In vitro comparison of efficacy of catheter locks in the treatment of catheter related blood stream infection

Gomes

2019

JoF

The ability to form biofilms is a common feature of microorganisms, such as bacteria or fungi. These consortiums can colonize a variety of surfaces, such as host tissues, dentures, and catheters, resulting in infections highly resistant to drugs, when compared with their planktonic counterparts. This refractory effect is particularly critical in polymicrobial biofilms involving both fungi and bacteria. This review emphasizes Candida spp.-bacteria biofilms, the epidemiology of this community, the challenges in the eradication of such biofilms, and the most relevant treatments.

Section: Innovative Treatments Of Other Diseasesmentioning

confidence: 62%

Candida spp./Bacteria Mixed Biofilms

Gomes

2019

JoF

“…In this study, Visek et al exposed catheters to different pathogens (Staphylococcus epidermidis, Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, Candida albicans), and these were afterwards incubated with a lock solution (ethanol 70%, taurolidine [Tauro-lock Hep 100 ], gentamicin, vancomycin). Antibiotics were effective after many hours of treatment whereas the antiseptic (non-antibiotic) compounds (ethanol and taurolidine) eradicated the above pathogens in less than 2 h [36]. Recently, another in vitro study evaluating the effectiveness of a 3 day treatment with heparinized 40% ethanol lock solution showed a decrease in metabolic activity and biomass of biofilms in clinical isolates from patients with CRBSI.…”

Section: Curative Treatment Of Crbsimentioning

confidence: 99%

Antimicrobial Locks in Patients Receiving Home Parenteral Nutrition

2020

Catheter-related bloodstream infection (CRBSI) is one of the most common and potentially fatal complications in patients receiving home parenteral nutrition (HPN). In order to prevent permanent venous access loss, catheter locking with an antimicrobial solution has received significant interest and is often a favored approach as part of the treatment of CRBSI, but mainly for its prevention. Several agents have been used for treating and preventing CRBSI, for instance antibiotics, antiseptics (ethanol, taurolidine) and, historically, anticoagulants such as heparin. Nonetheless, current guidelines do not provide clear guidance on the use of catheter locks. Therefore, this review aims to provide a better understanding of the current use of antimicrobial locking in patients on HPN as well as reviewing the available data on novel compounds. Despite the fact that our current knowledge on catheter locking is still hampered by several gaps, taurolidine and ethanol solutions seem promising for prevention and potentially, but not proven, treatment of CRBSI. Additional studies are warranted to further characterize the efficacy and safety of these agents.

“…Photodynamic therapy (Ghasemi et al, 2019), quorum sensing molecules and antibodies/peptides (Carrano et al, 2019) have emerged as viable treatment modalities in recent years. More sophisticated techniques, such as lock therapy (Visek et al, 2019), represent an important potential breakthrough in the treatment of biofilms produced due to infection by Candida spp.…”

Section: Introductionmentioning

confidence: 99%

Pathogenesis and Clinical Relevance of Candida Biofilms in Vulvovaginal Candidiasis

et al. 2020

The ability of Candida spp. to form biofilms is crucial for its pathogenicity, and thus, it should be considered an important virulence factor in vulvovaginal candidiasis (VVC) and recurrent VVC (RVVC). Its ability to generate biofilms is multifactorial and is generally believed to depend on the site of infection, species and strain involved, and the microenvironment in which the infection develops. Therefore, both cell surface proteins, such as Hwp1, Als1, and Als2, and the cell wall-related protein, Sun41, play a critical role in the adhesion and virulence of the biofilm. Immunological and pharmacological approaches have identified the NLRP3 inflammasome as a crucial molecular factor contributing to host immunopathology. In this context, we have earlier shown that Candida albicans associated with hyphae-secreted aspartyl proteinases (specifically SAP4-6) contribute to the immunopathology of the disease. Transcriptome profiling has revealed that non-coding transcripts regulate protein synthesis post-transcriptionally, which is important for the growth of Candida spp. Other studies have employed RNA sequencing to identify differences in the 1,245 Candida genes involved in surface and invasive cellular metabolism regulation. In vitro systems allow the simultaneous processing of a large number of samples, making them an ideal screening technique for estimating various physicochemical parameters, testing the activity of antimicrobial agents, and analyzing genes involved in biofilm formation and regulation ( in situ ) in specific strains. Murine VVC models are used to study C. albicans infection, especially in trials of novel treatments and to understand the cause(s) for resistance to conventional therapeutics. This review on the clinical relevance of Candida biofilms in VVC focuses on important advances in its genomics, transcriptomics, and proteomics. Moreover, recent experiments on the influence of biofilm formation on VVC or RVVC pathogenesis in laboratory animals have been discussed. A clear elucidation of one of the pathogenesis mechanisms employed by Candida biofilms in vulvovaginal candidiasis and its applications in clinical practice represents the most significant contribution of this manuscript.