grow 24 or 48 h biofilms, under standardized conditions. After that, the biofilms were exposed to nystatin, amphotericin B and CAP, separately or in combination. Different concentrations of the antifungals and sequences of treatment were evaluated to establish the most effective protocol. Biofilms viability after the treatments was compared to negative control. Data were compared by One-way ANOVA and post hoc Tukey (5%). The results demonstrate that 5 min exposure to CAP showed more effective antifungal effect on biofilms when compared to nystatin and amphotericin B. Additionally, it was detected that CAP showed similar (but smaller in magnitude) effects when applied in association with nystatin and amphotericin B at 40 µg/mL and 60 µg/mL. Therefore, it can be concluded that the application of CAP alone was more effective against C. albicans biofilms than in combination with conventional polyene antifungal agents.

中文翻译：

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与多烯抗真菌剂相关的冷大气等离子体射流对白色念珠菌生物膜的影响

越来越多的抗真菌药物耐药性发生在医学领域是一个巨大的挑战，因此，迫切需要新的治疗方法来治疗真菌感染。冷大气等离子体 (CAP) 已被提议作为治疗浅表念珠菌病的一种有前途的替代技术，在体外和体内都具有抑制作用。然而，关于 CAP 与常规抗真菌药的关联知之甚少。本研究的目的是评估 CAP 与常规多烯抗真菌剂之间的关联对白色念珠菌生物膜的影响。白色念珠菌SC 5314 和临床分离株用于在标准化条件下生长 24 或 48 小时的生物膜。之后，将生物膜分别或组合暴露于制霉菌素、两性霉素 B 和 CAP。评估了不同浓度的抗真菌剂和治疗顺序，以建立最有效的方案。将处理后的生物膜活力与阴性对照进行比较。数据通过单向方差分析和事后 Tukey (5%) 进行比较。结果表明，与制霉菌素和两性霉素 B 相比，暴露于 CAP 5 分钟对生物膜显示出更有效的抗真菌作用。此外，检测到当在40 µg/mL 和 60 µg/mL。所以，C. albicans生物膜比与常规多烯抗真菌剂组合。