血源型白色念珠菌菌株的生物膜形成能力及抗真菌药物的作用

Biofilm-forming capacity of blood-borne Candida albicans strains and effects of antifungal agents.

作者信息

Turan Hanni, Demirbilek Müge

机构信息

Department of Microbiology, Faculty of Medicine, Başkent University, Ankara, Turkey.

Department of Microbiology, Faculty of Medicine, Başkent University, Ankara, Turkey.

出版信息

Rev Argent Microbiol. 2018 Jan-Mar;50(1):62-69. doi: 10.1016/j.ram.2017.05.003. Epub 2017 Oct 6.

Abstract

Infections related to Candida albicans biofilms and subsequent antifungal resistance have become more common with the increased use of indwelling medical devices. Regimens for preventing fungal biofilm formation are needed, particularly in high-risk patients. In this study, we investigated the biofilm formation rate of multiple strains of Candida albicans (n=162 clinical isolates), their antifungal susceptibility patterns, and the efficacy of certain antifungals for preventing biofilm formation. Biofilm formation was graded using a modified Christensen's 96-well plate method. We further analyzed 30 randomly chosen intense biofilm-forming isolates using the XTT method. Minimum biofilm inhibition concentrations (MBIC) of caspofungin, micafungin, anidulafungin, fluconazole, voriconazole, posaconazole, itraconazole, and amphotericin B were determined using the modified Calgary biofilm method. In addition, the inhibitory effects of antifungal agents on biofilm formation were investigated. Our study showed weak, moderate, and extensive biofilm formation in 29% (n=47), 38% (n=61), and 23% (n=37) of the isolates, respectively. We found that echinocandins had the lowest MBIC values and that itraconazole inhibited biofilm formation in more isolates (26/32; 81.3%) than other tested agents. In conclusion, echinocandins were most effective against formed biofilms, while itraconazole was most effective for preventing biofilm formation. Standardized methods are needed for biofilm antifungal sensitivity tests when determining the treatment and prophylaxis of C. albicans infections.

摘要

随着留置医疗器械使用的增加,与白色念珠菌生物膜相关的感染及随后出现的抗真菌耐药性变得更加普遍。需要有预防真菌生物膜形成的方案,尤其是在高危患者中。在本研究中,我们调查了多株白色念珠菌(162株临床分离株)的生物膜形成率、它们的抗真菌药敏模式以及某些抗真菌药物预防生物膜形成的效果。生物膜形成采用改良的克里斯滕森96孔板法进行分级。我们进一步使用XTT法分析了30株随机选择的强生物膜形成分离株。使用改良的卡尔加里生物膜法测定了卡泊芬净、米卡芬净、阿尼芬净、氟康唑、伏立康唑、泊沙康唑、伊曲康唑和两性霉素B的最低生物膜抑制浓度(MBIC)。此外,还研究了抗真菌剂对生物膜形成的抑制作用。我们的研究表明,分别有29%(n = 47)、38%(n = 61)和23%(n = 37)的分离株表现出弱、中度和广泛的生物膜形成。我们发现棘白菌素的MBIC值最低,并且伊曲康唑比其他受试药物能抑制更多分离株(26/32;81.3%)的生物膜形成。总之,棘白菌素对已形成的生物膜最有效,而伊曲康唑对预防生物膜形成最有效。在确定白色念珠菌感染的治疗和预防措施时,生物膜抗真菌药敏试验需要标准化方法。

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