Candida biofilms associated with CVC and medical devices

Abstract

Summary Intravascular device‐related infections are often associated with biofilms (microbial communities encased within polysaccharide‐rich extracellular matrix) formed by pathogens on 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. Drug resistance in fungal biofilms is multifactorial and phase‐dependent, e.g. efflux pumps mediate resistance in biofilms during early phase whereas altered membrane sterol composition contributes to resistance in mature phase. Both substrate type and surface coatings play an important role in the pathogenesis of device‐related fungal biofilms. Microarray and proteomic analyses have identified the differentially expressed genes and proteins in Candida biofilms, and recent studies demonstrate that microbial biofilms interact with host immune cells. In this review, we will summarise recent advances in research on fungal biofilms and their relevance to device‐associated infections.

Exploiting Interkingdom Interactions for Development of Small-Molecule Inhibitors of Candida albicans Biofilm Formation

“…Candida albicans causes a variety of complications ranging from mucosal disease to deep-seated mycoses, particularly in immunocompromised individuals (21,24). Along with other fungal and yeast pathogens, C. albicans is known to form structured communities called biofilms on medical devices either pre-or postimplantation, leading to recurring infections and in some cases death (25,26). Once established in the biofilm phase, C. albicans presents a significant clinical problem, with current treatment options severely limited by the intrinsic tolerance of fungal biofilms for antimycotics (20,27,28).…”

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“…The ability of Candida biofilm to grow well on the surface of implants such as catheters, prosthetic heart valves, contact lenses, artificial joints and the intra-urine (IUD) which can cause bloodstream infections are a major cause of morbidity and mortality among hospitalized patients 8,9 .…”

Novel Antifungal Mechanism of Resveratrol: Apoptosis Inducer in Candida albicans

“…C. albicans can cause infections in humans by (a) epithelial adhesion in the yeast form, (b) yeast-hyphae transition and epithelial penetration, and (c) dissemination and infection [22,23]. Candida species may also cause the biofilm formation in medical devices and implants of patients [6]. Furthermore, Candida species has been reported to show azole resistance through upregulation of efflux [31], mutations in yeast transcription factor PDR1 [31], mutations or overexpression of ERG11 [21], and respiratory deficiency in mutants [9].…”