Clinical impact of Candida spp. biofilm production in a cohort of patients with candidemia

Persistent candidemia refers to the continued isolation of the same Candida species in the blood of a candidemic patient despite appropriate therapy. Despite the clinical importance of persistent candidemia, studies have superficially addressed the biological conditions behind this phenomenon. The a...

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Bibliographic Details
Published in:Medical mycology (Oxford) 2018-10, Vol.56 (7), p.803-808
Main Authors: Monfredini, Priscilla Morais, Souza, Ana Carolina Remondi, Cavalheiro, Renan Pelluzzi, Siqueira, Ricardo Andreotti, Colombo, Arnaldo Lopes
Format: Article
Language:English
Subjects:
Biofilms - growth & development
Candida - classification
Candida - genetics
Candida - growth & development
Candida - isolation & purification
Candidemia - microbiology
Candidemia - pathology
Cohort Studies
DNA, Fungal - chemistry
DNA, Fungal - genetics
DNA, Ribosomal Spacer - chemistry
DNA, Ribosomal Spacer - genetics
Gentian Violet - metabolism
Humans
Microbiological Techniques
Microscopy, Confocal
Sequence Analysis, DNA
Staining and Labeling
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Summary:Persistent candidemia refers to the continued isolation of the same Candida species in the blood of a candidemic patient despite appropriate therapy. Despite the clinical importance of persistent candidemia, studies have superficially addressed the biological conditions behind this phenomenon. The aim of this study was to evaluate the correlation between the biofilm-forming ability by Candida bloodstream isolates and the persistence of infection. A total of 55 isolates of Candida were tested and characterized in two groups: (i) group I, which included seven patients with persistent candidemia, and (ii) group II, which included 18 patients with nonpersistent candidemia. Microorganisms were identified at the species level by sequencing the internal transcribed spacer (ITS) region of ribosomal DNA (rDNA). Biofilm quantification was evaluated by the crystal violet staining method and confocal scanning laser microscopy (CSLM). Molecular tests confirmed the identification of Candida albicans (92% group I and 94% group II) and Candida dubliniensis isolates (8% group I and 6% group II). All 55 isolates were able to form biofilms, but a higher biofilm mass was produced by C. albicans/C. dubliniensis strains cultured from the persistent group (P < .05). Our data suggest that Candida sp. biofilm production should be considered a relevant biologic variable in explaining patients who fail to clear a bloodstream infection despite adequate antifungal treatment with triazoles.
ISSN:1369-3786
1460-2709
DOI:10.1093/mmy/myx133