# Enhanced in-vitro anti-Candida efficacy of Euphorbia milii Des Moul mediated copper nanoparticles against clinically isolated Candida albicans

## TL;DR

This study explores using copper nanoparticles made from Euphorbia milii extract to combat Candida infections, showing strong effectiveness against Candida albicans in lab tests.

## Contribution

The novel use of Euphorbia milii extract to synthesize copper nanoparticles with potent anti-Candida activity is introduced.

## Key findings

- Candidemia rate was 7.3% in ICU patients with higher colonization in those over 60 and females.
- Green copper nanoparticles showed significant fungicidal activity against Candida albicans in vitro.
- Nanoparticles induced reactive oxygen species and DNA degradation in Candida cells.

## Abstract

Emergence of fungi as a pathogenic threat presents a significant challenge to public health, notably in intensive care units (ICUs) and among immunocompromised patients.
Various factors, including sepsis-induced barrier disruptions, immune system dysfunction, and extremes of age, contribute to increased susceptibility to fungal infections.
Hospital practices, such as prolonged surgeries, broad-spectrum antibiotic use, and invasive procedures, further exacerbate the risk. Fungal bloodstream infections,
particularly those caused by Candida albicans, rank among the most common hospital-acquired infections, leading to substantial morbidity and mortality.
The global rise in invasive candidiasis, particularly due to non-albicans Candida species, presents challenges in the diagnosis and treatment due to nonspecific symptoms
and emerging antifungal resistance. Nanotechnology interventions particularly by utilizing green synthesized copper nanoparticles could possibly provide a novel solution to
combat microbial colonization, biofilm formation, and drug resistance. This study aimed to assess the prevalence of candidemia, identify the distribution
of causative Candida species, and understand their susceptibility patterns to commonly used antifungal agents for effective management in ICU settings.
Additionally, the study sought to explore the in vitro anti-Candida activity of green copper nanoparticles synthesized using Euphorbia milii des moul extract.

This study was conducted at Microbiology Laboratory of Maharishi Markandeshwar Institute of Medical Sciences and Research from January to December 2022, focused on ICU patients suspected of bloodstream infections. Blood samples were collected aseptically and processed using BD BACTECTM culture vials. Identification of organisms was performed via the Vitek-2 system by confirming candidemia with positivity in both blood samples. After that antifungal susceptibility testing was also performed against Clinical and Laboratory Standards Institute recommended antifungal drug using Vitek 2 system. G-CuNPs were synthesized using E. milii Des moul extract and possessed for physiochemical characterization.
The anti-Candida activity of G-CuNPs was evaluated through the MTT assay and time kill assay. After that generation of intracellular reactive oxygen species and DNA degradation were evaluated to understand its mechanism.

This study identified a candidemia rate of 7.3% (58/789). Age and gender analysis revealed higher Candida colonization rates in individuals above 60 years old and females.
Antifungal sensitivity profiling indicated notable resistance to fluconazole (27.59%) and voriconazole (25.86%). Synthesizing G-CuNPs using E. milii des moul extract
represents a novel approach exhibiting significant fungicidal potency against clinically isolated C. albicans, supporting potential therapeutic applications.

the findings concluded that synthesized G-CuNPs have tremendous potential to battle against medical device-borne infections by surface coating.