Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Gregorio Marañón Sanitary Research Institute, Madrid, Spain; Respiratory Diseases Networking Biomedical Research Centre, Madrid, Spain; Department of Medicine, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain.
Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Gregorio Marañón Sanitary Research Institute, Madrid, Spain.
Clin Microbiol Infect. 2018 Sep;24(9):1010-1015. doi: 10.1016/j.cmi.2018.01.022. Epub 2018 Mar 24.
The role of biofilm production in the outcome of candidaemia remains under discussion. Current evidence relies on variable biofilm detection methods while evaluating distinct clinical end points. We aimed to determine the impact of biofilm production measured by metabolic activity (MA) and biomass (BM) on the prognosis of adults with candidaemia.
Retrospective cohort including 280 adults with candidaemia admitted from 2010 to 2016. BM was assessed using crystal violet binding stain and the XTT reduction assay was used to detect MA. Strains were classified as high and moderate-low biofilm producers according to published cut-offs. The primary outcome was overall mortality within 7 and 30 days. The secondary outcome was unfavourable prognosis defined as metastatic infection, admission to an intensive care unit due to the severity of candidaemia, or death within 30 days.
High BM and high MA were detected in 90 (32.1%) and 114 (40.7%) of the 280 isolates, respectively. Comparison of high and moderate-low biofilm forming isolates revealed no correlation between biofilm production and 7-day mortality (BM high 15/90 (16.7%) versus moderate-low 24/190 (12.6%); MA high 12/114 (10.5%) versus moderate-low 27/166 (16.3%)), 30-day mortality (BM high 34/90 (37.8%) versus moderate-low 61/190 (32.1%); MA high 33/114 (28.9%) versus moderate-low 62/166 (37.3%)), or unfavourable prognosis (BM high 45/90 (50.0%) versus moderate-low 73/190 (38.4%); MA high 41/114 (36.0%) versus moderate-low 77/166 (46.4%)).
Biofilm production was not a predictor of mortality or of unfavourable prognosis in adults with candidaemia.
生物膜产生在念珠菌血症的结果中的作用仍存在争议。目前的证据依赖于不同的生物膜检测方法，同时评估不同的临床终点。我们旨在确定代谢活性（MA）和生物量（BM）测量的生物膜产生对成人念珠菌血症预后的影响。
回顾性队列包括 2010 年至 2016 年期间收治的 280 例成人念珠菌血症患者。使用结晶紫结合染色评估 BM，使用 XTT 还原测定法检测 MA。根据已发表的截止值，将菌株分类为高和中低生物膜产生者。主要结局是 7 天和 30 天内的总死亡率。次要结局是不良预后，定义为转移性感染、因念珠菌血症严重程度而入住重症监护病房或 30 天内死亡。
在 280 株分离株中，分别检测到 90 株（32.1%）和 114 株（40.7%）高 BM 和高 MA。高和中低生物膜形成分离株之间的比较显示，生物膜产生与 7 天死亡率（BM 高 15/90（16.7%）与中低 24/190（12.6%）；MA 高 12/114（10.5%）与中低 27/166（16.3%））、30 天死亡率（BM 高 34/90（37.8%）与中低 61/190（32.1%）；MA 高 33/114（28.9%）与中低 62/166（37.3%））或不良预后（BM 高 45/90（50.0%）与中低 73/190（38.4%）；MA 高 41/114（36.0%）与中低 77/166（46.4%））之间无相关性。
生物膜产生不是成人念珠菌血症死亡率或不良预后的预测因素。
