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Li C, Gao D, Li C, Cheng G, Zhang L. Fighting against biofilm: The antifouling and antimicrobial material. Biointerphases 2024; 19:040802. [PMID: 39023091 DOI: 10.1116/6.0003695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 06/07/2024] [Indexed: 07/20/2024] Open
Abstract
Biofilms are groups of microorganisms protected by self-secreted extracellular substances. Biofilm formation on the surface of biomaterial or engineering materials becomes a severe challenge. It has caused significant health, environmental, and societal concerns. It is believed that biofilms lead to life-threatening infection, medical implant failure, foodborne disease, and marine biofouling. To address these issues, tremendous effort has been made to inhibit biofilm formation on materials. Biofilms are extremely difficult to treat once formed, so designing material and coating bearing functional groups that are capable of resisting biofilm formation has attracted increasing attention for the last two decades. Many types of antibiofilm strategies have been designed to target different stages of biofilm formation. Development of the antibiofilm material can be classified into antifouling material, antimicrobial material, fouling release material, and integrated antifouling/antimicrobial material. This review summarizes relevant research utilizing these four approaches and comments on their antibiofilm properties. The feature of each method was compared to reveal the research trend. Antibiofilm strategies in fundamental research and industrial applications were summarized.
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Affiliation(s)
- Chao Li
- School of Engineering, Westlake University, Hangzhou, Zhejiang 310030, China
- Department of Pharmaceutical Sciences, State Key Laboratory of Fine Chemicals, School of Chemical Engineering, Dalian University of Technology, Dalian, Liaoning 116023, China
| | - Dongdong Gao
- School of Engineering, Westlake University, Hangzhou, Zhejiang 310030, China
- Department of Pharmaceutical Sciences, State Key Laboratory of Fine Chemicals, School of Chemical Engineering, Dalian University of Technology, Dalian, Liaoning 116023, China
| | - Chunmei Li
- Tsinglan School, Songshan Lake, Dongguan 523000, China
| | - Gang Cheng
- School of Engineering, Westlake University, Hangzhou, Zhejiang 310030, China
| | - Lijun Zhang
- Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Liaoning Provincial Optometry Technology Engineering Research Center, The Third People's Hospital of Dalian, Dalian, Liaoning 116033, China
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Almeida NLM, Peralta LCF, Pontes FML, Rinaldo D, Porto VC, Lara VS. Anti-Candida activity and biocompatibility of silver nanoparticles associated with denture glaze: a new approach to the management of denture stomatitis. Folia Microbiol (Praha) 2024:10.1007/s12223-024-01161-4. [PMID: 38652435 DOI: 10.1007/s12223-024-01161-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 03/26/2024] [Indexed: 04/25/2024]
Abstract
The association of silver nanoparticles (AgNps) to sealant agent Palaseal® can be a promising alternative for complete denture wearers who may develop denture stomatitis (DS). The study aimed to evaluate the anti-Candida and biocompatible potential of silver nanoparticles synthesized by three routes associated with denture glaze to prevent and/or treat oral candidiasis. Surface acrylic resin specimens were treated with different associations of glaze with AgNps (VER+AgUV, VER+AgTurk and VER+AgGm). As controls, specimens were treated with glaze+nystatin (VER+Nyst), glaze only (VER) or submerged in PBS (PBS). Afterwards, Candida albicans biofilm was developed for 24 h, 15 d and 30 d. Subsequently, the biofilm was quantified by CFU/mL, XTT assay and confocal laser scanning microscopy. Fibroblasts were submitted to conditioned medium with the same associations for 24, 48 and 72 h and LIVE/DEAD® viability test was carried out. Regardless of the period, there was a significant reduction (p < 0.01) of viable fungal cells load, as well as inhibition of fungal metabolic activity, in specimens treated with glaze+AgNps associations, compared to VER and PBS. The anti-Candida effects of the associations were similar to the VER+Nyst group, with emphasis on VER+AgGm, which showed the highest percentage values of non-viable fungal cells maintained over time. The associations did not prove toxicity to fibroblasts. The AgNps exerted antimicrobial activity against C. albicans biofilms and are biocompatible. The most effective results were achieved with the association of glaze+silver nanoparticles synthesized by the green chemistry method (AgGm), proving to be an innovative alternative in the management of DS.
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Affiliation(s)
- Nara Lígia Martins Almeida
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo (USP), Bauru, 17012-901, Brazil
| | - Laura Catalí Ferreira Peralta
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo (USP), Bauru 17012-901, Brazil
| | | | - Daniel Rinaldo
- Department of Chemistry, São Paulo State University (UNESP), Bauru 17033-360, Brazil
| | - Vinicius Carvalho Porto
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo (USP), Bauru 17012-901, Brazil
| | - Vanessa Soares Lara
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo (USP), Bauru, 17012-901, Brazil.
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Kumpakha R, Gordon DM. Occidiofungin inhibition of Candida biofilm formation on silicone elastomer surface. Microbiol Spectr 2023; 11:e0246023. [PMID: 37816202 PMCID: PMC10715079 DOI: 10.1128/spectrum.02460-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/25/2023] [Indexed: 10/12/2023] Open
Abstract
IMPORTANCE Candida are opportunistic fungal pathogens with medical relevance given their association with superficial to life-threatening infections. An important component of Candida virulence is the ability to form a biofilm. These structures are highly resistant to antifungal therapies and are often the cause of treatment failure. In this work, we evaluated the efficacy of the antifungal compound, occidiofungin, against Candida biofilms developed on a silicone surface. We demonstrate that occidiofungin eliminated cells at all stages of biofilm formation in a dose-dependent manner. Consistent with our understanding of occidiofungin bioactivity, we noted alterations to actin organization and cell morphology following antifungal exposure. Given the challenges associated with the treatment of biofilm-associated infections, occidiofungin exhibits potential as a therapeutic antifungal agent in the future.
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Affiliation(s)
- Rabina Kumpakha
- Department of Biological Sciences, Mississippi State University, Mississippi State, Mississippi, USA
| | - Donna M. Gordon
- Department of Biological Sciences, Mississippi State University, Mississippi State, Mississippi, USA
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Gerges MA, Fahmy YA, Hosny T, Gandor NH, Mohammed SY, Mohamed TMA, Abdelmoteleb NEM, Esmaeel NE. Biofilm Formation and Aspartyl Proteinase Activity and Their Association with Azole Resistance Among Candida albicans Causing Vulvovaginal Candidiasis, Egypt. Infect Drug Resist 2023; 16:5283-5293. [PMID: 37601561 PMCID: PMC10439283 DOI: 10.2147/idr.s420580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/01/2023] [Indexed: 08/22/2023] Open
Abstract
Background Candida albicans (C. albicans) is a major cause of vulvovaginal candidiasis (VVC), a condition that is commonly treated with azole agents. Biofilm formation and aspartyl proteinase production are important virulence factors that could be linked to azole resistance in C. albicans impeding therapy. Aim To find out the association of both factors with azole resistance among C. albicans isolated from VVC cases in Egyptian nonpregnant women of childbearing age. Patients and Methods In a cross-sectional study, C. albicans was isolated from nonpregnant females diagnosed clinically as having VVC during a 1-year study period. Susceptibility to azole agents was tested using the disc diffusion method. Biofilm formation and aspartyl proteinase production were assessed phenotypically. Additionally, two biofilm-related genes (ALS1 and HWP1) and three proteinase genes (SAP2, SAP4, and SAP6) were screened for using polymerase chain reaction (PCR). Results Among 204 C. albicans isolates, azole resistance ratios were as follows: voriconazole (30.4%), itraconazole (17.6%), fluconazole (11.3%) and econazole (6.4%). Biofilm-producing capacity was detected in 63.2% of isolates, and 63.2% were proteinase producers. The frequencies of ALS1 and HWP1 were 69.6% and 74.5%, respectively, while SAP2, SAP4, and SAP6 were 69.2%, 88.7%, and 64.7%, respectively. Biofilm formation was significantly associated with azole resistance (P < 0.001 for each tested azole agent) as was proteinase production (P < 0.001 for fluconazole, voriconazole, and econazole resistance and P = 0.047 for itraconazole). Conclusion Among nonpregnant Egyptian women of childbearing age, azole resistance in C. albicans causing VVC is significantly associated with biofilm formation and proteinase production. The development of new therapeutic agents that can target these factors is warranted.
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Affiliation(s)
- Marian A Gerges
- Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Yasmin Ahmed Fahmy
- Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Thoraya Hosny
- Clinical Pathology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Nessma H Gandor
- Clinical Pathology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Sherif Y Mohammed
- Clinical Pathology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | | | | | - Noura E Esmaeel
- Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Wijaya M, Halleyantoro R, Kalumpiu JF. Biofilm: The invisible culprit in catheter-induced candidemia. AIMS Microbiol 2023; 9:467-485. [PMID: 37649801 PMCID: PMC10462453 DOI: 10.3934/microbiol.2023025] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 04/20/2023] [Accepted: 04/24/2023] [Indexed: 09/01/2023] Open
Abstract
Candidemia is the most common form of invasive fungal infection associated with several risk factors, and one of them is the use of medical devices, to which microbial biofilms can attach. Candidemia related to the use of peripheral intravascular and central venous catheters (CVC) is referred to as Candida catheter-related bloodstream infection, with more than 90% being related to CVC usage. The infection is associated with a higher morbidity and mortality rate than nosocomial bacterial infections. Candida spp. can protect themselves from the host immune system and antifungal drugs because of the biofilm structure, which is potentiated by the extracellular matrix (ECM). Candida albicans and Candida parapsilosis are the most pathogenic species often found to form biofilms associated with catheter usage. Biofilm formation of C. albicans includes four mechanisms: attachment, morphogenesis, maturation and dispersion. The biofilms formed between C. albicans and non-albicans spp. differ in ECM structure and composition and are associated with the persistence of colonization to infection for various catheter materials and antifungal resistance. Efforts to combat Candida spp. biofilm formation on catheters are still challenging because not all patients, especially those who are critically ill, can be recommended for catheter removal; also to be considered are the characteristics of the biofilm itself, which readily colonizes the permanent medical devices used. The limited choice and increasing systemic antifungal resistance also make treating it more difficult. Hence, alternative strategies have been developed to manage Candida biofilm. Current options for prevention or therapy in combination with systemic antifungal medications include lock therapy, catheter coating, natural peptide products and photodynamic inactivation.
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Affiliation(s)
- Meiliyana Wijaya
- Department of Parasitology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Ryan Halleyantoro
- Department of Parasitology, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia
| | - Jane Florida Kalumpiu
- Department of Parasitology, Faculty of Medicine, Pelita Harapan University, Banten, Indonesia
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Lara VS, Silva RAD, Ferrari TP, Santos CFD, Oliveira SHPD. Losartan Plays a Fungistatic and Fungicidal Activity Against Candida albicans Biofilms: Drug Repurposing for Localized Candidosis. Assay Drug Dev Technol 2023; 21:157-165. [PMID: 37229625 DOI: 10.1089/adt.2023.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
Candidosis is one of the most frequent opportunistic infections and exhibits variable clinical presentations, including oral localized forms. Drugs affecting the renin-angiotensin system targets inhibit secreted aspartic proteases from Candida albicans. The objective of the study was to evaluate whether losartan has antimicrobial action against C. albicans biofilms. Biofilms were treated with losartan or aliskiren (for comparison) for 24 h. Metabolic activity of viable cells and growth inhibition of C. albicans biofilms were assessed using XTT [2,3-Bis(2-Methoxy-4-Nitro-5-Sulfophenyl)-5-[(Phenyl-Amino)Carbonyl]-2H-Tetrazolium Hydroxide] and colony-forming unit assays, respectively. In addition, the cytotoxicity of the drugs on human cells was evaluated using the AlamarBlue assay. Both drugs decreased fungal viability at all concentrations. In addition, all concentrations of losartan inhibited the growth of C. albicans biofilm, ranging from 47% to 88.5%, whereas aliskiren showed inhibition from 1 to 10 mg/mL, which ranged from 16% to 97.6%. Furthermore, at certain concentrations, these drugs maintained the viability of human cells. Losartan and aliskiren have fungistatic and fungicidal action against C. albicans biofilms and are compatible with human cells. Therefore, these antihypertensive drugs can be repurposed to interfere with the metabolism and development of Candida biofilms, which are widely associated with clinical forms of candidosis, including oral localized forms such as denture stomatitis.
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Affiliation(s)
- Vanessa Soares Lara
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo (USP), Bauru, Brazil
| | - Rafaela Alves da Silva
- Integrated Research Center, Bauru School of Dentistry, University of São Paulo (USP). Bauru, Brazil
| | - Tatiane Ponteado Ferrari
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo (USP), Bauru, Brazil
| | - Carlos Ferreira Dos Santos
- Department of Biological Sciences, Bauru School of Dentistry, University of Sa˜o Paulo (USP). Bauru, Brazil
| | - Sandra Helena Penha de Oliveira
- Immunopharmacology Laboratory, Department of Basic Sciences, São Paulo State University (UNESP), School of Dentistry. Araçatuba, Brazil
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Peralta LCF, Almeida NLM, Pontes FML, Rinaldo D, Carneiro CA, Neppelenbroek KH, Lara VS, Porto VC. Silver nanoparticles in denture adhesive: An antimicrobial approach against Candida albicans. J Dent 2023; 131:104445. [PMID: 36773742 DOI: 10.1016/j.jdent.2023.104445] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/21/2023] [Accepted: 02/03/2023] [Indexed: 02/11/2023] Open
Abstract
OBJECTIVE To evaluate the antimicrobial potential of silver nanoparticles (Ag NPs) synthesized using three different routes (ultraviolet light, Turkevich, and green chemistry method using Glycine max extract) associated with COREGA® denture powder adhesive. METHODS Heat-cured acrylic resin specimens were treated with different Ag NPs associated with the adhesive (AD + Ag UV, AD + Ag Turk, and AD + Ag Gm groups). As controls, the specimens were treated with a combination of adhesive and nystatin (AD + Nyst group), only adhesive (AD group), or submerged on the surface of the specimens (PBS group). After the treatments, biofilms of C. albicans developed for 3, 6, and 12 h on the specimen surfaces. The biofilm was quantified using colony-forming units per milliliter, colorimetric assay, and confocal laser scanning microscopy. RESULTS Regardless of the period, we observed an inhibition of fungal load and a reduction in metabolic activity and biofilm mass in the resin specimens treated with the combinations AD/Ag NPs, compared to AD and PBS. The antimicrobial action of the AD + Turk and AD + Ag Gm groups was similar than that for the AD + Nyst group in all periods and viability tests, except for the biofilm mass (12 h). CONCLUSIONS The COREGA® adhesive with Ag NPs, mainly those synthesized using the Turkevich and Glycine max methods, showed excellent antimicrobial activity against C. albicans biofilms, maintained for up to 12 h. CLINICAL SIGNIFICANCE The association of Ag NPs to the adhesive can add preventive or therapeutic effects against denture stomatitis, to this prosthetic material.
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Affiliation(s)
- Laura Catalí Ferreira Peralta
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo (USP), Bauru, Brazil, 17012-901
| | - Nara Ligia Martins Almeida
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo (USP), Bauru, Brazil, 17012-901
| | | | - Daniel Rinaldo
- Department of Chemistry, São Paulo State University (UNESP), Bauru, Brazil
| | - Camila Alves Carneiro
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo (USP), Bauru, Brazil, 17012-901
| | - Karin Hermana Neppelenbroek
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo (USP), Bauru, Brazil, 17012-901
| | - Vanessa Soares Lara
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo (USP), Bauru, Brazil, 17012-901
| | - Vinicius Carvalho Porto
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo (USP), Bauru, Brazil, 17012-901.
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Branco J, Miranda IM, Rodrigues AG. Candida parapsilosis Virulence and Antifungal Resistance Mechanisms: A Comprehensive Review of Key Determinants. J Fungi (Basel) 2023; 9:jof9010080. [PMID: 36675901 PMCID: PMC9862255 DOI: 10.3390/jof9010080] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/29/2022] [Accepted: 01/03/2023] [Indexed: 01/07/2023] Open
Abstract
Candida parapsilosis is the second most common Candida species isolated in Asia, Southern Europe, and Latin America and is often involved in invasive infections that seriously impact human health. This pathogen is part of the psilosis complex, which also includes Candida orthopsilosis and Candida metapsilosis. C. parapsilosis infections are particularly prevalent among neonates with low birth weights, individuals who are immunocompromised, and patients who require prolonged use of a central venous catheter or other indwelling devices, whose surfaces C. parapsilosis exhibits an enhanced capacity to adhere to and form biofilms. Despite this well-acknowledged prevalence, the biology of C. parapsilosis has not been as extensively explored as that of Candida albicans. In this paper, we describe the molecular mechanistic pathways of virulence in C. parapsilosis and show how they differ from those of C. albicans. We also describe the mode of action of antifungal drugs used for the treatment of Candida infections, namely, polyenes, echinocandins, and azoles, as well as the resistance mechanisms developed by C. parapsilosis to overcome them. Finally, we stress the importance of the ongoing search for species-specific features that may aid the development of effective control strategies and thus reduce the burden on patients and healthcare costs.
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Affiliation(s)
- Joana Branco
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Center for Health Technology and Services Research—CINTESIS@RISE, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
- Correspondence: ; Tel./Fax: +351-225513662
| | - Isabel M. Miranda
- Cardiovascular Research & Development Centre—UnIC@RISE, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
| | - Acácio G. Rodrigues
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Center for Health Technology and Services Research—CINTESIS@RISE, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
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Anagnostakos K, Thiery A, Sahan I. Retained Negative Pressure Wound Therapy Foams as a Cause of Infection Persistence. Adv Wound Care (New Rochelle) 2021; 10:699-710. [PMID: 32870776 DOI: 10.1089/wound.2019.1088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Significance: Negative pressure wound therapy (NPWT) has become a valuable adjunct in the treatment of acute and chronic wounds in several surgical disciplines. Retained foams are among its side effects, and they pose a rare but devastating complication at the site of this therapy, which might be associated with wound-healing complications, infection persistence, repeated surgical revisions, and prolonged antibiotic courses. Recent Advances: In the past 15 years, an increasing number of studies have identified this potential problem. Although the exact incidence remains unknown, initial studies have indicated rates of up to 10% in large collectives being treated by NPWT. Critical Issues: The lack of radiopaque markers does not allow for the visual control of retained foams using plain radiographs. Further imaging methods (e.g., CT and MRI) also do not help in adequate differential diagnosis. The lack of routine documentation of the number, type, and localization of the inserted foam(s) and unplanned surgery with a different surgical team pose risk factors for foam retainment. Future Directions: Introducing new documentation records for wounds treated with NPWT is recommended. At foam removal, all dressing materials should be examined for integrity. The development of foams with radiopaque markers by the industry, such as those routinely used in surgical gauze swabs, might also be a useful step to minimize the risk of foam retainment within wounds.
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Affiliation(s)
- Konstantinos Anagnostakos
- Department of Orthopedics, Center for Orthopedic and Trauma Surgery, Klinikum Saarbrücken, Saarbrücken, Germany
| | - Andreas Thiery
- Department of Orthopedics, Center for Orthopedic and Trauma Surgery, Klinikum Saarbrücken, Saarbrücken, Germany
| | - Ismail Sahan
- Department of Orthopedics, Center for Orthopedic and Trauma Surgery, Klinikum Saarbrücken, Saarbrücken, Germany
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Ravine TJ. Examining properties influencing infectious microbe associations with surfaces of four different thermoplastic radiation therapy masks. J Med Imaging Radiat Sci 2021; 52:576-585. [PMID: 34670723 DOI: 10.1016/j.jmir.2021.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 09/16/2021] [Accepted: 09/24/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Previous testing revealed that four different microbes applied to face-only masks from Civco, Klarity Medical, Orfit, and Qfix demonstrated variation in the number recovered from each mask type after a 1-hour contact time. In all cases, the Orfit mask demonstrated the largest number of recovered microbes suggesting a preference by tested microbes to create associations with this mask type. METHODS The current study evaluated three physiochemical features of these thermoplastic masks to determine why the Orfit mask encouraged greater microbial associations. Measurements including water contact angle (WCA), surface topography, and available contact area were determined for each mask type, where feasible. RESULTS The Orfit mask exhibited the greatest difference in each of the 3 evaluated characteristics. Overall, it showed decreased hydrophobicity, increased surface roughness, and increased surface contact area. The WCA of both Orfit (50.8°) and Klarity (95.6°) masks showed decreased hydrophobicity when compared to native PCL (129.97°). CONCLUSION The Orfit mask's decreased hydrophobicity, increased roughness, and larger surface contact area appears to have contributed to its ability to support a larger number of microbe associations. The decreased hydrophobicity and altered topography of both Klarity and Orfit masks may have been due to their additional antimicrobial coatings.
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Affiliation(s)
- Terrence J Ravine
- Department of Biomedical Sciences, University of South Alabama, 5721 USA Dr. N. Mobile, AL, 36688, USA.
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11
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Chen J, Hu N, Xu H, Liu Q, Yu X, Zhang Y, Huang Y, Tan J, Huang X, Zeng L. Molecular Epidemiology, Antifungal Susceptibility, and Virulence Evaluation of Candida Isolates Causing Invasive Infection in a Tertiary Care Teaching Hospital. Front Cell Infect Microbiol 2021; 11:721439. [PMID: 34604110 PMCID: PMC8479822 DOI: 10.3389/fcimb.2021.721439] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 08/09/2021] [Indexed: 01/08/2023] Open
Abstract
Background The incidence of invasive candidiasis is increasing worldwide. However, the epidemiology, antifungal susceptibility, and virulence of Candida spp. in most hospitals remain unclear. This study aimed to evaluate invasive candidiasis in a tertiary care hospital in Nanchang City, China. Methods MALDI-TOF MS and 18S rDNA ITS sequencing were used to identify Candida strains. Randomly amplified polymorphic DNA analysis was used for molecular typing; biofilm production, caseinase, and hemolysin activities were used to evaluate virulence. The Sensititre™ YeastOne YO10 panel was used to examine antifungal susceptibility. Mutations in ERG11 and the hotspot regions of FKS1 of drug-resistant strains were sequenced to evaluate the possible mechanisms of antifungal resistance. Results We obtained 110 Candida strains, which included 40 Candida albicans (36.36%), 37 C. parapsilosis (33.64%), 21 C. tropicalis (19.09%), 9 C. glabrata (8.18%), 2 C. rugose (1.82%), and 1 C. haemulonii (0.91%) isolates. At a limiting point of 0.80, C. albicans isolates could be grouped into five clusters, C. parapsilosis and C. tropicalis isolates into seven clusters, and C. glabrata isolates into only one cluster comprising six strains by RAPD typing. Antifungal susceptibility testing revealed that the isolates showed the greatest overall resistance against fluconazole (6.36%), followed by voriconazole (4.55%). All C. albicans and C. parapsilosis isolates exhibited 100% susceptibility to echinocandins (i.e., anidulafungin, caspofungin, and micafungin), whereas one C. glabrata strain was resistant to echinocandins. The most common amino acid substitutions noted in our study was 132aa (Y132H, Y132F) in the azole-resistant strains. No missense mutation was identified in the hotpot regions of FKS1. Comparison of the selected virulence factors detectable in a laboratory environment, such as biofilm, caseinase, and hemolysin production, revealed that most Candida isolates were caseinase and hemolysin producers with a strong activity (Pz < 0.69). Furthermore, C. parapsilosis had greater total biofilm biomass (average Abs620 = 0.712) than C. albicans (average Abs620 = 0.214, p < 0.01) or C. tropicalis (average Abs620 = 0.450, p < 0.05), although all C. glabrata strains were either low- or no-biofilm producers. The virulence level of the isolates from different specimen sources or clusters showed no obvious correlation. Interesting, 75% of the C. albicans from cluster F demonstrated azole resistance, whereas two azole-resistant C. tropicalis strains belonged to the cluster Y. Conclusion This study provides vital information regarding the epidemiology, pathogenicity, and antifungal susceptibility of Candida spp. in patients admitted to Nanchang City Hospital.
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Affiliation(s)
- Junzhu Chen
- Department of Clinical Laboratory, The First Affiliated Hospital of Nanchang University, Nanchang, China.,Department of Medical Microbiology, School of Medicine, Nanchang University, Nanchang, China
| | - Niya Hu
- Department of Clinical Laboratory, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Hongzhi Xu
- Department of Clinical Laboratory, The First Affiliated Hospital of Nanchang University, Nanchang, China.,Department of Preventive Medicine and Public Health, School of Public Health, Nanchang University, Nanchang, China
| | - Qiong Liu
- Department of Medical Microbiology, School of Medicine, Nanchang University, Nanchang, China
| | - Xiaomin Yu
- Department of Medical Microbiology, School of Medicine, Nanchang University, Nanchang, China
| | - Yuping Zhang
- Department of Medical Microbiology, School of Medicine, Nanchang University, Nanchang, China
| | - Yongcheng Huang
- Department of Preventive Medicine and Public Health, School of Public Health, Nanchang University, Nanchang, China
| | - Junjun Tan
- Department of Medical Microbiology, School of Medicine, Nanchang University, Nanchang, China
| | - Xiaotian Huang
- Department of Clinical Laboratory, The First Affiliated Hospital of Nanchang University, Nanchang, China.,Department of Medical Microbiology, School of Medicine, Nanchang University, Nanchang, China
| | - Lingbing Zeng
- Department of Clinical Laboratory, The First Affiliated Hospital of Nanchang University, Nanchang, China.,Department of Preventive Medicine and Public Health, School of Public Health, Nanchang University, Nanchang, China
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12
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Masfufatun M, Raharjo LH, Wiradinata H, Tania POA, Ni'matuzahroh N, Baktir A. New phenomena for clinicians, model of Candida albicans mobilization before and after biofilm formation in the intestinal mucosa of Wistar rats (Rattus norvegicus). INTERNATIONAL JOURNAL OF ONE HEALTH 2021. [DOI: 10.14202/ijoh.2021.165-170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background and Aim: The virulence and antifungal resistance of Candida albicans are recently known for their ability to form biofilm. This research aimed to construct an in vivo model of C. albicans biofilm in Wistar rats' intestinal mucosa and study their mobilization while in a planktonic and biofilm formation. In this study, there was one treatment group that was treated with three antibiotics, immunosuppressants, and C. albicans.
Materials and Methods: This study was divided into control and treatment groups. The data sampling was conducted after C. albicans inoculation. The C. albicans biofilm formation stage was monitored with colony-forming units method calculation every week post-inoculation and then observed by the confocal laser scanning microscope.
Results: The planktonic C. albicans overgrowth occurred up to 14 days after inoculation. The formation and maturation of C. albicans biofilm in the intestinal mucosa started in the 28th and 35th-day post-inoculation, respectively. The density of planktonic C. albicans in the stool was dramatically decreased on the 35th day. Before the biofilm formation, the planktonic Candida was carried away by food scraps to be released as a stool. However, there were minuscule or no planktonic Candida observed in the stool during and after biofilm formation. Instead, they were attached to the caecum's mucosa as a biofilm.
Conclusion: We have proved that the planktonic C. albicans with its mobile nature were carried into the stool along with the rest of the feed, as we observed a lot of C. albicans cells found in the stool. Meanwhile, on day 28 after administration of antibiotics and immunosuppressants, no C. albicans was found in the stool samples, and at the same time, we observed C. albicans cells and their matrix attached to the intestinal mucosa as a biofilm.
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Affiliation(s)
- Masfufatun Masfufatun
- Department of Biochemistry, Faculty of Medicine, University of Wijaya Kusuma Surabaya, Surabaya, Indonesia
| | - Loo Hariyanto Raharjo
- Department of Biochemistry, Faculty of Medicine, University of Wijaya Kusuma Surabaya, Surabaya, Indonesia
| | - Harsono Wiradinata
- Department of Biochemistry, Faculty of Medicine, University of Wijaya Kusuma Surabaya, Surabaya, Indonesia
| | - Putu Oky Ari Tania
- Department of Biomedicine and Biomolecular, Faculty of Medicine, University of Wijaya Kusuma Surabaya, Surabaya, Indonesia
| | | | - Afaf Baktir
- Department of Chemistry, Faculty of Science and Technology, Airlangga University, Surabaya, Indonesia
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13
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Cavalheiro M, Pereira D, Formosa-Dague C, Leitão C, Pais P, Ndlovu E, Viana R, Pimenta AI, Santos R, Takahashi-Nakaguchi A, Okamoto M, Ola M, Chibana H, Fialho AM, Butler G, Dague E, Teixeira MC. From the first touch to biofilm establishment by the human pathogen Candida glabrata: a genome-wide to nanoscale view. Commun Biol 2021; 4:886. [PMID: 34285314 PMCID: PMC8292413 DOI: 10.1038/s42003-021-02412-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 06/30/2021] [Indexed: 02/06/2023] Open
Abstract
Candida glabrata is an opportunistic pathogen that adheres to human epithelial mucosa and forms biofilm to cause persistent infections. In this work, Single-cell Force Spectroscopy (SCFS) was used to glimpse at the adhesive properties of C. glabrata as it interacts with clinically relevant surfaces, the first step towards biofilm formation. Following a genetic screening, RNA-sequencing revealed that half of the entire transcriptome of C. glabrata is remodeled upon biofilm formation, around 40% of which under the control of the transcription factors CgEfg1 and CgTec1. Using SCFS, it was possible to observe that CgEfg1, but not CgTec1, is necessary for the initial interaction of C. glabrata cells with both abiotic surfaces and epithelial cells, while both transcription factors orchestrate biofilm maturation. Overall, this study characterizes the network of transcription factors controlling massive transcriptional remodelling occurring from the initial cell-surface interaction to mature biofilm formation.
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Affiliation(s)
- Mafalda Cavalheiro
- Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
- Biological Sciences Research Group, iBB - Institute for Bioengineering and Biosciences, Instituto Superior Técnico, Lisbon, Portugal
| | - Diana Pereira
- Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
- Biological Sciences Research Group, iBB - Institute for Bioengineering and Biosciences, Instituto Superior Técnico, Lisbon, Portugal
| | | | - Carolina Leitão
- Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
- Biological Sciences Research Group, iBB - Institute for Bioengineering and Biosciences, Instituto Superior Técnico, Lisbon, Portugal
| | - Pedro Pais
- Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
- Biological Sciences Research Group, iBB - Institute for Bioengineering and Biosciences, Instituto Superior Técnico, Lisbon, Portugal
| | - Easter Ndlovu
- LAAS-CNRS, Université de Toulouse, CNRS, Toulouse, France
| | - Romeu Viana
- Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
- Biological Sciences Research Group, iBB - Institute for Bioengineering and Biosciences, Instituto Superior Técnico, Lisbon, Portugal
| | - Andreia I Pimenta
- Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
- Biological Sciences Research Group, iBB - Institute for Bioengineering and Biosciences, Instituto Superior Técnico, Lisbon, Portugal
| | - Rui Santos
- Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
- Biological Sciences Research Group, iBB - Institute for Bioengineering and Biosciences, Instituto Superior Técnico, Lisbon, Portugal
| | | | - Michiyo Okamoto
- Medical Mycology Research Center (MMRC), Chiba University, Chiba, Japan
| | - Mihaela Ola
- School of Biomedical and Biomolecular Sciences, Conway Institute, University College Dublin, Dublin, Ireland
| | - Hiroji Chibana
- Medical Mycology Research Center (MMRC), Chiba University, Chiba, Japan
| | - Arsénio M Fialho
- Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
- Biological Sciences Research Group, iBB - Institute for Bioengineering and Biosciences, Instituto Superior Técnico, Lisbon, Portugal
| | - Geraldine Butler
- School of Biomedical and Biomolecular Sciences, Conway Institute, University College Dublin, Dublin, Ireland
| | - Etienne Dague
- LAAS-CNRS, Université de Toulouse, CNRS, Toulouse, France.
| | - Miguel C Teixeira
- Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal.
- Biological Sciences Research Group, iBB - Institute for Bioengineering and Biosciences, Instituto Superior Técnico, Lisbon, Portugal.
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14
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Antiadhesive Properties of Imidazolium Ionic Liquids Based on (-)-Menthol Against Candida spp. Int J Mol Sci 2021; 22:ijms22147543. [PMID: 34299160 PMCID: PMC8304783 DOI: 10.3390/ijms22147543] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/25/2021] [Accepted: 07/12/2021] [Indexed: 01/02/2023] Open
Abstract
Infections with Candida spp. are commonly found in long-time denture wearers, and when under immunosuppression can lead to stomatitis. Imidazolium ionic liquids with an alkyl or alkyloxymethyl chain and a natural (1R,2S,5R)-(-)-menthol substituent possess high antifungal and antiadhesive properties towards C. albicans, C. parapsilosis, C. glabrata and C. krusei. We tested three compounds and found they disturbed fungal plasma membranes, with no significant hemolytic properties. In the smallest hemolytic concentrations, all compounds inhibited C. albicans biofilm formation on acrylic, and partially on porcelain and alloy dentures. Biofilm eradication may result from hyphae inhibition (for alkyl derivatives) or cell wall lysis and reduction of adhesins level (for alkyloxymethyl derivative). Thus, we propose the compounds presented herein as potential anti-fungal denture cleaners or denture fixatives, especially due to their low toxicity towards mammalian erythrocytes after short-term exposure.
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De Rose DU, Piersigilli F, Goffredo BM, Danhaive O, Dotta A, Auriti C. Treatment with Micafungin in a Preterm Neonate with an Invasive Candida parapsilosis Infection after a Severe Terlipressin-Induced Skin Necrosis. Pathogens 2021; 10:pathogens10070890. [PMID: 34358040 PMCID: PMC8308678 DOI: 10.3390/pathogens10070890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/03/2021] [Accepted: 07/08/2021] [Indexed: 12/18/2022] Open
Abstract
Candida parapsilosis infections are increasingly reported in preterm neonates, but the optimal treatment remains uncertain. We report the clinical history of an extremely preterm neonate, who developed a devastating skin necrosis due to terlipressin administration, with subsequent superinfection by Candida parapsilosis. The infant underwent multiple curettages and skin grafts to resolve skin lesions and was treated with systemic micafungin administration at a high dose (8 mg/kg/day), with resolution of the fungal infection.
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Affiliation(s)
- Domenico Umberto De Rose
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus, Newborn and Infant—“Bambino Gesù” Children’s Hospital IRCCS, 00165 Rome, Italy; (D.U.D.R.); (A.D.)
| | - Fiammetta Piersigilli
- Division of Neonatology, Cliniques Saint-Luc, Catholic University of Louvain, 1200 Brussels, Belgium; (F.P.); (O.D.)
| | - Bianca Maria Goffredo
- Biochemistry Laboratory, Department of Specialist Pediatrics, “Bambino Gesù” Children’s Hospital IRCCS, 00165 Rome, Italy;
| | - Olivier Danhaive
- Division of Neonatology, Cliniques Saint-Luc, Catholic University of Louvain, 1200 Brussels, Belgium; (F.P.); (O.D.)
- Division of Neonatology, San Francisco Benioff Children’s Hospital, University of California, San Francisco, CA 94158, USA
| | - Andrea Dotta
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus, Newborn and Infant—“Bambino Gesù” Children’s Hospital IRCCS, 00165 Rome, Italy; (D.U.D.R.); (A.D.)
| | - Cinzia Auriti
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus, Newborn and Infant—“Bambino Gesù” Children’s Hospital IRCCS, 00165 Rome, Italy; (D.U.D.R.); (A.D.)
- Correspondence: ; Tel.: +39-06-6859-2427; Fax: +39-06-6859-3916
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16
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Sasani E, Khodavaisy S, Rezaie S, Salehi M, Yadegari MH. The relationship between biofilm formation and mortality in patients with Candida tropicalis candidemia. Microb Pathog 2021; 155:104889. [PMID: 33878395 DOI: 10.1016/j.micpath.2021.104889] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Biofilm formation by Candida species is an influential virulence factor in candidemia pathogenesis. We investigated the relationship between biofilm formation of Candida tropicalis isolates with the clinical characteristics and mortality outcomes in patients with candidemia. MATERIALS AND METHODS Thirty-nine C. tropicalis isolates were recovered from patients with candidemia admitted to two university hospitals in Tehran, Iran. Biofilm mass and metabolic activity of C. tropicalis biofilms were assessed in vitro with two colorimetric methods. The sessile minimum inhibitory concentrations (SMICs) were evaluated in vitro by treating preformed biofilms with diluted concentrations of azoles according to CLSI-M27 A3/S4 protocol, followed by metabolic activity quantification. The expressions of ERG11, UPC2, MDR1, and CDR1 genes were also evaluated. RESULTS All C. tropicalis isolates produced biofilm. Respectively, higher <7-day and ≥7-day mortality rates were found among cases with high metabolic activity (46.7% vs. 13%, P = 0.03) and high biofilm mass (31.8% vs. 0, P = 0.029). Sessile cells had high resistance to fluconazole, voriconazole, and itraconazole. The azole minimum inhibitory concentrations (MICs) of C. tropicalis sessile were significantly greater than the planktonic minimum inhibitory concentrations (PMICs). In fluconazole-treated biofilms, the expression of ERG11 and UPC2 genes was increased. CONCLUSION Our findings highlight the importance of C. tropicalis biofilm formation as an important factor in candidemia pathogenesis and the clinical outcome of patients with candidemia.
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Affiliation(s)
- Elahe Sasani
- Department of Medical Mycology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Sadegh Khodavaisy
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Sassan Rezaie
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Salehi
- Department of Infectious Diseases and Tropical Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hossein Yadegari
- Department of Medical Mycology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
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Biofilm Formed by Candida haemulonii Species Complex: Structural Analysis and Extracellular Matrix Composition. J Fungi (Basel) 2020; 6:jof6020046. [PMID: 32260180 PMCID: PMC7345111 DOI: 10.3390/jof6020046] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 04/01/2020] [Accepted: 04/01/2020] [Indexed: 01/18/2023] Open
Abstract
Candida haemulonii species complex (C. haemulonii, C. duobushaemulonii, and C. haemulonii var. vulnera) has emerged as opportunistic, multidrug-resistant yeasts able to cause fungemia. Previously, we showed that C. haemulonii complex formed biofilm on polystyrene. Biofilm is a well-known virulence attribute of Candida spp. directly associated with drug resistance. In the present study, the architecture and the main extracellular matrix (ECM) components forming the biofilm over polystyrene were investigated in clinical isolates of the C. haemulonii complex. We also evaluated the ability of these fungi to form biofilm on catheters used in medical arena. The results revealed that all fungi formed biofilms on polystyrene after 48 h at 37 °C. Microscopic analyses demonstrated a dense network of yeasts forming the biofilm structure, with water channels and ECM. Regarding ECM, proteins and carbohydrates were the main components, followed by nucleic acids and sterols. Mature biofilms were also detected on late bladder (siliconized latex), nasoenteric (polyurethane), and nasogastric (polyvinyl chloride) catheters, with the biomasses being significantly greater than on polystyrene. Collectively, our results demonstrated the ability of the C. haemulonii species complex to form biofilm on different types of inert surfaces, which is an incontestable virulence attribute associated with devices-related candidemia in hospitalized individuals.
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18
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A versatile approach to antimicrobial coatings via metal-phenolic networks. Colloids Surf B Biointerfaces 2020; 187:110771. [DOI: 10.1016/j.colsurfb.2020.110771] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 11/10/2019] [Accepted: 01/01/2020] [Indexed: 11/23/2022]
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19
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Reginatto P, Bergamo VZ, Berlitz SJ, Guerreiro ICK, de Andrade SF, Fuentefria AM. Rational selection of antifungal drugs to propose a new formulation strategy to control Candida biofilm formation on venous catheters. Braz J Microbiol 2020; 51:1037-1049. [PMID: 32077074 DOI: 10.1007/s42770-020-00242-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 02/06/2020] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Infections associated with medical devices are often related to colonization by Candida spp. biofilm; in this way, numerous strategies have been developed and studied, mainly in order to prevent this type of fungal growth. AIM Considering the above, the main objective of the present study is to make a rational choice of the best antifungal therapy for the in vitro treatment of the biofilm on venous catheters, proposing an innovative formulation of a film-forming system to coat the surface in order to prevent the formation of biofilms. METHODOLOGY Anidulafungin, fluconazole, voriconazole, ketoconazole, amphotericin B, and the association of anidulafungin and amphotericin B were tested against biofilms of C. albicans, C. tropicalis, and C. parapsilosis strains in microtiter plates and in a polyurethane catheter. Besides, anidulafungin, amphotericin B, and the combination of both were incorporated in a film-forming system and were evaluated against biofilm. RESULTS The superior activity of anidulafungin was demonstrated in relation to the other antifungal agents. Although amphotericin B showed good activity, high concentrations were required. The combination showed a synergistic action, in solution and in the formulation, showing excellent results, with activity above 90%. CONCLUSION Due to the superiority of anidulafungin and the synergistic activity of the combination, these alternatives were the most promising options for use in a formulation proposal as a new strategy to combat the Candida spp. biofilm. These formulations demonstrated high in vitro performance in the prevention of biofilms, indicating that they are candidates with great potential for in vivo tests.
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Affiliation(s)
- Paula Reginatto
- Programa de Pós-Graduação em Microbiologia Agrícola e do Ambiente, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. .,Laboratório de Micologia Aplicada, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Vanessa Zafanelli Bergamo
- Programa de Pós-Graduação em Microbiologia Agrícola e do Ambiente, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Simone Jacobus Berlitz
- Programa de Pós-Graduação em Nanotecnologia Farmacêutica, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Irene Clemes Kulkamp Guerreiro
- Programa de Pós-Graduação em Nanotecnologia Farmacêutica, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Departamento de Produção de Matéria-Prima, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Saulo Fernandes de Andrade
- Programa de Pós-Graduação em Microbiologia Agrícola e do Ambiente, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Departamento de Produção de Matéria-Prima, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Alexandre Meneghello Fuentefria
- Programa de Pós-Graduação em Microbiologia Agrícola e do Ambiente, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Departamento de Análises, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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20
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Galocha M, Pais P, Cavalheiro M, Pereira D, Viana R, Teixeira MC. Divergent Approaches to Virulence in C. albicans and C. glabrata: Two Sides of the Same Coin. Int J Mol Sci 2019; 20:E2345. [PMID: 31083555 PMCID: PMC6539081 DOI: 10.3390/ijms20092345] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/08/2019] [Accepted: 05/08/2019] [Indexed: 12/27/2022] Open
Abstract
Candida albicans and Candida glabrata are the two most prevalent etiologic agents of candidiasis worldwide. Although both are recognized as pathogenic, their choice of virulence traits is highly divergent. Indeed, it appears that these different approaches to fungal virulence may be equally successful in causing human candidiasis. In this review, the virulence mechanisms employed by C. albicans and C. glabrata are analyzed, with emphasis on the differences between the two systems. Pathogenesis features considered in this paper include dimorphic growth, secreted enzymes and signaling molecules, and stress resistance mechanisms. The consequences of these traits in tissue invasion, biofilm formation, immune system evasion, and macrophage escape, in a species dependent manner, are discussed. This review highlights the observation that C. albicans and C. glabrata follow different paths leading to a similar outcome. It also highlights the lack of knowledge on some of the specific mechanisms underlying C. glabrata pathogenesis, which deserve future scrutiny.
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Affiliation(s)
- Mónica Galocha
- Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisboa, Portugal.
- iBB-Institute for Bioengineering and Biosciences, Biological Sciences Research Group, Instituto Superior Técnico, University of Lisbon, Av. Rovisco Pais, 1049-001 Lisboa, Portugal.
| | - Pedro Pais
- Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisboa, Portugal.
- iBB-Institute for Bioengineering and Biosciences, Biological Sciences Research Group, Instituto Superior Técnico, University of Lisbon, Av. Rovisco Pais, 1049-001 Lisboa, Portugal.
| | - Mafalda Cavalheiro
- Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisboa, Portugal.
- iBB-Institute for Bioengineering and Biosciences, Biological Sciences Research Group, Instituto Superior Técnico, University of Lisbon, Av. Rovisco Pais, 1049-001 Lisboa, Portugal.
| | - Diana Pereira
- Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisboa, Portugal.
- iBB-Institute for Bioengineering and Biosciences, Biological Sciences Research Group, Instituto Superior Técnico, University of Lisbon, Av. Rovisco Pais, 1049-001 Lisboa, Portugal.
| | - Romeu Viana
- Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisboa, Portugal.
- iBB-Institute for Bioengineering and Biosciences, Biological Sciences Research Group, Instituto Superior Técnico, University of Lisbon, Av. Rovisco Pais, 1049-001 Lisboa, Portugal.
| | - Miguel C Teixeira
- Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisboa, Portugal.
- iBB-Institute for Bioengineering and Biosciences, Biological Sciences Research Group, Instituto Superior Técnico, University of Lisbon, Av. Rovisco Pais, 1049-001 Lisboa, Portugal.
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21
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Díaz-García J, Marcos-Zambrano LJ, Muñoz P, Guinea J, Escribano P. Does the composition of polystyrene trays affect Candida spp. biofilm formation? Med Mycol 2019; 57:504-509. [PMID: 30202852 DOI: 10.1093/mmy/myy064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 06/22/2018] [Accepted: 07/14/2018] [Indexed: 01/01/2023] Open
Abstract
The biofilm formation ability of Candida species seems to have a role in the prognosis of patients with candidemia. Biofilm formation is usually tested using 96 well flat bottom polystyrene microtiter plates, although the type of plastic used is not commonly reported. This study compares biofilm formation by Candida spp. on six types of plates from three brands (three non-tissue-treated and three tissue-treated). Thirty isolates of each of the following species were selected: C. albicans, C. parapsilosis, C. glabrata, C. tropicalis, as well as 15 isolates of C. krusei (n = 135 isolates) from patients with candidemia. Biofilm production was evaluated by measuring biomass production and metabolic activity. Our results show higher biomass production and metabolic activity of biofilms formed on non-tissue-treated plates in comparison to those formed on tissue-treated plates (P < .001). We only found significant differences in metabolic activity of biofilms formed on non-tissue-treated plates (P < .003). All comparisons including biofilm formation and metabolic activity among plates of the same brand yielded higher biofilm formation on non-treated plates compared to treated plates (P < .001). Significant difference in biomass production by C. parapsilosis was only seen when comparing between the various tissue-treated plastics (P < .03). In contrast, comparisons of different non-tissue-treated tray brands yielded significant metabolic activity differences for all species except for C. parapsilosis (P < .05). Biofilm formation and metabolic activity is significantly affected by the plastic composition of non-tissue-treated trays leading to increased biofilm formation.
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Affiliation(s)
- Judith Díaz-García
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain.,Instituto de Investigación Sanitaria del Hospital Gregorio Marañón, Madrid, Spain
| | - Laura Judith Marcos-Zambrano
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain.,Instituto de Investigación Sanitaria del Hospital Gregorio Marañón, Madrid, Spain
| | - Patricia Muñoz
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain.,Instituto de Investigación Sanitaria del Hospital Gregorio Marañón, Madrid, Spain.,CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain.,Medicine Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Jesús Guinea
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain.,Instituto de Investigación Sanitaria del Hospital Gregorio Marañón, Madrid, Spain.,CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain.,Medicine Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Pilar Escribano
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain.,Instituto de Investigación Sanitaria del Hospital Gregorio Marañón, Madrid, Spain
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22
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Candida glabrata Has No Enhancing Role in the Pathogenesis of Candida-Associated Denture Stomatitis in a Rat Model. mSphere 2019; 4:4/2/e00191-19. [PMID: 30944214 PMCID: PMC6449607 DOI: 10.1128/msphere.00191-19] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Many denture wearers suffer from Candida-associated denture stomatitis (DS), a fungal infection of the hard palate in contact with dentures. Biofilm formation by Candida albicans on denture/palate surfaces is considered a central process in the infection onset. Although Candida glabrata is frequently coisolated with C. albicans, its role in DS pathogenesis is unknown. We show here, using a contemporary rat model that employed a patented intraoral denture system, that C. glabrata established stable colonization on the denture/palate. However, in contrast to C. albicans inoculated rats, rats inoculated with C. glabrata exhibited minimal changes in weight gain or palatal tissue damage. Likewise, coinoculation with the two Candida species resulted in no exacerbation of C. albicans-induced DS pathology. Together, our findings indicate that C. glabrata has no inducing/enhancing role in DS pathogenesis. Denture stomatitis (DS) is a condition characterized by inflammation of the oral mucosa in direct contact with dentures and affects a significant number of otherwise healthy denture wearers. Candida-associated DS is predominantly caused by Candida albicans, a dimorphic fungus that readily colonizes and forms biofilms on denture materials. Previous studies showed a requirement for Candida biofilm formation on both palate and dentures in infection and identified fungal morphogenic transcription factors, Efg1 and Bcr1, as key players in DS pathogenesis. While both C. albicans and Candida glabrata are frequently coisolated in mucosal candidiasis, a pathogenic role for C. glabrata in DS remains unknown. Using an established rat model of DS, we sought to determine whether C. glabrata alone or coinoculation with C. albicans establishes colonization and causes palatal tissue damage and inflammation. Rats fitted with custom dentures were inoculated with C. albicans and/or C. glabrata and monitored over a 4-week period for fungal burden (denture/palate), changes in body weight, and tissue damage via lactate dehydrogenase (LDH) release as well as palatal staining by hematoxylin and eosin (H&E) and immunohistochemistry for myeloperoxidase (MPO) as measures of inflammation. C. glabrata colonized the denture/palate similarly to C. albicans. In contrast to C. albicans, colonization by C. glabrata resulted in minimal changes in body weight, palatal LDH release, and MPO expression. Coinoculation with both species had no obvious modulation of C. albicans-mediated pathogenic effects. These data suggest that C. glabrata readily establishes colonization on denture and palate but has no apparent role for inducing/enhancing C. albicans pathogenesis in DS. IMPORTANCE Many denture wearers suffer from Candida-associated denture stomatitis (DS), a fungal infection of the hard palate in contact with dentures. Biofilm formation by Candida albicans on denture/palate surfaces is considered a central process in the infection onset. Although Candida glabrata is frequently coisolated with C. albicans, its role in DS pathogenesis is unknown. We show here, using a contemporary rat model that employed a patented intraoral denture system, that C. glabrata established stable colonization on the denture/palate. However, in contrast to C. albicans inoculated rats, rats inoculated with C. glabrata exhibited minimal changes in weight gain or palatal tissue damage. Likewise, coinoculation with the two Candida species resulted in no exacerbation of C. albicans-induced DS pathology. Together, our findings indicate that C. glabrata has no inducing/enhancing role in DS pathogenesis.
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Vieira de Melo AP, Zuza-Alves DL, da Silva-Rocha WP, Ferreira Canário de Souza LB, Francisco EC, Salles de Azevedo Melo A, Maranhão Chaves G. Virulence factors of Candida spp. obtained from blood cultures of patients with candidemia attended at tertiary hospitals in Northeast Brazil. J Mycol Med 2019; 29:132-139. [PMID: 30876744 DOI: 10.1016/j.mycmed.2019.02.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 01/30/2019] [Accepted: 02/07/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Yeasts of the Candida genus are one of the most common causes of bloodstream infections associated with high rates of morbidity and mortality, mainly affecting immunocompromised patients. We aimed to identify yeasts obtained from blood cultures of patients interned at tertiary hospitals in Brazil. METHODS We evaluated some of the major virulence factors of Candida spp., including the ability to adhere to human buccal epithelial cells, biofilm formation, hemolytic and phospholipase activity. RESULTS We analyzed 70 isolates of Candida spp. obtained from March 2011 and March 2015. Candida spp. showed different peculiarities in terms of expression of virulence factors evaluated in vitro. C. albicans strains were more adherent to HBEC than all the other Candida species. C. tropicalis strains were considered strong biofilm producers. Strains belonging to the C. parapsilosis species complex were able to produce hemolysins, while C. glabrata was also able to lyse erythrocytes and to produce phospholipase. CONCLUSION These results suggest that Non-Candida albicans Candida species are also able to express virulence factors which play an important role in bloodstream infectious caused by these yeasts.
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Affiliation(s)
- A P Vieira de Melo
- Natal City, Rio Grande do Norte, Brazil; Department of Clinical and Toxicological Analysis, Federal University of Rio Grande do Norte, Brazil
| | - D L Zuza-Alves
- Natal City, Rio Grande do Norte, Brazil; Department of Clinical and Toxicological Analysis, Federal University of Rio Grande do Norte, Brazil
| | - W P da Silva-Rocha
- Natal City, Rio Grande do Norte, Brazil; Department of Clinical and Toxicological Analysis, Federal University of Rio Grande do Norte, Brazil
| | - L B Ferreira Canário de Souza
- Natal City, Rio Grande do Norte, Brazil; Department of Clinical and Toxicological Analysis, Federal University of Rio Grande do Norte, Brazil
| | - E C Francisco
- São Paulo City, Laboratório Especial de Micologia, Federal University of São Paulo, São Paulo, Brazil
| | - A Salles de Azevedo Melo
- São Paulo City, Laboratório Especial de Micologia, Federal University of São Paulo, São Paulo, Brazil
| | - G Maranhão Chaves
- Natal City, Rio Grande do Norte, Brazil; Department of Clinical and Toxicological Analysis, Federal University of Rio Grande do Norte, Brazil.
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El-Houssaini HH, Elnabawy OM, Nasser HA, Elkhatib WF. Correlation between antifungal resistance and virulence factors in Candida albicans recovered from vaginal specimens. Microb Pathog 2019; 128:13-19. [DOI: 10.1016/j.micpath.2018.12.028] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 12/12/2018] [Accepted: 12/14/2018] [Indexed: 01/12/2023]
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25
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In vitro interaction of Candida tropicalis biofilm formed on catheter with human cells. Microb Pathog 2018; 125:177-182. [DOI: 10.1016/j.micpath.2018.09.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 08/14/2018] [Accepted: 09/15/2018] [Indexed: 11/19/2022]
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Effect of chitosan nanoparticles on the inhibition of Candida spp. biofilm on denture base surface. Arch Oral Biol 2018; 94:99-107. [PMID: 30015218 DOI: 10.1016/j.archoralbio.2018.07.004] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 07/03/2018] [Accepted: 07/07/2018] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Chitosan nanoparticles (ChNPs) have antifungal effects, however there is a lack of information about the effects of ChNPs against Candida biofilm on denture base surface. This study investigated the ChNPs effect against C. albicans biofilm adhesion and formation, and against Candida spp. biofilm on heat-cured acrylic resin. DESIGN The ChNPs were synthetized (3800 μg/mL) and characterized by infra-red spectrophotometry and transmission electron microscopy. The minimum inhibitory/fungicidal concentrations (MIC/MFC) against Candida spp. were determined. The time-kill assay and changes on C. albicans micromorphology were evaluated. The % inhibition of ChNPs on C. albicans biofilm formation and reduction were investigated using 1 min and 8 h exposure. Candida biofilm was developed on resin surfaces and ChNPs were applied every 8 h for 5 days. After, fungal cells were counted (CFU/mL) and the surface roughness (Ra) and vickers microhardness (HV) of resin were analysed. For all experiments, sodium hypochlorite (NaOCl) was used as control. Data were analyzed by ANOVA, Tukey and paired t-tests (α = 0.05). RESULTS The MIC80% of ChNPs was 30.1 μg/mL. ChNPs at 4 MIC showed complete inhibition in the time-kill assays. Blastoconidia cells were predominant after ChNPs application. The % inhibition ChNPs on C. albicans was proportional to its concentration, regardless of the exposure time. ChNPs decreased the CFU/mL of Candida spp. and showed lower alteration of HV and Ra values of resin surface compared to NaOCl. CONCLUSIONS The ChNPs inhibited C. albicans biofilm, reduced Candida biofilm on resin and caused small changes in roughness and hardness of acrylic resin surface.
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Cavalheiro M, Teixeira MC. Candida Biofilms: Threats, Challenges, and Promising Strategies. Front Med (Lausanne) 2018; 5:28. [PMID: 29487851 PMCID: PMC5816785 DOI: 10.3389/fmed.2018.00028] [Citation(s) in RCA: 353] [Impact Index Per Article: 58.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 01/26/2018] [Indexed: 12/19/2022] Open
Abstract
Candida species are fungal pathogens known for their ability to cause superficial and systemic infections in the human host. These pathogens are able to persist inside the host due to the development of pathogenicity and multidrug resistance traits, often leading to the failure of therapeutic strategies. One specific feature of Candida species pathogenicity is their ability to form biofilms, which protects them from external factors such as host immune system defenses and antifungal drugs. This review focuses on the current threats and challenges when dealing with biofilms formed by Candida albicans, Candida glabrata, Candida tropicalis, and Candida parapsilosis, highlighting the differences between the four species. Biofilm characteristics depend on the ability of each species to produce extracellular polymeric substances (EPS) and display dimorphic growth, but also on the biofilm substratum, carbon source availability and other factors. Additionally, the transcriptional control over processes like adhesion, biofilm formation, filamentation, and EPS production displays great complexity and diversity within pathogenic yeasts of the Candida genus. These differences not only have implications in the persistence of colonization and infections but also on antifungal resistance typically found in Candida biofilm cells, potentiated by EPS, that functions as a barrier to drug diffusion, and by the overexpression of drug resistance transporters. The ability to interact with different species in in vivo Candida biofilms is also a key factor to consider when dealing with this problem. Despite many challenges, the most promising strategies that are currently available or under development to limit biofilm formation or to eradicate mature biofilms are discussed.
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Affiliation(s)
- Mafalda Cavalheiro
- Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal.,iBB - Institute for Bioengineering and Biosciences, Biological Sciences Research Group, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
| | - Miguel Cacho Teixeira
- Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal.,iBB - Institute for Bioengineering and Biosciences, Biological Sciences Research Group, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
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Almeida NLM, Saldanha LL, da Silva RA, Pinke KH, da Costa EF, Porto VC, Dokkedal AL, Lara VS. Antimicrobial activity of denture adhesive associated with Equisetum giganteum- and Punica granatum-enriched fractions against Candida albicans biofilms on acrylic resin surfaces. BIOFOULING 2018; 34:62-73. [PMID: 29250982 DOI: 10.1080/08927014.2017.1407408] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 11/07/2017] [Indexed: 06/07/2023]
Abstract
Candida biofilms adhere to the internal surface of removable dentures, which is an etiological factor in the pathogenesis of denture stomatitis (DS). Adhesive materials are used at the base of maxillary complete dentures to improve their retention and chewing qualities. This article reports the antimicrobial activity of the enriched fractions of Equisetum giganteum and Punica granatum incorporated into a denture adhesive against C. albicans biofilm. The biofilms were induced on the surface of heat-cured acrylic resin specimens that were previously treated with a mixture of adhesive/herb extracts. The antimicrobial activity was evaluated by CFU counts, XTT reduction, and SEM and CLSM analysis. Both herb extracts amplified the anti-biofilm action of the adhesive on the acrylic resin by up to 12 h. Therefore, when these extracts were combined with COREGA®, they played a collaborative and innovative role in biofilm control and can be considered alternatives for temporary use in the treatment and/or prevention of DS.
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Affiliation(s)
- Nara Ligia Martins Almeida
- a Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry , University of São Paulo , Bauru , Brazil
| | - Luiz Leonardo Saldanha
- b Department of Botany, Institute of Biosciences , São Paulo State University (UNESP) , Botucatu , Brazil
- c Department of Biological Sciences, Faculty of Sciences , São Paulo State University (UNESP) , Bauru , Brazil
| | - Rafaela Alves da Silva
- a Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry , University of São Paulo , Bauru , Brazil
| | - Karen Henriette Pinke
- a Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry , University of São Paulo , Bauru , Brazil
| | - Eliane Ferraz da Costa
- a Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry , University of São Paulo , Bauru , Brazil
| | - Vinicius Carvalho Porto
- d Department of Prosthodontics and Periodontics, Bauru School of Dentistry , University of São Paulo , Bauru , Brazil
| | - Anne Lígia Dokkedal
- c Department of Biological Sciences, Faculty of Sciences , São Paulo State University (UNESP) , Bauru , Brazil
| | - Vanessa Soares Lara
- a Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry , University of São Paulo , Bauru , Brazil
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Giles C, Lamont-Friedrich SJ, Michl TD, Griesser HJ, Coad BR. The importance of fungal pathogens and antifungal coatings in medical device infections. Biotechnol Adv 2017; 36:264-280. [PMID: 29199134 DOI: 10.1016/j.biotechadv.2017.11.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 11/15/2017] [Accepted: 11/28/2017] [Indexed: 12/23/2022]
Abstract
In recent years, increasing evidence has been collated on the contributions of fungal species, particularly Candida, to medical device infections. Fungal species can form biofilms by themselves or by participating in polymicrobial biofilms with bacteria. Thus, there is a clear need for effective preventative measures, such as thin coatings that can be applied onto medical devices to stop the attachment, proliferation, and formation of device-associated biofilms. However, fungi being eukaryotes, the challenge is greater than for bacterial infections because antifungal agents are often toxic towards eukaryotic host cells. Whilst there is extensive literature on antibacterial coatings, a far lesser body of literature exists on surfaces or coatings that prevent attachment and biofilm formation on medical devices by fungal pathogens. Here we review strategies for the design and fabrication of medical devices with antifungal surfaces. We also survey the microbiology literature on fundamental mechanisms by which fungi attach and spread on natural and synthetic surfaces. Research in this field requires close collaboration between biomaterials scientists, microbiologists and clinicians; we consider progress in the molecular understanding of fungal recognition of, and attachment to, suitable surfaces, and of ensuing metabolic changes, to be essential for designing rational approaches towards effective antifungal coatings, rather than empirical trial of coatings.
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Affiliation(s)
- Carla Giles
- Future Industries Institute, University of South Australia, Mawson Lakes Blvd, Mawson Lakes, Adelaide, SA 5000, Australia
| | - Stephanie J Lamont-Friedrich
- Future Industries Institute, University of South Australia, Mawson Lakes Blvd, Mawson Lakes, Adelaide, SA 5000, Australia
| | - Thomas D Michl
- Future Industries Institute, University of South Australia, Mawson Lakes Blvd, Mawson Lakes, Adelaide, SA 5000, Australia
| | - Hans J Griesser
- Future Industries Institute, University of South Australia, Mawson Lakes Blvd, Mawson Lakes, Adelaide, SA 5000, Australia
| | - Bryan R Coad
- Future Industries Institute, University of South Australia, Mawson Lakes Blvd, Mawson Lakes, Adelaide, SA 5000, Australia; School of Agriculture Food & Wine, The University of Adelaide, Waite Campus, Adelaide, SA 5000, Australia.
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Wiebusch L, de Almeida-Apolonio AA, Rodrigues LMC, de Paula Bicudo B, dos Santos Silva DB, Lonchiati DF, de Araujo RP, Grisolia AB, de Oliveira KMP. Candida albicans isolated from urine: Phenotypic and molecular identification, virulence factors and antifungal susceptibility. Asian Pac J Trop Biomed 2017. [DOI: 10.1016/j.apjtb.2017.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Assessment and Optimizations of Candida albicans In Vitro Biofilm Assays. Antimicrob Agents Chemother 2017; 61:AAC.02749-16. [PMID: 28289028 DOI: 10.1128/aac.02749-16] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 03/03/2017] [Indexed: 01/07/2023] Open
Abstract
Candida albicans biofilms have a significant medical impact due to their rapid growth on implanted medical devices, their resistance to antifungal drugs, and their ability to seed disseminated infections. Biofilm assays performed in vitro allow for rapid, high-throughput screening of gene deletion libraries or antifungal compounds and typically serve as precursors to in vivo studies. Here, we compile and discuss the protocols for several recently published C. albicansin vitro biofilm assays. We also describe improved versions of these protocols as well as novel in vitro assays. Finally, we consider some of the advantages and disadvantages of these different types of assays.
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Núñez-Beltrán A, López-Romero E, Cuéllar-Cruz M. Identification of proteins involved in the adhesionof Candida species to different medical devices. Microb Pathog 2017; 107:293-303. [PMID: 28396240 DOI: 10.1016/j.micpath.2017.04.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 03/04/2017] [Accepted: 04/06/2017] [Indexed: 01/09/2023]
Abstract
Adhesion is the first step for Candida species to form biofilms on medical devices implanted in the human host. Both the physicochemical nature of the biomaterial and cell wall proteins (CWP) of the pathogen play a determinant role in the process. While it is true that some CWP have been identified in vitro, little is known about the CWP of pathogenic species of Candida involved in adhesion. On this background, we considered it important to investigate the potential role of CWP of C. albicans, C. glabrata, C. krusei and C. parapsilosis in adhesion to different medical devices. Our results indicate that the four species strongly adher to polyvinyl chloride (PVC) devices, followed by polyurethane and finally by silicone. It was interesting to identify fructose-bisphosphate aldolase (Fba1) and enolase 1 (Eno1) as the CWP involved in adhesion of C. albicans, C. glabrata and C. krusei to PVC devices whereas phosphoglycerate kinase (Pgk) and Eno1 allow C. parapsilosis to adher to silicone-made implants. Results presented here suggest that these CWP participate in the initial event of adhesion and are probably followed by other proteins that covalently bind to the biomaterial thus providing conditions for biofilm formation and eventually the onset of infection.
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Affiliation(s)
- Arianna Núñez-Beltrán
- Departamento de Biología, División de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, Guanajuato, Mexico
| | - Everardo López-Romero
- Departamento de Biología, División de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, Guanajuato, Mexico
| | - Mayra Cuéllar-Cruz
- Departamento de Biología, División de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, Guanajuato, Mexico.
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Sweileh WM, Sawalha AF, Al-Jabi S, Zyoud SH. Bibliometric analysis of literature on antifungal triazole resistance: 1980 - 2015. Germs 2017; 7:19-27. [PMID: 28331838 PMCID: PMC5348213 DOI: 10.18683/germs.2017.1104] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 02/04/2017] [Accepted: 02/06/2016] [Indexed: 02/05/2023]
Abstract
BACKGROUND Triazole antifungal agents play an important role in the treatment of a wide range of fungal infections. Little is known about antifungal triazole drug resistance when compared to antibiotic resistance. Therefore, this study was carried out to give a bibliometric overview of literature on triazole antifungal drug resistance. METHODS Keywords related to triazole drug class and resistance were used in a search query in the Scopus search engine. The time span was set from 1980 to 2015. Data pertaining to growth of publications, the most active countries and institutions, the most cited articles, and mapping of molecular mechanisms of resistance were analyzed. RESULTS A total of 1648 journal articles were retrieved with an average of 20.46 citations per article. Annual growth of triazole resistance showed an increasing pattern during the study period. The United States of America (n=446; 27.06%) ranked first in productivity followed by the United Kingdom (UK) (n=176; 10.68%), and China (n=133; 8.07%). Radboud University Nijmegen Medical Centre (n=69, 4.19%) in the Netherlands ranked first in productivity, while the journal Antimicrobial Agents and Chemotherapy ranked first (n=255; 15.47%) in publishing articles on triazole resistance. Mapping mechanisms of resistance showed that efflux pump and mutations in target enzyme are major mechanisms described in resistance to triazoles. CONCLUSION There was a growth of publications on triazole resistance in the past two decades with the bulk of publications on triazole resistance in Candida species. The data presented here will serve as baseline information for future comparative purposes.
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Affiliation(s)
- Waleed M. Sweileh
- PhD, Professor, Department of Physiology, Pharmacology and Toxicology, College of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine
| | - Ansam F. Sawalha
- PhD, Professor, Department of Physiology, Pharmacology and Toxicology, College of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine
- Corresponding Author: Ansam F. Sawalha, PhD, Professor, Department of Physiology, Pharmacology and Toxicology, College of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine.
| | - Samah Al-Jabi
- PhD, Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine
| | - Sa’ed H. Zyoud
- PhD, Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine
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Tomičić R, Tomičić Z, Raspor P. Adhesion of Candida spp. and Pichia spp. to Wooden Surfaces. Food Technol Biotechnol 2017; 55:138-142. [PMID: 28559743 PMCID: PMC5434367 DOI: 10.17113/ftb.55.01.17.4514] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 11/23/2016] [Indexed: 11/12/2022] Open
Abstract
Yeast adhesion to and biofilm formation on surfaces is present in many different environments. In food industry, biofilms may be a source of contaminations, causing food spoilage and reducing quality of products. Candida and Pichia are two common yeast genera involved in the spoilage of some food products. The aim of this study is to assess the potential of Candida and Pichia species to adhere to two types of wooden surfaces (smooth and rough), one of the materials typical for the food processing industry, and investigate the influence of surface roughness of wood on the degree of yeast adhesion. The adhesion of the cells to the wooden surfaces was determined by rinsing them from the surface, followed by methylene blue staining, and quantification after imaging under microscope by automatic counting of viable cells. The results showed that all Candida and Pichia strains were able to adhere to the wooden surfaces in a species- and strain-dependent manner. On the other hand, our data indicated that adhesion by these yeasts was not significantly affected by the roughness of the wood surfaces.
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Affiliation(s)
- Ružica Tomičić
- Faculty of Technology, University of Novi Sad, Bulevar cara Lazara 1, RS-21000 Novi Sad, Serbia
| | - Zorica Tomičić
- Institute of Food Technology, University of Novi Sad, Bulevar cara Lazara 1, RS-21000 Novi Sad, Serbia
| | - Peter Raspor
- Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, SI-1000 Ljubljana, Slovenia
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Tomičić R, Raspor P. Influence of growth conditions on adhesion of yeast Candida spp. and Pichia spp. to stainless steel surfaces. Food Microbiol 2017; 65:179-184. [PMID: 28400000 DOI: 10.1016/j.fm.2017.02.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 02/23/2017] [Accepted: 02/24/2017] [Indexed: 11/27/2022]
Abstract
An understanding of adhesion behavior of Candida and Pichia yeast under different environmental conditions is key to the development of effective preventive measures against biofilm-associated infection. Hence in this study we investigated the impact of growth medium and temperature on Candida and Pichia adherence using stainless steel (AISI 304) discs with different degrees of surface roughness (Ra = 25.20-961.9 nm), material typical for the food processing industry as well as medical devices. The adhesion of the yeast strains to stainless steel surfaces grown in Malt Extract broth (MEB) or YPD broth at three temperatures (7 °C, 37 °C, 43 °C for Candida strains and 7 °C, 27 °C, 32 °C for Pichia strains) was assessed by crystal violet staining. The results showed that the nutrient content of medium significantly influenced the quantity of adhered cells by the tested yeasts. Adhesion of C. albicans and C. glabrata on stainless steel surfaces were significantly higher in MEB, whereas for C. parapsilosis and C. krusei it was YPD broth. In the case with P. pijperi and P. membranifaciens, YPD broth was more effective in promoting adhesion than MEB. On the other hand, our data indicated that temperature is a very important factor which considerably affects the adhesion of these yeast. There was also significant difference in cell adhesion on all types of stainless steel surfaces for all tested yeast.
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Affiliation(s)
- Ružica Tomičić
- Faculty of Technology, University of Novi Sad, Bulevar cara Lazara 1, 21000, Novi Sad, Serbia.
| | - Peter Raspor
- Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, 1000, Ljubljana, Slovenia.
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Retrospective study of Candida sp. contaminations of endoscopes at the University Hospital of Tlemcen (Algeria). J Mycol Med 2017; 27:127-132. [PMID: 28214143 DOI: 10.1016/j.mycmed.2017.01.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 01/10/2017] [Accepted: 01/11/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND Improper cleaning and disinfection of endoscopes has been responsible for multiple nosocomial outbreaks and sometimes serious life-threatening infections. OBJECTIVE The aim of our study is, at first, to identify Candida species responsible for the contamination of endoscopes, and to determine the minimal inhibitory concentrations of planktonic (MIC) and sessile cells (SMIC) of amphotericin B (AmB) against our isolated strains. MATERIALS AND METHODS The present study was performed on four endoscopes in the department of gastroenterology at the University Hospital of Tlemcen (Algeria). A total of 300 samples from endoscopes were examined over a period of 3years. RESULTS Thirty-four strains of Candida sp. were isolated, representing 11.33% of the considered samples. The number of isolated strains dropped significantly in the second and the third year compared to the first year of our study. After testing the antifungal property of amphotericin B, we showed clearly that the sessile cells of Candida sp. were much more resistant than their planktonic counterparts (suspended cells). CONCLUSION The methods of sterilization of the endoscopes are very important; drying by compressed air is a critical step that reduces significantly the number of yeasts contamination.
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The Correlation Between Biofilm Production and Catheter-Related Bloodstream Infections Sustained by Candida. A Case Control Study. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 973:89-98. [PMID: 28213809 DOI: 10.1007/5584_2016_196] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Biofilm forming capacity of yeasts colonizing the intravenous devices is considered a key factor involved in the pathogenesis of Candida catheter-related bloodstream infections (CCRBSI). The biofilm production of strains of Candida spp. isolated both from the CVC and from the blood of patients with CCRBSI was compared to that of strains isolated from patients not having CCRBSI. Results, expressed in terms of Biofilm Index (BI), revealed that biofilm-producing strains were isolated in the CCRBSI group with a frequency significantly higher than in the non-CCRBSI group (χ2 = 4.25, p = 0.03). The species more frequently cultured was C. parapsilosis complex (including C. parapsilosis sensu stricto, C. orthopsilosis and C. metapsilosis). When this species was isolated from the CVC tip cultures of the CCRBSI group it showed BIs significantly (p = 0.05) higher than those found in the non-CCRBSI group. All the strains of C. tropicalis isolated from the CCRBSI group produced biofilm. Instead most of the isolates of C. glabrata were non-producers. The cumulative BI of non-albicans Candida strains isolated from CCRBSI patients was significantly higher than that of non-albicans strains cultured from patients non-CCRBSI (χ2 = 6.91; p = 0.008). C. albicans was a biofilm producer both in the CCRBSI and in the non-CCRBSI group. When isolated from the blood it showed enhanced biofilm production in the CCRBSI group only, while when colonizing the CVC it displayed high BIs both in the CCRBSI group and in non-CCRBSI group. Our data seem to indicate that the biofilm production capacity should be considered in the clinical management of CCRBSI.
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Ramasamy M, Lee J. Recent Nanotechnology Approaches for Prevention and Treatment of Biofilm-Associated Infections on Medical Devices. BIOMED RESEARCH INTERNATIONAL 2016; 2016:1851242. [PMID: 27872845 PMCID: PMC5107826 DOI: 10.1155/2016/1851242] [Citation(s) in RCA: 118] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 10/13/2016] [Indexed: 11/23/2022]
Abstract
Bacterial colonization in the form of biofilms on surfaces causes persistent infections and is an issue of considerable concern to healthcare providers. There is an urgent need for novel antimicrobial or antibiofilm surfaces and biomedical devices that provide protection against biofilm formation and planktonic pathogens, including antibiotic resistant strains. In this context, recent developments in the material science and engineering fields and steady progress in the nanotechnology field have created opportunities to design new biomaterials and surfaces with anti-infective, antifouling, bactericidal, and antibiofilm properties. Here we review a number of the recently developed nanotechnology-based biomaterials and explain underlying strategies used to make antibiofilm surfaces.
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Affiliation(s)
| | - Jintae Lee
- School of Chemical Engineering, Yeungnam University, Gyeongsan 38541, Republic of Korea
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Jabeur I, Tobaldini F, Martins N, Barros L, Martins I, Calhelha RC, Henriques M, Silva S, Achour L, Santos-Buelga C, Ferreira ICFR. Bioactive properties and functional constituents of Hypericum androsaemum L.: A focus on the phenolic profile. Food Res Int 2016; 89:422-431. [PMID: 28460934 DOI: 10.1016/j.foodres.2016.08.040] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 08/18/2016] [Accepted: 08/26/2016] [Indexed: 11/26/2022]
Abstract
Hypericum androsaemum L. ethanol:water extract acted as a lipid peroxidation inhibitor and free radical scavenger. A marked inhibition of the growth of breast, lung, cervical and hepatocellular human carcinoma cell lines was also observed, whereas no toxicity was shown against non-tumor porcine liver cells (>400μg/mL). The extract was also effective in inhibiting nitric oxide production, as an indicator of the anti-inflammatory potential. The anti-Candida effects varied among different strains of the same species, C. glabrata and C. tropicalis being the most sensible species with an effect directly related with the extract concentrations tested. A significant anti-biofilm formation potential was also observed, namely for C. glabrata and C. tropicalis (biofilm reduction >90%). 5-O-Caffeoylquinic and 3-O-caffeoylquinic acids were the most abundant phenolic compounds identified in the extract, and might be related with the observed bioactive effects. Nevertheless, future studies should be carried out to obtain dose-response curves of the isolated active compounds, in order to perform further pre-clinically testing to quantify the presence of the most active compounds in the extract.
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Affiliation(s)
- Inés Jabeur
- Mountain Research Centre (CIMO), ESA, Polytechnic Institute of Bragança, Campus de Santa Apolónia, 1172, 5300-253 Bragança, Portugal; Laboratoire de Recherche "Bioressources: Biologie Intégrative & Valorisation", Institut Supérieur de Biotechnologie de Monastir, Avenue Tahar Hadded, BP 74, Université de Monastir, 5000 Monastir, Tunisia
| | - Flávia Tobaldini
- CEB - Centre of Biological Engineering, LIBRO-Laboratório de Investigação em Biofilmes Rosário Oliveira, University of Minho, 4710-057 Braga, Portugal; Laboratory of Medical Mycology, Department of Clinical Analysis and Biomedicine, Universidade Estadual de Maringá, Maringá, PR, Brazil
| | - Natália Martins
- Mountain Research Centre (CIMO), ESA, Polytechnic Institute of Bragança, Campus de Santa Apolónia, 1172, 5300-253 Bragança, Portugal; CEB - Centre of Biological Engineering, LIBRO-Laboratório de Investigação em Biofilmes Rosário Oliveira, University of Minho, 4710-057 Braga, Portugal
| | - Lillian Barros
- Mountain Research Centre (CIMO), ESA, Polytechnic Institute of Bragança, Campus de Santa Apolónia, 1172, 5300-253 Bragança, Portugal; Laboratory of Separation and Reaction Engineering - Laboratory of Catalysis and Materials (LSRE-LCM), Polytechnic Institute of Bragança, Campus de Santa Apolónia, 1134, 5301-857 Bragança, Portugal
| | - Ivone Martins
- CEB - Centre of Biological Engineering, LIBRO-Laboratório de Investigação em Biofilmes Rosário Oliveira, University of Minho, 4710-057 Braga, Portugal
| | - Ricardo C Calhelha
- Mountain Research Centre (CIMO), ESA, Polytechnic Institute of Bragança, Campus de Santa Apolónia, 1172, 5300-253 Bragança, Portugal
| | - Mariana Henriques
- CEB - Centre of Biological Engineering, LIBRO-Laboratório de Investigação em Biofilmes Rosário Oliveira, University of Minho, 4710-057 Braga, Portugal
| | - Sónia Silva
- Laboratoire de Recherche "Bioressources: Biologie Intégrative & Valorisation", Institut Supérieur de Biotechnologie de Monastir, Avenue Tahar Hadded, BP 74, Université de Monastir, 5000 Monastir, Tunisia.
| | - Lotfi Achour
- Laboratoire de Recherche "Bioressources: Biologie Intégrative & Valorisation", Institut Supérieur de Biotechnologie de Monastir, Avenue Tahar Hadded, BP 74, Université de Monastir, 5000 Monastir, Tunisia
| | - Celestino Santos-Buelga
- Grupo de Investigación en Polifenoles (GIP-USAL), Faculty of Pharmacy, University of Salamanca, Campus Miguel de Unamuno, 37007 Salamanca, Spain
| | - Isabel C F R Ferreira
- Mountain Research Centre (CIMO), ESA, Polytechnic Institute of Bragança, Campus de Santa Apolónia, 1172, 5300-253 Bragança, Portugal.
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Brilhante RSN, Oliveira JSD, Evangelista AJDJ, Serpa R, Silva ALD, Aguiar FRMD, Pereira VS, Castelo-Branco DDSCM, Pereira-Neto WA, Cordeiro RDA, Sidrim JJC, Rocha MFG. Candida tropicalis from veterinary and human sources shows similar in vitro hemolytic activity, antifungal biofilm susceptibility and pathogenesis against Caenorhabditis elegans. Vet Microbiol 2016; 192:213-219. [PMID: 27527785 DOI: 10.1016/j.vetmic.2016.07.022] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 07/26/2016] [Accepted: 07/27/2016] [Indexed: 10/21/2022]
Abstract
The aim of this study was to evaluate the in vitro hemolytic activity and biofilm antifungal susceptibility of veterinary and human Candida tropicalis strains, as well as their pathogenesis against Caenorhabditis elegans. Twenty veterinary isolates and 20 human clinical isolates of C. tropicalis were used. The strains were evaluated for their hemolytic activity and biofilm production. Biofilm susceptibility to itraconazole, fluconazole, voriconazole, amphotericin B and caspofungin was assessed using broth microdilution assay. The in vivo evaluation of strain pathogenicity was investigated using the nematode C. elegans. Hemolytic factor was observed in 95% of the strains and 97.5% of the isolates showed ability to form biofilm. Caspofungin and amphotericin B showed better results than azole antifungals against mature biofilms. Paradoxical effect on mature biofilm metabolic activity was observed at elevated concentrations of caspofungin (8-64μg/mL). Azole antifungals were not able to inhibit mature C. tropicalis biofilms, even at the higher tested concentrations. High mortality rates of C. elegans were observed when the worms were exposed to with C. tropicalis strains, reaching up to 96%, 96h after exposure of the worms to C. tropicalis strains. These results reinforce the high pathogenicity of C. tropicalis from veterinary and human sources and show the effectiveness of caspofungin and amphotericin B against mature biofilms of this species.
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Affiliation(s)
- Raimunda Sâmia Nogueira Brilhante
- Department of Pathology and Legal Medicine, School of Medicine, Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, CE, Brazil; Postgraduate Program in Medical Sciences, Federal University of Ceará, Fortaleza, CE, Brazil.
| | - Jonathas Sales de Oliveira
- Department of Pathology and Legal Medicine, School of Medicine, Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, CE, Brazil
| | | | - Rosana Serpa
- Department of Pathology and Legal Medicine, School of Medicine, Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Aline Lobão da Silva
- School of Veterinary, Postgraduate Program in Veterinary Sciences, State University of Ceará, Fortaleza, CE, Brazil
| | - Felipe Rodrigues Magalhães de Aguiar
- Department of Pathology and Legal Medicine, School of Medicine, Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Vandbergue Santos Pereira
- Department of Pathology and Legal Medicine, School of Medicine, Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Débora de Souza Collares Maia Castelo-Branco
- Department of Pathology and Legal Medicine, School of Medicine, Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Waldemiro Aquino Pereira-Neto
- Department of Pathology and Legal Medicine, School of Medicine, Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Rossana de Aguiar Cordeiro
- Department of Pathology and Legal Medicine, School of Medicine, Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, CE, Brazil; Postgraduate Program in Medical Sciences, Federal University of Ceará, Fortaleza, CE, Brazil
| | - José Júlio Costa Sidrim
- Department of Pathology and Legal Medicine, School of Medicine, Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Marcos Fábio Gadelha Rocha
- Department of Pathology and Legal Medicine, School of Medicine, Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, CE, Brazil; School of Veterinary, Postgraduate Program in Veterinary Sciences, State University of Ceará, Fortaleza, CE, Brazil
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Pongrácz J, Benedek K, Juhász E, Iván M, Kristóf K. In vitro biofilm production of Candida bloodstream isolates: any association with clinical characteristics? J Med Microbiol 2016; 65:272-277. [DOI: 10.1099/jmm.0.000207] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Júlia Pongrácz
- Clinical Microbiology Laboratory, Institute of Laboratory Medicine, Semmelweis University, Budapest, Hungary
| | - Kálmán Benedek
- Nanomedicine Research and Education Center, Semmelweis University, Budapest, Hungary
| | - Emese Juhász
- Clinical Microbiology Laboratory, Institute of Laboratory Medicine, Semmelweis University, Budapest, Hungary
| | - Miklós Iván
- Clinical Microbiology Laboratory, Institute of Laboratory Medicine, Semmelweis University, Budapest, Hungary
| | - Katalin Kristóf
- Clinical Microbiology Laboratory, Institute of Laboratory Medicine, Semmelweis University, Budapest, Hungary
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Savastano C, de Oliveira Silva E, Gonçalves LL, Nery JM, Silva NC, Dias ALT. Candida glabrata among Candida spp. from environmental health practitioners of a Brazilian Hospital. Braz J Microbiol 2016; 47:367-72. [PMID: 26991302 PMCID: PMC4874588 DOI: 10.1016/j.bjm.2015.05.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Accepted: 05/29/2015] [Indexed: 11/30/2022] Open
Abstract
The incidence of the species Candida albicans and non-albicans Candida was evaluated in a Brazilian Tertiary Hospital from the environment and health practitioners. In a 12-month period we had a total positivity of 19.65% of Candida spp. The most recurring non-albicans Candida species was C. glabrata (37.62%), generally considered a species of low virulence, but with a higher mortality rate than C. albicans. Subsequently, C. parapsilosis (25.74%) and C. tropicalis (16.86%) were the second and third most commonly isolated species. Considering the total samples collected from the emergency room and from the inpatient and the pediatric sector, 19.10% were positive for Candida spp., with the predominance of non-albicans Candida species (89.42%). The high percentage of positivity occurred in the hands (24.32%) and the lab coats (21.88%) of the health care assistants. No sample of C. albicans presented a profile of resistance to the drugs. All the non-albicans Candida species presented a decreased susceptibility to miconazole and itraconazole, but they were susceptible to nystatin. Most of the isolates were susceptible to fluconazole and amphotericin B. As expected, a high resistance rate was observed in C. glabrata and C. krusei, which are intrinsically less susceptible to this antifungal agent. The contamination of environmental surfaces by Candida spp. through hand touching may facilitate the occurrence of Candida infections predominantly in immunocompromised patients. In addition to that, the antifungal agents used should be carefully evaluated considering local epidemiologic trends in Candida spp. infections, so that therapeutic choices may be better guided.
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Affiliation(s)
- Catarina Savastano
- Microbiology and Immunology Department, Federal University of Alfenas (UNIFAL-MG), Alfenas, Minas Gerais, Brazil
| | - Elisa de Oliveira Silva
- Microbiology and Immunology Department, Federal University of Alfenas (UNIFAL-MG), Alfenas, Minas Gerais, Brazil
| | - Lindyanne Lemos Gonçalves
- Microbiology and Immunology Department, Federal University of Alfenas (UNIFAL-MG), Alfenas, Minas Gerais, Brazil
| | - Jéssica Maria Nery
- Microbiology and Immunology Department, Federal University of Alfenas (UNIFAL-MG), Alfenas, Minas Gerais, Brazil
| | - Naiara Chaves Silva
- Microbiology and Immunology Department, Federal University of Alfenas (UNIFAL-MG), Alfenas, Minas Gerais, Brazil
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Silva MJ, de Oliveira DG, Marcillo OO, Neppelenbroek KH, Lara VS, Porto VC. Effect of denture-coating composite on Candida albicans biofilm and surface degradation after disinfection protocol. Int Dent J 2016; 66:86-92. [PMID: 26748533 DOI: 10.1111/idj.12212] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Denture stomatitis is the most common pathology affecting denture wearers and its main cause is colonisation of dentures with Candida albicans. OBJECTIVE This study investigated the effectiveness of two commercial composite surface sealants (Biscover(®) LV and Surface Coat(®)) to reduce C. albicans biofilm colonisation on denture resin, as well as their surface integrity after disinfection cycles with 1% sodium hypochlorite solution. METHODS Heat-cured acrylic resin specimens were manufactured (10 mm × 10 mm × 1 mm). The specimen surfaces were mechanically polished to simulate rough or smooth denture surfaces. Four surface-treatment groups were tested: smooth surfaces [0.3 μm of mean roughness (Ra)]; rough surfaces (3 μm of Ra); rough surfaces treated with Biscover(®) LV; and rough surfaces treated with Surface Coat(®). Specimens of each group were randomly divided to undergo immersion in distilled water or 1% sodium hypochlorite for 30 or 90 cycles each. Specimens of all groups in each immersion solution were tested using a crystal violet (CV) staining assay for biofilm quantification and by scanning electron microscopy for visual analyses of surface integrity and biofilm structure. CV assay data were analysed using one-way analysis of variance (ANOVA) followed by Tukey's multiple comparison test (P < 0.05). RESULTS The effectiveness and surface integrity of Biscover(®) LV-treated surfaces were similar to those of smooth surfaces, whereas Surface Coat(®) -treated surfaces presented a similar performance to rough surfaces in all solutions and cycles. CONCLUSION These results suggest the possibility of clinical use of Biscover(®) LV for denture coating on surfaces in which mechanical polish is not indicated, such as the fitting surface.
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Affiliation(s)
- Matheus Jacobina Silva
- Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Denise G de Oliveira
- Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Oscar O Marcillo
- Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Karin H Neppelenbroek
- Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Vanessa S Lara
- Department of Stomatology, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil
| | - Vinícius C Porto
- Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
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Evaluation of baicalein, chitosan and usnic acid effect on Candida parapsilosis and Candida krusei biofilm using a Cellavista device. J Microbiol Methods 2015; 118:106-12. [DOI: 10.1016/j.mimet.2015.09.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 09/04/2015] [Accepted: 09/05/2015] [Indexed: 11/21/2022]
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Chandra J, Mukherjee PK. Candida Biofilms: Development, Architecture, and Resistance. Microbiol Spectr 2015; 3:10.1128/microbiolspec.MB-0020-2015. [PMID: 26350306 PMCID: PMC4566167 DOI: 10.1128/microbiolspec.mb-0020-2015] [Citation(s) in RCA: 96] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Indexed: 12/17/2022] Open
Abstract
Intravascular device-related infections are often associated with biofilms (microbial communities encased within a polysaccharide-rich extracellular matrix) formed by pathogens on the surfaces of these devices. Candida species are the most common fungi isolated from catheter-, denture-, and voice prosthesis-associated infections and also are commonly isolated from contact lens-related infections (e.g., fungal keratitis). These biofilms exhibit decreased susceptibility to most antimicrobial agents, which contributes to the persistence of infection. Recent technological advances have facilitated the development of novel approaches to investigate the formation of biofilms and identify specific markers for biofilms. These studies have provided extensive knowledge of the effect of different variables, including growth time, nutrients, and physiological conditions, on biofilm formation, morphology, and architecture. In this article, we will focus on fungal biofilms (mainly Candida biofilms) and provide an update on the development, architecture, and resistance mechanisms of biofilms.
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Affiliation(s)
- Jyotsna Chandra
- Center for Medical Mycology and Mycology Reference Laboratory, Department of Dermatology, University Hospitals of Cleveland and Case Western Reserve University, Cleveland, OH 44106
| | - Pranab K Mukherjee
- Center for Medical Mycology and Mycology Reference Laboratory, Department of Dermatology, University Hospitals of Cleveland and Case Western Reserve University, Cleveland, OH 44106
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Silva-Dias A, Miranda IM, Branco J, Monteiro-Soares M, Pina-Vaz C, Rodrigues AG. Adhesion, biofilm formation, cell surface hydrophobicity, and antifungal planktonic susceptibility: relationship among Candida spp. Front Microbiol 2015; 6:205. [PMID: 25814989 PMCID: PMC4357307 DOI: 10.3389/fmicb.2015.00205] [Citation(s) in RCA: 120] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 02/26/2015] [Indexed: 11/13/2022] Open
Abstract
We have performed the characterization of the adhesion profile, biofilm formation, cell surface hydrophobicity (CSH) and antifungal susceptibility of 184 Candida clinical isolates obtained from different human reservoirs. Adhesion was quantified using a flow cytometric assay and biofilm formation was evaluated using two methodologies: XTT and crystal violet assay. CSH was quantified with the microbial adhesion to hydrocarbons test while planktonic susceptibility was assessed accordingly the CLSI protocol for yeast M27-A3 S4. Yeast cells of non-albicans species exhibit increased ability to adhere and form biofilm. However, the correlation between adhesion and biofilm formation varied according to species and also with the methodology used for biofilm assessment. No association was found between strain's site of isolation or planktonic antifungal susceptibility and adhesion or biofilm formation. Finally CSH seemed to be a good predictor for biofilm formation but not for adhesion. Despite the marked variability registered intra and inter species, C. tropicalis and C. parapsilosis were the species exhibiting high adhesion profile. C. tropicalis, C. guilliermondii, and C. krusei revealed higher biofilm formation values in terms of biomass. C. parapsilosis was the species with lower biofilm metabolic activity.
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Affiliation(s)
- Ana Silva-Dias
- Department of Microbiology, Faculty of Medicine, University of Porto Porto, Portugal ; Cardiovascular Research and Development Unit, Faculty of Medicine, University of Porto Porto, Portugal ; CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, University of Porto Porto, Portugal
| | - Isabel M Miranda
- Department of Microbiology, Faculty of Medicine, University of Porto Porto, Portugal ; Cardiovascular Research and Development Unit, Faculty of Medicine, University of Porto Porto, Portugal ; CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, University of Porto Porto, Portugal
| | - Joana Branco
- Department of Microbiology, Faculty of Medicine, University of Porto Porto, Portugal
| | - Matilde Monteiro-Soares
- CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, University of Porto Porto, Portugal ; CIDES, Department of Information and Decision Sciences in Health, Faculty of Medicine, University of Porto Porto, Portugal
| | - Cidália Pina-Vaz
- Department of Microbiology, Faculty of Medicine, University of Porto Porto, Portugal ; CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, University of Porto Porto, Portugal ; Department of Microbiology, Centro Hospitalar S. João Porto, Portugal
| | - Acácio G Rodrigues
- Department of Microbiology, Faculty of Medicine, University of Porto Porto, Portugal ; CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, University of Porto Porto, Portugal ; Burn Unit and Department of Plastic and Reconstructive Surgery, Centro Hospitalar S. João Porto, Portugal
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Cordeiro RDA, Oliveira JSD, Castelo-Branco DDSCM, Teixeira CEC, Marques FJDF, Bittencourt PV, Carvalho VL, Bandeira TDJPG, Brilhante RSN, Moreira JLB, Pereira-Neto WDA, Sidrim JJC, Rocha MFG. Candida tropicalis isolates obtained from veterinary sources show resistance to azoles and produce virulence factors. Med Mycol 2014; 53:145-52. [DOI: 10.1093/mmy/myu081] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Girardot M, Guerineau A, Boudesocque L, Costa D, Bazinet L, Enguehard-Gueiffier C, Imbert C. Promising results of cranberry in the prevention of oral Candida biofilms. Pathog Dis 2014; 70:432-9. [PMID: 24623607 DOI: 10.1111/2049-632x.12168] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Revised: 02/05/2014] [Accepted: 03/06/2014] [Indexed: 11/27/2022] Open
Abstract
In the context of dental caries prevention by natural foodstuff sources, antifungal and antibiofilm activities of dry commercial extracts of cranberry fruit (Vaccinium macrocarpon Aiton) and two other red fruits (Vaccinium myrtillus L. and Malpighia punicifolia L.) were assessed on Candida albicans and Candida glabrata yeasts. When added to the culture medium, the cranberry extract displayed a significant anti-adhesion activity against Candida spp. when used at low concentrations. In addition, the pretreatment of surfaces with this extract induced an anti-adhesion activity mainly against C. glabrata yeasts and an antibiofilm activity against C. albicans. This activity was dependent on concentration, species, and strain. A phytochemical investigation bioguided by anti-adhesion tests against the two Candida species was carried out on crude cranberry juice to determine the active fractions. Three subfractions enriched in proanthocyanidins showed an anti-adhesion activity at low concentrations. This study investigated for the first time the interest of crude extracts of cranberry and cranberry juice fractions to prevent biofilms of C. glabrata. It highlighted the potency of consuming this fruit and using it as a source of anti-adhesion agents.
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Affiliation(s)
- Marion Girardot
- UMR CNRS 7267 Laboratory of Ecology and Biology of Interactions, Faculty of Medicine and Pharmacy, Poitiers, France
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Kucharíková S, Neirinck B, Sharma N, Vleugels J, Lagrou K, Van Dijck P. In vivo Candida glabrata biofilm development on foreign bodies in a rat subcutaneous model. J Antimicrob Chemother 2014; 70:846-56. [PMID: 25406296 DOI: 10.1093/jac/dku447] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES Biofilm studies have been mostly dedicated to the major human fungal pathogen Candida albicans, whereas much less is known about this virulence factor in Candida glabrata, certainly under in vivo conditions. This study provides a deeper understanding of the biofilm development of C. glabrata, its architecture and susceptibility profile to fluconazole and echinocandins. METHODS In vitro and in vivo C. glabrata biofilms were developed inside serum-coated triple-lumen catheters placed in 24-well polystyrene plates or implanted subcutaneously in the back of a rat, respectively. Scanning electron microscopy and confocal scanning laser microscopy were used to visualize the biofilm architecture. Quantitative real-time PCR was used to demonstrate the expression profile of EPA1, EPA3, EPA6 and AWP1-AWP7 during in vivo biofilm formation. RESULTS Mature biofilms were observed within the first 48 h and the amount of biofilm reached its maximum by 6 days. Architecturally, mature C. glabrata biofilms consisted of a thick network of yeast cells embedded in an extracellular matrix. Moreover, in vivo biofilms were susceptible to echinocandin drugs, whereas fluconazole remained ineffective. Gene expression profiling revealed that EPA3, EPA6, AWP2, AWP3 and AWP5 were up-regulated in in vivo biofilms compared with in vitro biofilms. CONCLUSIONS C. glabrata is a unique microorganism, which, despite the lack of transition to the hyphal form, formed thick biofilms inside foreign bodies in vivo. To our knowledge, this is the first study that has described in vivo C. glabrata biofilm development and its architectural changes in detail and provides an insight into the susceptibility profile, as well as the gene expression machinery, of biofilm-associated infections.
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Affiliation(s)
- Soňa Kucharíková
- Department of Molecular Microbiology, VIB, KU Leuven, Leuven, Belgium Laboratory of Molecular Cell Biology, Institute of Botany and Microbiology, KU Leuven, Kasteelpark Arenberg 31, B-3001 Heverlee-Leuven, Belgium
| | - Bram Neirinck
- Department of Materials Engineering, KU Leuven, Kasteelpark Arenberg 44, B-3001 Heverlee-Leuven, Belgium
| | - Nidhi Sharma
- Department of Molecular Microbiology, VIB, KU Leuven, Leuven, Belgium Laboratory of Molecular Cell Biology, Institute of Botany and Microbiology, KU Leuven, Kasteelpark Arenberg 31, B-3001 Heverlee-Leuven, Belgium
| | - Jef Vleugels
- Department of Materials Engineering, KU Leuven, Kasteelpark Arenberg 44, B-3001 Heverlee-Leuven, Belgium
| | - Katrien Lagrou
- Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - Patrick Van Dijck
- Department of Molecular Microbiology, VIB, KU Leuven, Leuven, Belgium Laboratory of Molecular Cell Biology, Institute of Botany and Microbiology, KU Leuven, Kasteelpark Arenberg 31, B-3001 Heverlee-Leuven, Belgium
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Micafungin at physiological serum concentrations shows antifungal activity against Candida albicans and Candida parapsilosis biofilms. Antimicrob Agents Chemother 2014; 58:5581-4. [PMID: 24957821 DOI: 10.1128/aac.02738-14] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We assessed the in vitro activity of micafungin against preformed Candida biofilms by measuring the concentration of drug causing the most fungal damage and inhibition of regrowth. We studied 37 biofilm-producing Candida spp. strains from blood cultures. We showed that micafungin was active against planktonic and sessile forms of Candida albicans strains and moderately active against Candida parapsilosis sessile cells. Concentrations of micafungin above 2 μg/ml were sufficiently high to inactivate regrowth of Candida sessile cells.
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