Biofilm Production by Candida Species and Inadequate Antifungal Therapy as Predictors of Mortality for Patients with Candidemia

Abstract

1.09 to 5.10; P ‫؍‬ 0.03), infection with overall biofilm-forming Candida species (OR, 2.33; 95% CI, 1.26 to 4.30; P ‫؍‬ 0.007), and Acute Physiology and Chronic Health Evaluation III scores (OR, 1.03; 95% CI, 1.01 to 1.15; P < 0.001) as independent predictors of mortality. Notably, if mortality was analyzed according to the different biofilm-forming Candida species studied, only infections caused by C. albicans (P < 0.001) and C. parapsilosis (P ‫؍‬ 0.003) correlated with increased mortality. Together with well-established factors, Candida biofilm production was therefore shown to be associated with greater mortality of patients with candidemia, probably by preventing complete organism eradication from the blood.

Secretion of E , E -Farnesol and Biofilm Formation in Eight Different Candida Species

“…In addition to visual reading at 450 nm, optical density was measured at 405 nm for data validation (15). All tests were done twice and analyzed with the two-tailed paired Student t test comparing 0 and 10% FCS cultivations (significance was set at a P value of Յ0.05).…”

“…1). An optical density cutoff of Ն0.2 (Ͼ35% transmission blocked) was used to discriminate biofilm producers according to recent suggestions (14,15). With both media, C. albicans and C. dubliniensis formed good biofilms.…”

Different scenarios for Candida parapsilosis fungaemia reveal high numbers of mixed C. parapsilosis and Candida orthopsilosis infections

“…parapsilosis is notorious for the ability to form biofilms on catheters and other implanted devices (Tumbarello et al, 2007), more so than the closely related species C. orthopsilosis and C. metapsilosis (Lattif et al, 2010). This may explain why in all cases of polyfungal infection the species identified in the catheter was C. parapsilosis and never C. orthopsilosis.…”

“…While Candida albicans remains the most common causative agent of candidaemia, the incidence of Candida parapsilosis has increased significantly, outranking C. albicans in some studies, depending on the period and geographical area (Aittakorpi et al, 2012;Lagrou et al, 2007;Lockhart et al, 2012;Maganti et al, 2011;Nucci et al, 2013;Parmeland et al, 2013;Tragiannidis et al, 2012;Wu et al, 2011;Xess et al, 2007). Candidaemia risk factors include the use of broad-spectrum antibiotics, cancer chemotherapy, immunosuppressive agents and indwelling medical devices (Tumbarello et al, 2007). Nosocomial fungaemia due to C. parapsilosis is mainly associated with the presence of a central venous catheter, and with the use of parenteral nutrition (Barchiesi et al, 2004).…”

Transcriptional regulation of drug-resistance genes in Candida albicans biofilms in response to antifungals

“…Candidal infections rank as the third or fourth leading cause of hospital-acquired infection in the USA and are associated with high morbidity and mortality rates (Pfaller & Diekema, 2007). The ability of free-floating (planktonic) cells to exhibit an attached biofilm mode of growth is a major virulence attribute of Candida species and a direct cause of therapeutic failure (Tumbarello et al, 2007). As with other microbial biofilms, a key phenotypic feature of Candida biofilms is their high degree of drug resistance (Seneviratne et al, 2008a).…”