Microbiologic and clinical characteristics of biofilm-forming Candida parapsilosis isolates associated with fungaemia and their impact on mortality

Soldini, Silvia; Posteraro, Brunella; Vella, Antonietta; Carolis, Elena De; Borghi, Elisa; Falleni, Monica; Losito, Angela Raffaella; Maiuro, G.; Trecarichi, Enrico Maria; Sanguinetti, Maurizio; Tumbarello, Mario

doi:10.1016/j.cmi.2017.11.005

Cited by 45 publications

(51 citation statements)

References 41 publications

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“…The studies described above show that in vitro drug susceptibility results are not clearly correlated with patient outcomes. C. parapsilosis biofilms are a major factor in outcomes for certain patients (329), particularly in the setting of infected foreign materials. In particular, C. parapsilosis is frequently associated with central venous catheters (330)(331)(332)(333).…”

Section: Antifungal Susceptibility and Resistancementioning

confidence: 99%

Candida parapsilosis: from Genes to the Bedside

et al. 2019

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SUMMARY Patients with suppressed immunity are at the highest risk for hospital-acquired infections. Among these, invasive candidiasis is the most prevalent systemic fungal nosocomial infection. Over recent decades, the combined prevalence of non-albicans Candida species outranked Candida albicans infections in several geographical regions worldwide, highlighting the need to understand their pathobiology in order to develop effective treatment and to prevent future outbreaks. Candida parapsilosis is the second or third most frequently isolated Candida species from patients. Besides being highly prevalent, its biology differs markedly from that of C. albicans, which may be associated with C. parapsilosis’ increased incidence. Differences in virulence, regulatory and antifungal drug resistance mechanisms, and the patient groups at risk indicate that conclusions drawn from C. albicans pathobiology cannot be simply extrapolated to C. parapsilosis. Such species-specific characteristics may also influence their recognition and elimination by the host and the efficacy of antifungal drugs. Due to the availability of high-throughput, state-of-the-art experimental tools and molecular genetic methods adapted to C. parapsilosis, genome and transcriptome studies are now available that greatly contribute to our understanding of what makes this species a threat. In this review, we summarize 10 years of findings on C. parapsilosis pathogenesis, including the species’ genetic properties, transcriptome studies, host responses, and molecular mechanisms of virulence. Antifungal susceptibility studies and clinician perspectives are discussed. We also present regional incidence reports in order to provide an updated worldwide epidemiology summary.

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Section: Antifungal Susceptibility and Resistancementioning

confidence: 99%

Candida parapsilosis: from Genes to the Bedside

et al. 2019

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“…Candida albicans remains the most frequently isolated fungal species from catheter-associated infections followed by C. parapsilosis due to their high biofilm-forming ability (Bassetti et al 2013;Soldini et al 2018;Monfredini et al 2018). A previous study revealed that Candida biofilm production is associated with significantly higher mortality compared to patients with bloodstream infections caused by non-biofilm-forming Candida species (Rajendran et al 2016).…”

Section: Introductionmentioning

confidence: 99%

Synergistic effect of nikkomycin Z with caspofungin and micafungin against Candida albicans and Candida parapsilosis biofilms

Kovács

Nagy

Tóth

et al. 2019

Lett Appl Microbiol

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Antifungal lock therapy has received significant interest in the last few years because the frequently usage of intravascular devices is associated with an increasing number of catheter‐related bloodstream infections caused by Candida species. Antifungal combinations with synergistic interaction can be a good choice for antifungal lock therapy; therefore, interactions were examined between two echinocandins (caspofungin and micafungin) and the chitin synthesis inhibitor nikkomycin Z against Candida albicans and C. parapsilosis biofilms. Susceptibility was evaluated using the XTT‐based checkerboard microdilution method, while the nature of interactions was assessed by calculating fractional inhibitory concentration indices and using the Bliss independence model. Mathematic‐based evaluations were supplemented with fluorescent LIVE/DEAD viability assay. The results obtained by statistical interaction analyses correlated well with the viability assay. The tested echinocandins with nikkomycin Z caused an extended cell death and the structure of the biofilm was sparse compared to the control, especially for C. albicans. The findings support the simultaneous usage of nikkomycin Z and caspofungin or micafungin in alternative therapies such as the antifungal lock therapy. Significance and Impact of the Study Antifungal lock therapy can be a potential therapeutic approach to eradicate the intraluminal Candida biofilms; however, there is no approved lock strategy against fungal species so far. The results of this study provide valuable evidence that nikkomycin Z acts synergistically in combination with caspofungin or micafungin against biofilms. In addition, this synergy was more pronounced for micafungin combined with nikkomycin Z. Therefore, nikkomycin Z can be considered as a potential agent in antifungal lock therapy especially with micafungin against C. albicans or C. parapsilosis biofilms.

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“…Moreover detached from biofilm yeast cells are important infections source. Recently it was showed that C. parapsilosis biofilm is associated with candidemia and it has an impact on mortality due to this infection [21] . Thus, it is possible to think, in the current case, C. parapsilosis firstly has formed a biofilm on CVC and next reached the blood flow being responsible by candidemia.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and management of a fatal case of sepsis caused by Candida parapsilosis sensu stricto in a neonate with omphalocele

Santana¹,

Salci²,

Andriato³

et al. 2018

Medical Mycology Case Reports

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We present a fatal case of persistent neonatal candidemia by Candida parapsilosis following omphalocele, without other anomalies. Despite an encouraging initial prognosis, after surgical correction and closure of the abdominal wall the case became difficult to treat, as in addition to the exposure of the patient to multiple risk factors for candidemia, antifungal therapy apparently was not adequate.

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Microbiologic and clinical characteristics of biofilm-forming Candida parapsilosis isolates associated with fungaemia and their impact on mortality

Abstract: C. parapsilosis BF influences the clinical outcome in patients with fungaemia.

Cited by 45 publications

References 41 publications

Candida parapsilosis: from Genes to the Bedside

Candida parapsilosis: from Genes to the Bedside

Synergistic effect of nikkomycin Z with caspofungin and micafungin against Candida albicans and Candida parapsilosis biofilms

Diagnosis and management of a fatal case of sepsis caused by Candida parapsilosis sensu stricto in a neonate with omphalocele

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