Impact of Brief and Sequential Exposure to Nystatin on the Germ Tube Formation and Cell Surface Hydrophobicity of Oral Candida Albicans Isolates from Human Immunodeficiency Virus-Infected Patients

Objective: To evaluate the impact of brief and sequential exposure to nystatin on the germ tube formation and cell surface hydrophobicity of oral isolates of Candida albicans obtained from patients infected with human immunodeficiency virus (HIV). Materials and Methods: After determining the minimum inhibitory concentration of nystatin, 10 oral isolates of C. albicans from 10 different HIV-infected patients were briefly (1 h) and sequentially (10 days) exposed to subtherapeutic concentrations of nystatin. Following a subsequent drug removal, the germ tube formation and cell surface hydrophobicity of these isolates were determined via a germ tube induction assay and an aqueous hydrocarbon assay, respectively. The data obtained from these assays for the control (unexposed to nystatin) and nystatin-exposed isolates were analyzed using Student’s t tests. Results: The mean percentage reduction in the germ tube formation and cell surface hydrophobicity of the nystatin-exposed isolates compared to the controls was 30.12 ± 1.99 (p 0.001) and 29.65 ± 2.33 (p 0.001), respectively. Conclusion: These data elucidate the possible pharmacodynamic mechanisms by which nystatin might operate in vivo in the modulation of candidal virulence.