Assessment of the types of catheter infectivity caused by Candida species and their biofilm formation. First study in an intensive care unit in Algeria

Abstract

Nosocomial candidiasis remains a potential risk in intensive care units (ICUs), wherein Candida albicans is most responsible for its occurrence. Equally, non-C. albicans species, especially C. glabrata, are also involved. These infections are frequently associated with biofilms that contaminate medical devices, such as catheters. These biofilms constitute a significant clinical problem, and cause therapeutic failures, because they can escape the immune response and considerably decrease sensitivity to antifungal therapy. The diagnosis of catheter-related candidiasis is difficult; however, the differentiation between an infection of the catheter (or other medical implant) and a simple contamination is essential to start an antifungal treatment. Among the methods used for this type of study is the Brun-Buisson method, but this method only examines the infectivity of catheters caused by bacteria. For this reason, we wanted to adapt this method to the yeast cells of Candida spp. To assess the various types of infectivity of catheters (contamination, colonization, or infection) and their corresponding rates, as well as the responsible yeast species, we conducted our study, between February 2011 and January 2012, in the ICU at the University Hospital Center of Sidi Bel Abbes, Algeria; during this study, we took photographic images of the tongue of one patient and of that patient’s implanted orobronchial catheter. In addition, catheters contaminated by C. albicans biofilms were observed by scanning electron microscopy.

Candida albicans Biofilms and Human Disease

“…Accounting for 15% of all hospital-acquired sepsis cases, species within the CTG clade (predominantly C. albicans , but including several closely related species as well) are the fourth most frequent cause of bloodstream infections in clinical settings and are the predominant fungal species isolated from medical device infections (43, 152, 202, 204). Urinary and central venous catheters, pacemakers, mechanical heart valves, joint prostheses, contact lenses, and dentures are all susceptible to C. albicans biofilms (22, 45, 90, 175). Once it forms on an implanted medical device, a Candida biofilm has the potential to seed disseminated bloodstream infections and to lead to invasive systemic infections of tissues and organs.…”

An expanded regulatory network temporally controls Candida albicans biofilm formation

“…As biofilms are highly adherent and drug resistant, these infections typically require costly device removal and replacement. In some cases, biofilm infections act as reservoirs for systemic infections with high morbidity and mortality rates (Kojic et al, 2004;Raad et al, 2007;Cauda, 2009;Seddiki et al, 2013).…”

Antibiofilm and Antihyphal Activities of Cedar Leaf Essential Oil, Camphor, and Fenchone Derivatives against Candida albicans

“…Biofilms attach to surfaces or interfaces, and are embedded in a matrix of extracellular polymeric substances, and cause various infections (Costerton et al, 1999 ). Biofilm formation on medical devices and biomaterials, such as catheters, and heart valves, and cause infections, which are often chronic, with high morbidity and mortality rates (Uppuluri et al, 2010 ; Seddiki et al, 2013 ). Furthermore, biofilms are inherently difficult to eradicate in cases of implant-associated infections, and thus, new antifungal agents are required to prevent biofilm formation.…”