الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 16 |  |  |
| | | from | 16 | | |
Abstract
This study was carried out to study the prevalence of Candida albicans infections in different hospitals at Minia governorate, to evaluate the antimicrobial susceptibility pattern of the isolated Candida albicans against different antimicrobial agents, to know the ability of these isolates to form a biofilm using TCP, to study the effect of different antifungal agents on initial adherence and preformed biofilm by Candida albicans, to study the effect of NAC on adherence and preformed biofilm by Candida albicans and the effect of each antifungal with NAC combination on initial adherence and on preformed biofilm by Candida albicans.
the study revealed that 23 Candida albicans were isolated and identified. 14 (14%) were isolated from vaginal infection, 9 (23%) were isolated from oral infection and no Candida albicans isolated from ear infection patients.
the isolated Candida albicans were tested for antimicrobial susceptibility pattern. It was found that ketoconazole, Amphotericin B and fluconazole showed high activity against Candida albicans. It was found also that Candida albicans show no resistance to ketoconazole, Amphotericin B and fluconazole.
It was found that Candida albicans has the ability to produce a biofilm. Which is a structured microbial communities, embedded in an extracellular matrix, characterized by increased resistance to antifungal therapy. It was found that 10 (43.47%) of the isolates were biofilm producers. 7 from patients suffering from vaginal infection and 3 from patients suffering from oral infections, 1 (4.3%) was high biofilm producer. 9 (39.1%) were moderate biofilm producers and 13 (56.5%) were non or weak biofilm producers.
Also this study revealed that the combination between antifungal agents and NAC produce the greatest effect on inhibition of initial adherence and in disruption of preformed biofilm than when each one act alone. Also this study revealed that ketoconazole/NAC combination was the most effective on the inhibition of initial adherence and disruption of preformed biofilm by (40.1-99.1%) at(1/2MIC/2-2MIC/8) on adherence and (47.4-100%) on preformed biofilm. But Amphotericin B/NAC combination by (38.75- 95.9%) on adherence and (42.2- 92.1%) on preformed biofilm and Fluconazole/NAC combination by (50.6-90.4%) on adherence and by (27.4-97.8%) on preformed biofilm at the same concentrations.This showed by the Scanning electron micrograph which show the morphological response and the extent of biofilm formation of Candida albicans by ketoconazole/N-acetylcysteine combination. Also SEM showed the inhibition of dimorphism of Candida albicans by ketoconazole.