Lack of efficacy of echinocandins against high metabolic activity biofilms of Candida parapsilosis clinical isolates

Autor(es)

Thomaz, Danilo Yamamoto ^{[1, 2]} ; Carvalho Melhem, Marcia de Souza ^{[3, 4]} ; de Almeida Junior, Joao Nobrega ^{[1, 2, 5]} ; Benard, Gil ^{[1, 2]} ; Barbaro Del Negro, Gilda Maria ^{[1, 2]}

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Lab Med Mycol LIM 53, Clin Dermatol Div, Hosp Clin, Av Dr Eneas Carvalho de Aguiar 500, Predio 2, BR-05403000 Sao Paulo, SP - Brazil

^[2] Univ Sao Paulo, Inst Med Trop Sao Paulo, Fac Med, Av Dr Eneas Carvalho de Aguiar 500, Predio 2, BR-05403000 Sao Paulo, SP - Brazil

^[3] Univ Fed Mato Grosso do Sul, Sao Paulo, MS - Brazil

^[4] Secretary Hlth, Mycol Unit, Adolfo Lutz Inst, Sao Paulo, MS - Brazil

^[5] Univ Sao Paulo, Hosp Clin, Fac Med, Cent Lab Div, LIM 03, Sao Paulo, SP - Brazil

• Tipo de documento: Artigo Científico
• Fonte: Brazilian Journal of Microbiology; v. 51, n. 3 JAN 2020.
• Citações Web of Science: 1

Resumo

Candida parapsilosis produces biofilm, which colonizes catheters and other invasive medical devices that are manipulated by health care workers. In previous studies, C. parapsilosis in vitro biofilms have exhibited high resistance rates against conventional antifungals, but susceptibility to both echinocandins and lipid formulations of amphotericin B (lipid complex and liposomal). However, a recent study showed good activity of amphotericin B deoxycholate on the biomass of C. parapsilosis biofilms. Although moderate activity of echinocandins has been demonstrated against low metabolic activity biofilms of C. parapsilosis, few studies have analyzed the action of these drugs on high metabolic activity biofilms. Moreover, high biofilm-forming isolates have been associated with central venous catheter-related fungemia outbreaks and higher mortality rates. Therefore, it is relevant to verify the activity of the main antifungal drugs against high metabolic activity biofilms of C. parapsilosis. Our study aimed to evaluate the in vitro activity of amphotericin B deoxycholate, anidulafungin, caspofungin, and micafungin against high biofilm-forming and high metabolic activity clinical isolates of C. parapsilosis. Our results showed good activity of amphotericin B against C. parapsilosis biofilms, but none of the echinocandin drugs was effective. This suggests that amphotericin B deoxycholate may be a better choice than echinocandins for the treatment of biofilm-associated infections by C. parapsilosis, mainly in countries with insufficient health care resources to purchase lipid formulations of amphotericin B. These results warn of the possibility of persistent catheter-related candidemia caused by high biofilm-forming C. parapsilosis strains when treated with echinocandin drugs. (AU)

• Processo FAPESP: 18/15491-3 - Diversidade genética de Candida parapsilosis (sensu stricto): correlação de clusters emergentes com suscetibilidade a antifúngicos, formação de biofilme e virulência de isolados obtidos de Candidíase Invasiva em hospital terciário
• Beneficiário: Danilo Yamamoto Thomaz
• Modalidade de apoio: Bolsas no Brasil - Pós-Doutorado