Diagnostic of Fungal Infections Related to Biofilms

Abstract

Fungal biofilm-related infections, most notably those caused by the Candida and Aspergillus genera, need to be diagnosed accurately and rapidly to avoid often unfavorable outcomes. Despite diagnosis of these infections is still based on the traditional histopathology and culture, the use of newer, rapid methods has enormously enhanced the diagnostic capability of a modern clinical mycology laboratory. Thus, while accurate specieslevel identification of fungal isolates can be achieved with turnaround times considerably shortened, nucleic acid-based or antigen-based detection methods can be considered useful adjuncts for the diagnosis of invasive forms of candidiasis and aspergillosis. Furthermore, simple, reproducible, and fast methods have been developed to quantify biofilm production by fungal isolates in vitro. In this end, isolates can be categorized as low, moderate, or high biofilm-forming, and this categorization may reflect their differential response to the conventional antifungal therapy. By means of drug susceptibility testing performed on fungal biofilm-growing isolates, it is now possible to evaluate not only the activity of conventional antifungal agents, but also of novel anti-biofilm agents. Despite this, future diagnostic methods need to target specific biofilm components/molecules, in order to provide a direct proof of the presence of this growth phenotype on the site of infection. In the meantime, our knowledge of the processes underlying the adaptive drug resistance within the biofilm has put into evidence biofilm-specific molecules that could be potentially helpful as therapeutic targets. Surely, the successful management of clinically relevant fungal biofilms will rely upon the advancement and/or refinement of these approaches.

BIOF–HILO Assay: A New MALDI–TOF Mass Spectrometry Based Method for Discriminating Between High- and Low-Biofilm-Producing Candida parapsilosis Isolates

“…High (and/or moderate) biofilm formation levels were a significant risk factor for in-hospital mortality in C. parapsilosis candidemia (Soldini et al, 2018). Therefore, rapid information on high or low biofilm-forming C. parapsilosis isolates would aid to improve treatment outcomes in infected patients (Sanguinetti and Posteraro, 2016).…”

Preservation of cognition in hypertension-treated South Indian rural population

“…Hypertension is one the most prevalent (30-40%) and silent killer, non-communicable diseases which can occur at any age, more so in middle age 16,47 . More importantly, middle age hypertension shows very strong association with later age dementia 16,48 .…”

“…Hypertension is one the most prevalent (30-40%) and silent killer, non-communicable diseases which can occur at any age, more so in middle age 16,47 . More importantly, middle age hypertension shows very strong association with later age dementia 16,48 . Hence, hypertension alone and in combination with diabetes and dementia with huge morbidity and mortality rates, and the social, financial and economic burden on the world community, needs to be contained in all its totality.…”

“…Therefore diagnosis of hypertension and its treatment is essential. Drugs targeting different pathways 16 , namely, calcium channel blockade(nitrendipine) 16,17 , angiotensin-renin system's angiotensin converting enzyme inhibitors-enalapril, and or angiotensin receptor II (ARII) inhibition, with or without a diuretic (hydrazine/ hydrochlorothiazide), could control hypertension 15 . The longer the time on antihypertensive, lesser is the chance of dementia 18 .…”

“…The longer the time on antihypertensive, lesser is the chance of dementia 18 . Interestingly, various large cohort meta-analysis has revealed, that calcium channel blockers and ARII inhibitors may protect better against cognitive decline 16 . Another trial which included the biogenic amine downregulator, reserpine, was inconclusive due to several control group switching to treatment 16 .…”