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Antimicrobial Agents and Chemotherapy, October 2009, p. 4377-4384, Vol. 53, No. 10
0066-4804/09/$08.00+0     doi:10.1128/AAC.00316-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Biofilm Formation and Effect of Caspofungin on Biofilm Structure of Candida Species Bloodstream Isolates {triangledown}

J. A. G. Ferreira,1,3* J. H. Carr,2 C. E. F. Starling,3 M. A. de Resende,1 and R. M. Donlan2

Departamento de Microbiologia, Universidade Federal de Minas Gerais,1 Departamento de Doenças Infecciosas, Hospital Vera Cruz, Belo Horizonte, Brazil,3 Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia2

Received 8 March 2009/ Returned for modification 15 April 2009/ Accepted 12 June 2009

Candida biofilms are microbial communities, embedded in a polymeric matrix, growing attached to a surface, and are highly recalcitrant to antimicrobial therapy. These biofilms exhibit enhanced resistance against most antifungal agents except echinocandins and lipid formulations of amphotericin B. In this study, biofilm formation by different Candida species, particularly Candida albicans, C. tropicalis, and C. parapsilosis, was evaluated, and the effect of caspofungin (CAS) was assessed using a clinically relevant in vitro model system. CAS displayed in vitro activity against C. albicans and C. tropicalis cells within biofilms. Biofilm formation was evaluated after 48 h of antifungal drug exposure, and the effects of CAS on preformed Candida species biofilms were visualized using scanning electron microscopy (SEM). Several species-specific differences in the cellular morphologies associated with biofilms were observed. Our results confirmed the presence of paradoxical growth (PG) in C. albicans and C. tropicalis biofilms in the presence of high CAS concentrations. These findings were also confirmed by SEM analysis and were associated with the metabolic activity obtained by biofilm susceptibility testing. Importantly, these results suggest that the presence of atypical, enlarged, conical cells could be associated with PG and with tolerant cells in Candida species biofilm populations. The clinical implications of these findings are still unknown.

* Corresponding author. Mailing address: Departamento de Microbiologia, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Belo Horizonte, Minas Gerais, Brazil 31270-901. Phone: 55-31-3499-2730. Fax: 55-31-2952152. E-mail: jantgferr{at}hotmail.com

{triangledown} Published ahead of print on 22 June 2009.

Antimicrobial Agents and Chemotherapy, October 2009, p. 4377-4384, Vol. 53, No. 10
0066-4804/09/$08.00+0     doi:10.1128/AAC.00316-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.





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