Potential Anti-fungal Activity of Lactobacilli Probiotic Against Fluconazole Resistant Candida albicans Clinical Isolates

Fluconazole resistance by Candida albicans (C. albicans) is a growing medical issue which makes patient management more difficult. The development of new effective, safe and inexpensive alternatives becomes essential. Probiotics represent an intriguing strategy that can be applied for prevention or treatment of Candida infections. The aim of our study is to investigate the anti-fungal activity of different Lactobacillus species against fluconazole resistant C. albicans isolates and to evaluate the inhibitory effect of cell free supernatant of the most potent one. Sixty-nine C. albicans isolates were collected from different clinical specimens and subjected to antifungal susceptibility testing. Then, the anti-Candida activity of various Lactobacillus spp was investigated via different methods, spot overlay method, radial streak method and agar well diffusion method. Results showed that 33% of C. albicans isolates were resistant to fluconazole with MIC ≥ 64 μg/ml. L. rhamnosus demonstrated strong inhibitory activity against the majority of fluconazole resistant C. albicans isolates, followed by L. reuteri and L. salivarus respectively. Inhibitory activity of L. rhamnosus against C. albicans may be due to acid production. Our findings conclude that L. rhamnosus represent a promising candidate to be used in the treatment of candidiasis caused by fluconazole-resistant C. albicans strains.