Antifungal activity against planktonic and biofilm Candida albicans in an experimental model of foreign-body infection. Issue 3 (March 2016)

• Record Type: Journal Article
• Authors: Maiolo, Elena Maryka; Oliva, Alessandra; Furustrand Tafin, Ulrika; Perrotet, Nancy; Borens, Olivier; Trampuz, Andrej
• Is Part Of: Journal of infection. Volume 72:Issue 3(2016)
• Page Start: 386
• Page End: 392
• Publication Date: 2016-03
• Subjects: Candida spp. -- Biofilm -- Foreign-body infection -- Animal model -- Antifungals; Infection -- Periodicals; Bacterial Infections -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.905
• DOI: 10.1016/j.jinf.2015.12.008
• Languages: English
• ISSNs: 0163-4453

Abstract

Summary: Objectives: The treatment of Candida implant-associated infections remains challenging. We investigated the antifungal activity against planktonic and biofilm Candida albicans in a foreign-body infection model. Methods: Teflon cages were subcutaneously implanted in guinea pigs, infected with C. albicans (ATCC 90028). Animals were treated intraperitoneally 12 h after infection for 4 days once daily with saline, fluconazole (16 mg/kg), amphotericin B (2.5 mg/kg), caspofungin (2.5 mg/kg) or anidulafungin (20 mg/kg). Planktonic Candida was quantified, the clearance rate and cure rate determined. Results: In untreated animals, planktonic Candida was cleared from cage fluid in 25% (infected with 4.5 × 10 3 CFU/cage), 8% (infected with 4.8 × 10 4 CFU/cage) and 0% (infected with 6.2 × 10 5 CFU/cage). Candida biofilm persisted on all explanted cages. Compared to untreated controls, caspofungin reduced the number of planktonic C. albicans to 0.22 and 0.0 CFU/ml, respectively, and anidulafungin to 0.11 and 0.13 CFU/ml, respectively. Fluconazole cured 2/12 cages (17%), amphotericin B and anidulafungin 1/12 cages (8%) and caspofungin 3/12 cages (25%). Conclusion: Echinocandins showed superior activity against planktonic C. albicans . Caspofungin showed the highest cure rate of C. albicans biofilm. However, no antifungal exceeded 25% cure rate, demonstrating the difficulty of eradicating Candida biofilms from implants. Highlights: The treatment of Candida implant-associated infections remains challenging. Echinocandins showed superior activity against planktonic C. albicans in the cage fluid. Among antifungals, Caspofungin showed the highest cure rate against C. albicans biofilm. Additional antifungal combinations against biofilm should be evaluated.