The role of biofilm forming on mortality in patients with candidemia: a study derived from real world data

Tascini, Carlo; Sozio, Emanuela; Corte, Laura Della; Sbrana, Francesco; Scarparo, Claudio; Ripoli, Andrea; Bertolino, Giacomo; Merelli, Maria; Tagliaferri, Enrico; Corcione, Antonio; Bassetti, Matteo; Cardinali, Gianluigi; Menichetti, Francesco

doi:10.1080/23744235.2017.1384956

Cited by 36 publications

(28 citation statements)

References 29 publications

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“…Based on a recent epidemiological meta‐analysis, the incidence of candidaemia in Europe is 3.88 cases per 100 000 corresponding to approximately 79 cases per day . According to a number of studies, patients infected by biofilm‐producing isolates have a worse prognosis; however, contradicting studies also exist . This controversy is probably due, at least partly, to variability in the cut‐off values used to distinguish low from intermediate and high biofilm producers The other possible reason may be the high variability of the examined patient populations …”

Section: Discussionmentioning

confidence: 99%

“…In multivariate analysis, infection with an isolate producing biofilm with intermediate/ high metabolic activity is an independent predictor of mortality (Table 2B), while this association was not demonstrated using crystal violet-based biofilm mass determination (Table 2A). 26 According to a number of studies, patients infected by biofilm-producing isolates have a worse prognosis 8,10,27 ; however, contradicting studies also exist. 11,12 This controversy is probably due, at least partly, to variability in the cut-off values used to distinguish low from intermediate and high biofilm producers 12,13 The other possible reason may be the high variability of the examined patient populations.…”

Section: Re Sultsmentioning

confidence: 99%

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Candida biofilm production is associated with higher mortality in patients with candidaemia

Vitális

Nagy

Tóth

et al. 2020

Mycoses

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Summary Background Candidaemia is a common life‐threatening disease among hospitalised patients, but the effect of the Candida biofilm‐forming ability on the clinical outcome remains controversial. Objective The aim was to determine the impact of biofilms, specifically focusing on biofilm mass and metabolic activity, on the mortality in candidaemia. Patients/Methods The clinical data of patients (n = 127) treated at the University of Debrecen, Clinical Centre, between January 2013 and December 2018, were investigated retrospectively. Biofilm formation was assessed using the crystal violet and XTT assays, measuring the biofilm mass and metabolic activity, respectively. Isolates were classified as low, intermediate and high biofilm producers both regarding biofilm mass and metabolic activity. The susceptibility of one‐day‐old biofilms to fluconazole, amphotericin B, anidulafungin, caspofungin and micafungin was evaluated and compared to planktonic susceptibility. Results Intermediate/high biofilm mass was associated with significantly higher mortality (61%). All Candida tropicalis, Candida parapsilosis and Candida glabrata isolates originating from fatal infections were intermediate/high biofilm producers, whereas this ratio was 85% for Candida albicans. Solid malignancy was associated with intermediate/high biofilm producers (P = .043). The mortality was significantly higher in infections caused by Candida strains producing biofilms with intermediate/high metabolic activity (62% vs. 33%, P = .010). The ratio of concomitant bacteraemia was higher for isolates forming biofilms with low metabolic activity (53% vs 28%, P = .015). Conclusions This study provides evidence that the Candida biofilms especially with intermediate/high metabolic activity are related to higher mortality in candidaemia.

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Section: Discussionmentioning

confidence: 99%

Section: Re Sultsmentioning

confidence: 99%

Candida biofilm production is associated with higher mortality in patients with candidaemia

Vitális

Nagy

Tóth

et al. 2020

Mycoses

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“…When dead patients were compared with those alive, no difference was observed regarding the presence of biofilmproducing strains or the use of antifungal therapy with antibiofilm activity. Nevertheless, after performing a random forest analysis with a model-based clustering approach and risk stratification, an increased proportion of biofilm-producing strains was detected in the subgroup of patients with the highest probability of death, especially among those treated with azoles or with a high APACHE II score [26].…”

Section: Discussionmentioning

confidence: 99%

Is biofilm production a prognostic marker in adults with candidaemia?

Muñóz

Agnelli

Guinea

et al. 2018

Clinical Microbiology and Infection

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“…This is an important antecedent given that C. albicans and, on a smaller scale, other Candida species are reported to be frequently found in adults and children's oral cavities, serving as reservoir for inoculation and infection of any part of the body [60,61]. These infections are difficult to treat with antifungals, which means a high mortality rate [62,63]. Consequently, if the oral cavity in pathological conditions is a reservoir triggering Candida parapsilosis strains colonization and pathogenicity, such condition is an important risk factor for candidemia or invasive infections by this yeast.…”

Section: Discussionmentioning

confidence: 99%

The Oral Cavity: A Reservoir that Favors Colonization and Selection of Candida parapsilosis sensu stricto Strains with High Pathogen Potential Under Conditions of Gingival-periodontal Disease

Rodríguez¹

2018

J. Dent. Sci. Ther

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The Candida parapsilosis complex comprises three genetically related species: Candida parapsilosis sensu stricto, Candida orthopsilosis and Candida metapsilosis. During the last decade, Candida parapsilosis sensu stricto has become the second most commonly isolated yeast from patients with blood stream invasive fungal infections, following Candida albicans. Despite its clinical significance, little is known about its distribution and behavior in oral cavity niches. Given this background, we intended to perform a molecular characterization of 38 isolates of the Candida parapsilosis complex collected from oral cavities of immunocompetent patients with and without gingivalperiodontal disease, with the aim of determining its distribution and establishing a correlation with clinical data. Besides, we assessed the virulence of the strains by examining the in vitro biofilm-forming capacity in two different culture media: YPD and RPMI 1640. Being more frequently isolated from oral cavities with pathological conditions, 89.5% of the strains were reconfirmed to be Candida parapsilosis sensu stricto. More than 70% of the Candida parapsilosis sensu stricto strains showed biofilm-forming capacity in both culture media, reflecting a statistically significant association between biofilm-forming capacity and the clinical conditions of the subjects from whom the strains were isolated. Among the three complex species, Candida parapsilosis sensu stricto is a normal commensal in the oral cavity, being more frequently recovered in inflammatory conditions. Gingival-periodontal disease may be a factor triggering overgrowth and virulence of Candida parapsilosis sensu stricto commensal strains.

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The role of biofilm forming on mortality in patients with candidemia: a study derived from real world data

Abstract: BF by Candida spp. seems to be clinically associated with increased mortality especially in medical patients with higher Apache II score or treated with azoles.

Cited by 36 publications

References 29 publications

Candida biofilm production is associated with higher mortality in patients with candidaemia

Candida biofilm production is associated with higher mortality in patients with candidaemia

Is biofilm production a prognostic marker in adults with candidaemia?

The Oral Cavity: A Reservoir that Favors Colonization and Selection of Candida parapsilosis sensu stricto Strains with High Pathogen Potential Under Conditions of Gingival-periodontal Disease

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