Kakeya Hiroshi, Imamura Yoshihumi, Miyazaki Taiga, Izumikawa Koichi, Yamamoto Yoshihiro, Tashiro Takayoshi, Kohno Shigeru
Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences.
Kansenshogaku Zasshi. 2011 Jul;85(4):333-9. doi: 10.11150/kansenshogakuzasshi.85.333.
Deep-seated mycosis usually occurred in severe immunocompromised patients and is sometimes fatal. Hence, chronic fungal infection occurred in the patients with mild to moderate immunocompromised status and persists for longer period. Biofilm formation is one of the factors related to persisting infection of Candida spp. Biofilm formation resists to the antifungals in catheter-related Candida infection and selection of appropriate antifungals will be an important key to achieve good outcome. Although azoles possessed excellent antifungal activity against planktonic Candida spp., they show lower activity against biofilm-formed Candida spp. Overexpression of efflux pump of Candida spp. is reported to be involved in lowered activity of azoles. Amphotericin B, liposomal amphotericin B, and micafungin however, are expected to have high antifungal activity against biofilm-formed Candida spp. Recently, Aspergillus is also reported to possess potential of forming biofilm. Biofilm formation of Aspergillus is considered to be related to pathogenesis of chronic pulmonary aspergillosis. General antifungals are not highly active to biofilm-formed Aspergillus as same as Candida, and only amphotericin B and its liposomal formulation are expected to be effective in vitro.
深部真菌病通常发生在严重免疫功能低下的患者中，有时会致命。因此，慢性真菌感染发生在轻度至中度免疫功能低下的患者中，并持续较长时间。生物膜形成是与念珠菌属持续感染相关的因素之一。在导管相关念珠菌感染中，生物膜形成会对抗真菌药物产生耐药性，选择合适的抗真菌药物将是取得良好治疗效果的关键。虽然唑类对浮游念珠菌属具有优异的抗真菌活性，但它们对形成生物膜的念珠菌属活性较低。据报道，念珠菌属外排泵的过表达与唑类活性降低有关。然而，两性霉素B、脂质体两性霉素B和米卡芬净预计对形成生物膜的念珠菌属具有较高的抗真菌活性。最近，也有报道称曲霉具有形成生物膜的潜力。曲霉的生物膜形成被认为与慢性肺曲霉病的发病机制有关。与念珠菌一样，一般抗真菌药物对形成生物膜的曲霉活性不高，只有两性霉素B及其脂质体制剂在体外有望有效。
