Elucidating fungal etiology and multi-drug resistance in oculomycosis and bioprospecting native medical plants as candidates for antifungal therapy

Abstract Despite their debilitating impact on eye health, it is unclear the fungal pathogens implicated in oculomycosis; and the efficacy of clinically used antifungal therapy among ophthalmic clinicians, especially from Ghana, remains enigmatic. Here we use a comprehensive clinical and laboratory data to fill this evidence gap. About ten percent (9.36%) of the ocular specimen was positive for fungal culture with the predominant fungal etiology being Candida albicans. Multi-drug resistance was observed for clinically utilized antifungal agents; amphotericin B, and fluconazole, itraconazole, terbinafine. Alternatively, ethanolic extracts of native medicinal plants, Cinnamomum verum and Syzygium aromaticum, demonstrated potent fungistatic and fungicidal activity against clinically recovered ocular fungal isolates including the common implicating etiology, Candida albicans. Overall, this study broadens our current understanding of the pathogenesis of oculomycosis, and the repercussions of clinically available antifungal treatment therapy. Leveraging on the results of the preliminary medicinal plant screening, we propose further characterization and mechanistic studies to illuminate the bioactive ingredient in plant extracts and their potential mechanism of action for clinical translation.