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Nystatin - An Antifungal Medicine for Candida Infections

Updated on September 18, 2015
AliciaC profile image

Linda Crampton is a teacher with an honours degree in biology. She enjoys writing about human biology and the science of health and disease.

This child has developed thrush or oral candidiasis as a result of taking antibiotics.
This child has developed thrush or oral candidiasis as a result of taking antibiotics. | Source

Nystatin - A Useful Medicine

Nystatin is a very useful medication which kills the Candida albicans yeast that infects humans. This yeast is usually harmless and lives permanently in our mouth and large intestine or on our skin. Unfortunately, under certain conditions the yeast population can grow dramatically, causing a disease called candidiasis. This disease ranges in severity from an uncomfortable and annoying condition to a deadly infection.

In most people, candidiasis is unpleasant but not dangerous. In people with weakened or suppressed immune systems, such as AIDS patients, organ transplant patients and people receiving chemotherapy, candidiasis can be serious.

Nystatin is made by a bacterium called Streptomyces noursei. It was discovered in 1950 by Elizabeth Lee Hazen and Rachel Fuller Brown, who named it after their employer, the New York State Health Department.

Candida albicans cells and filaments
Candida albicans cells and filaments | Source

Candida albicans

Yeasts are a type of fungus. Most yeasts consist of a single cell. They produce new individuals in the form of buds that separate from the parent cell. Other fungi have a different structure. Their body consists of branching, thread-like structures called hyphae. The tangle of hyphae that forms is called a mycelium.

Candida albicans exists as single, oval cells, like other yeasts. Unlike other yeasts, however, a C. albicans cell also produces filaments that resemble hyphae. The filaments are present when Candida becomes invasive.

This is a simplified diagram of a typical yeast cell. As in other cells, the nucleus contains the genetic material and the mitochondria produce energy. Yeast cells reproduce by a process called budding.
This is a simplified diagram of a typical yeast cell. As in other cells, the nucleus contains the genetic material and the mitochondria produce energy. Yeast cells reproduce by a process called budding. | Source

Candidiasis and Candidemia

The Candida albicans population in our bodies is normally kept at a low level by factors such as other microorganisms in the body, the environment in which the yeast is living and our immune system. However, under certain conditions the population can increase and cause unpleasant symptoms, a condition known as candidiasis.

In serious cases, the yeast can spread through the blood away from its initial site of colonization and cause infections in other organs, which is known as a systemic infection. The presence of Candida in the blood is called candidemia.

Although Candida albicans is the most publicized species of the genus Candida, there are over twenty species in the genus that can infect humans.

Another view of Candida albicans
Another view of Candida albicans | Source

Candida Infections and Biofilms on Medical Devices

C. albicans causes "opportunistic" infections in humans. Most of the time, opportunistic organisms are not pathogens (ones that cause disease). They are able to increase in population size and cause health problems when there is a suitable change in their environment, however.

A troubling development with respect to Candida infections is the formation of yeast biofilms on implanted medical devices. These devices include catheters and shunts. C. albicans exists in both yeast and hyphal forms in biofilms.

The microbes in a biofilm produce chemicals that help them stick to each other and to the surface on which they're living. They are much harder to kill than free-living microbes. Another problem is that biofilms can release microbes that produce infections in other areas of the body.

Investigating bacterial biofilms is a very active area of scientific research. Scientists are paying increased attention to fungal biofilms as they realize how important they are.

Inhaled corticosteroids increase the chance of thrush development.
Inhaled corticosteroids increase the chance of thrush development. | Source

Thrush or Oral Candidiasis

Candidiasis in the mouth is usually known as thrush or oral candidiasis. The yeast collections appear as white spots on the lining of the mouth or throat, on the gums or tonsils, inside the cheeks or on the tongue.

The appearance of thrush generally means that there's been a change in the environment in the mouth or the body. Conditions which promote the growth of the yeast population are listed below.

  • If asthmatics use inhaled corticosteroids without rinsing out their mouths they may develop thrush.
  • People who wear dentures are more likely to develop thrush.
  • People who are taking antibiotics are also susceptible to thrush, probably because the antibiotics have killed the bacteria that help keep yeasts under control.
  • Someone with a weakened immune system may develop thrush because their body is unable to limit the growth of the yeast population.
  • Thrush may appear in diabetics due to the increased sugar level in their saliva.
  • Thrush is more common in pregnant women or obese people than in the women who aren't pregnant or in people of normal weight.
  • Babies have an immature immune system and may develop thrush.

Treating Thrush in Newborn Babies

Candidiasis in Other Parts of the Body

In addition to appearing in the mouth, candidiasis may develop on the lips or skin, under a nail, in the gastrointestinal or reproductive tracts, around the anus, in the urinary bladder or under a baby's diaper.

In general, Candida only reaches the lungs or the esophagus in a person whose immune system isn't working efficiently. Although someone with candidiasis may need to take medications to deal with the yeast outbreak, if their immune system is healthy the yeasts won't penetrate deeper into the body's tissues.

Signs of a yeast infection depend on where it develops. They may include a thick, white discharge, redness, itching and a burning sensation.

A Candida albicans Infection

The Discovery and Naming of Nystatin

The discovery of nystatin is an interesting story. The two women who discovered the chemical worked in different cities. Elizabeth Lee Hazen was based in New York City while Rachel Fuller Brown lived in Albany. Hazen collected soil samples, grew cultures of the microbes in each sample and tested them for antifungal action against Candida albicans and another yeast named Cryptococcus neoformans. If she found activity she mailed the culture to Brown in a Mason jar. Brown extracted the active chemical from the culture and then mailed it to Hazen. Hazen would then test the extract on the two yeasts to see if it killed them. She also checked to see if the extract was toxic to animals.

One soil sample collected by Hazen came from the garden (or farm) of a friend named Walter Nourses. This sample contained a microbe that produced a chemical that killed the yeasts yet was apparently safe for animals. Hazen named the microbe Streptomyces noursei, using a species name to honor her friend, and called the active chemical fungicidin. Later the two women discovered that the name fungicidin was already used for another chemical, so they renamed their antifungal substance nystatin. The name was derived from "New York State".

This orange is infected by a midew fungus. The orange spot at the front was treated by nystatin and is clear of the fungus.
This orange is infected by a midew fungus. The orange spot at the front was treated by nystatin and is clear of the fungus. | Source

The Value of Collaboration and Methodical Work

Without an efficient mail service and the patient, painstaking and determined work of Elizabeth Hazen and Rachel Brown, nystatin might never have been discovered. The women lacked the relatively sophisticated lab equipment that we have today, as well as computer software, email and video communication. Despite these apparent limitations, their methodical work enabled them to discover nystatin as well as other antimicrobial substances. Both women made other valuable contributions to science, but they are best known for their collaborative effort and their discovery of nystatin.

Candida albicans cultures on nutrient agar
Candida albicans cultures on nutrient agar | Source

Nystatin Effects on Fungi

As in all fungi, the membrane around yeast cells contains a chemical called ergosterol. Nystatin targets this ergosterol. Ergosterol is a steroid molecule that helps the yeast membrane to maintain its correct structure. The membrane is a very important part of a cell. It determines which substances are able to enter and leave the cell.

Nystatin binds to ergosterol molecules and causes abnormal channels to appear in the membrane. These channels allow vital substances such as potassium ions to leave the yeast cells, resulting in their death.

Ergosterol is found in fungi but not in animals or humans. Therefore nystatin is able to kill fungal cells but Is safe for our cells. There are newer antifungal medications available today, but nystatin is still widely used. It's one of a range of medicines that doctors can prescribe to cure a patient's fungal infection.

The word "ergosterol" is derived from ergot, a common name for the fungus Claviceps purpurea. This fungus infects rye and other grains. Ergosterol was first found in ergot.

Don't give nystatin to a baby without seeking a doctor's advice.
Don't give nystatin to a baby without seeking a doctor's advice. | Source

Nystatin Effects on Humans

Nystatin is a prescription medication. It's administered in an oral form, as a mouthwash, as a cream or in powder form. There are several trade names for nystatin. For example, mycostatin is the trade name of a medication that actually consists of nystatin.

The medication isn't absorbed into the bloodstream, or is absorbed in only tiny amounts, so it stays at the site of the infection and is unlikely to cause serious side effects. However, this means that other medicines are needed if a fungal infection is systemic.

The most common side effects of nystatin treatment - if they appear - are gastrointestinal upset and irritated skin or mucous membranes. As with any substance that enters the body, an allergic reaction is possible.

It's very important that pregnant or nursing women use nystatin only with a doctor's advice. Although nystatin isn't absorbed through the lining of the gastrointestinal tract in significant amounts, it's unclear whether it can enter the fetus or a mother's milk. A doctor should also be consulted before administering nystatin to a baby.

Nystatin is a wonderful medicine whose discovery was very important. It can be a great help for Candida infections. Like any medication, however, it should be treated with care.

More Information About Candida

© 2012 Linda Crampton

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    • Judi Bee profile image

      Judith Hancock 4 years ago from UK

      I just had to read this after seeing that child's tongue - poor thing! Interesting hub - voted up.

    • AliciaC profile image
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      Linda Crampton 4 years ago from British Columbia, Canada

      Thanks for the comment and vote, Judi. The condition of that tongue does look sad. The thrush must have been an unpleasant experience for the child!

    • jennzie profile image

      jennzie 4 years ago from Lower Bucks County, PA

      That definitely looks unpleasant! Very informative hub, voted up!

    • AliciaC profile image
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      Linda Crampton 4 years ago from British Columbia, Canada

      Thank you for the visit and the vote, Jennzie. Yes, I hope the child was soon cured of that yeast infection!

    • susiebrown48 profile image

      susiebrown48 4 years ago from Clearwater, FL

      Fascinating, well-researched article. Loved it.

    • AliciaC profile image
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      Linda Crampton 4 years ago from British Columbia, Canada

      I appreciate the comment, susiebrown48. Thank you very much for the visit.

    • GoodLady profile image

      Penelope Hart 4 years ago from Rome, Italy

      Ugh...but read on and absorbed (oops wrong word perhaps). Good to know about the cure for yeast infection which isn't THAT rare is it? Very interesting and many thanks. Wont be pinning it though aliciaC! Shall vote instead

    • AliciaC profile image
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      Linda Crampton 4 years ago from British Columbia, Canada

      Hi, GoodLady. Thanks for the visit and the vote. No, unfortunately yeast infections - especially Candida albicans infections - are not rare. They are something that many people have to deal with at some time or other.

    • kashmir56 profile image

      Thomas Silvia 4 years ago from Massachusetts

      Hi my friend, great well written and well researched article, found all the information interesting .

      Vote up and more !!!

    • AliciaC profile image
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      Linda Crampton 4 years ago from British Columbia, Canada

      Thank you, Tom. I appreciate your comment and your vote. Have a great weekend!

    • drbj profile image

      drbj and sherry 4 years ago from south Florida

      Terrific painstaking research, Alicia, and much needed information. Particularly interesting was the collaboration between Hazen and Brown. Thanks for sharing this knowledge.

    • AliciaC profile image
      Author

      Linda Crampton 4 years ago from British Columbia, Canada

      Hi, drbj. Thank you for the comment. I appreciate your visit - and all your visits - very much! I found the collaboration between Hazen and Brown very interesting too. They worked so methodically and made such an important discovery.

    • A.A. Zavala profile image

      Augustine A Zavala 4 years ago from Texas

      Acommon condition that is very annoying I'm sure. Using a fungus to kill another fungus? Fascinating...

    • unknown spy profile image

      IAmForbidden 4 years ago from Neverland - where children never grow up.

      that was an interesting to read. it helps you better understand how to protect yourself from this infection

    • AliciaC profile image
      Author

      Linda Crampton 4 years ago from British Columbia, Canada

      Hi, Augustine. Thanks for the visit and the comment. Yes, yeast infections are certainly annoying. Streptomyces noursei is actually a bacterium, but it's still very interesting that one microbe can be used to fight another!

    • AliciaC profile image
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      Linda Crampton 4 years ago from British Columbia, Canada

      Thank you for the comment, unknown spy. It's nice to meet you!

    • teaches12345 profile image

      Dianna Mendez 4 years ago

      I read through this and was fascinated by the many conditions that may cause candida. Glad that nystatin was discovered to combat this infection. I guess it also supports the fact that we must maintain a healthy diet and immune system to avoid these types of conditions.

    • AliciaC profile image
      Author

      Linda Crampton 4 years ago from British Columbia, Canada

      Thank you for the visit and the comment, teaches. Yes, it would be a very good idea to try to maintain a healthy immune system in order to prevent the Candida population from growing out of control. Candida infections are very unpleasant!

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