Title: In the past few decades, not only

Title: The antifungal activities of Psidium Guajava (Guava) peels extract against Candida Albican.

Problem statement:

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            In the past few decades, not only the antibiotics resistant bacteria has become a major concern for the public but also fungi. This emerging occurrence called as antifungal resistance Centers for Disease Control and Prevention (CDC), 2017. The genus Candida has variety type of species that can cause infections in human, and Candida albicans (C.albicans) is the most common species among the varieties. C. albicans that known as the fungal pathogen of human can grow in different morphologies such as yeast, hyphae and pseudohyphae. However, it will appear in the yeast form on or in human as pathogen due to the harsh environment (Sudbery et al., 2004).

            It is harmless when C.albicans live on the skin or mucous membranes except when it is overgrown because it can cause the fungal infection that known as Candidiasis.  The infected body area determines the candidiasis symptoms. The candidiasis called as oropharyngeal candidiasis or”thrush” when it is developing in the mouth or throat, “vaginal yeast infection”, vaginal candidiasis,” or “vulvovaginal candidiasis” when it is developing in the vagina and invasive candidiasis when it is in the bloodstream. Symptoms of oropharyngeal candidiasis are white patches on the tongue, inner cheeks, roof of the throat and mouth (CDC, 2017).  According to CDC (2017), vaginal itching, abnormal vaginal discharge, discomfort or pain when urinating and more are the symptoms of vaginal candidiasis.

            Besides that, systemic or invasive candidiasis tend to occur in person who is already sick due to some medical conditions or immunosuppressed such as HIV-infected patients, chemotherapy patients, transplant recipients, and infants that having low-birth-weight (M. Anaul Kabir et al., 2012). When a person’s fever and chills do not have any improvement after took the antibiotic treatment for suspected bacterial infections, it is suspected due to systemic candidiasis (CDC, 2015). The development of other symptoms depends on the parts of the body it spread. Among these three type of candidiasis, invasive Candida infections are the major public health concern due to it can cause high rates of morbidity and mortality in candidiasis infected patients.

            According to CDC’s report of Antibiotic Resistance Threats in the United States (2013), Candidiasis rank number four among all the causative agent of healthcare-associated bloodstream with estimated 46,000 cases in the United States. However, it will not create any severe problem to immunocompetent person. Recent data showed that the first and second-line antifungal drug including azoles and echinocandins are increasingly resistant to some of the Candida strains.

            CDC stated that the resistance to antifungal drug lead to approximately 30% of candidaemia (bloodstream infection with Candida) infected patients died due to drug-resistant Candida. Based on the estimation of CDC to the Fluconazole-resistant Candida species, the percentage of Candida bloodstream isolates testing resistant is 7%, the estimated number of infections per year is 3,400 while the estimated number of deaths is 220.

            The rapid spread of antifungal drug resistance reduces the effectiveness of available antifungal drug and cause treatment more difficult. Eventually, the morbidity and mortality rate related to fungal infection increases every year. Until now, there is still lack of a well-defined or specific prevention strategies for candidaemia. These increase the need for the discovery of new antifungal drug in order to prevent, control and treat candidiasis.

Hypothesis

·         Null Hypothesis (H0): The Psidium Guajava (Guava) peels extract does not possess antifungal activity against Candida Albican.

·         Alternative Hypothesis (H1): The Psidium Guajava (Guava) peels extract does possess antifungal activity against Candida Albican.

Research objectives: To evaluate the antifungal effect of Psidium Guajava (Guava) peels extract against Candida Albican.

Specific objectives: 1) To compare in vitro antifungal effects between Methanol, Ethanol and water extract of Psidium Guajava (Guava) peels on Candida Albican.

                                   2) To identify the minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) of Psidium Guajava (Guava) extract.

Significant of study:

            The aim of the present study was to investigate the antifungal effect of Psidium guajava peels extracts against Candida Albican. The peels of P.guajava was chosen for this study because the peels usually remain as waste part of P.guajava and not received much attention from people.

            The findings of this study will provide useful information on antifungal activities of P.guajava. So far, different parts of P.guajava such as fruits, leaves, barks, roots, twigs and seeds have been screened for its antibacterial activity except for the peels (Joseph & Priya, 2011). Thus, the result of this study can be used as a source of pharmacological data for future clinical therapy.