Elena Maryka Maiolo1, Alessandra Oliva2, Ulrika Furustrand Tafin2, Nancy Perrotet3, Olivier Borens2, Andrej Trampuz4. 1. Charité - University Medicine Berlin, Center for Musculoskeletal Surgery, Berlin, Germany; Septic Surgical Unit, Department of Surgery and Anesthesiology, Lausanne University Hospital, Lausanne, Switzerland. 2. Septic Surgical Unit, Department of Surgery and Anesthesiology, Lausanne University Hospital, Lausanne, Switzerland. 3. Department of Hospital Pharmacy, Lausanne University Hospital, Lausanne, Switzerland. 4. Charité - University Medicine Berlin, Center for Musculoskeletal Surgery, Berlin, Germany. Electronic address: andrej.trampuz@charite.de.
Abstract
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.
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.
Authors: Patrick Van Dijck; Jelmer Sjollema; Bruno P Cammue; Katrien Lagrou; Judith Berman; Christophe d'Enfert; David R Andes; Maiken C Arendrup; Axel A Brakhage; Richard Calderone; Emilia Cantón; Tom Coenye; Paul Cos; Leah E Cowen; Mira Edgerton; Ana Espinel-Ingroff; Scott G Filler; Mahmoud Ghannoum; Neil A R Gow; Hubertus Haas; Mary Ann Jabra-Rizk; Elizabeth M Johnson; Shawn R Lockhart; Jose L Lopez-Ribot; Johan Maertens; Carol A Munro; Jeniel E Nett; Clarissa J Nobile; Michael A Pfaller; Gordon Ramage; Dominique Sanglard; Maurizio Sanguinetti; Isabel Spriet; Paul E Verweij; Adilia Warris; Joost Wauters; Michael R Yeaman; Sebastian A J Zaat; Karin Thevissen Journal: Microb Cell Date: 2018-06-14
Authors: Hafsa Abduljalil; Ahmed Bakri; Khawlah Albashaireh; Om Alkhir Alshanta; Jason L Brown; Leighann Sherry; Ryan Kean; Christopher Nile; William McLean; Gordon Ramage Journal: APMIS Date: 2022-07-20 Impact factor: 3.428
Authors: Eddie Dominguez; Robert Zarnowski; Hiram Sanchez; Antonio S Covelli; William M Westler; Parastoo Azadi; Jeniel Nett; Aaron P Mitchell; David R Andes Journal: mBio Date: 2018-04-03 Impact factor: 7.867