Association between Candida biofilm-forming bloodstream isolates and the clinical evolution in patients with candidemia: An observational nine-year single center study in Mexico

• Published in: Revista iberoamericana de micologia Vol. 35; no. 1; pp. 11 - 16
• Main Authors: Treviño-Rangel, Rogelio de J, Peña-López, Cynthia D, Hernández-Rodríguez, Pedro A, Beltrán-Santiago, Dinael, González, Gloria M
• Format: Journal Article
• Language: English
• Published: Spain Elsevier España, S.L.U 01.01.2018
• Subjects: Biofilm formation; Candidemia; Epidemiology; Epidemiología; Factor de riesgo; Formación de biopelícula; Infectious Disease; Mortalidad; Mortality; Risk factor; Epidemiología; Factor de riesgo; Biofilm formation; Mortality; Risk factor; Formación de biopelícula; Mortalidad; Candidemia; Epidemiology
• ISSN: 1130-1406; 2173-9188
• DOI: 10.1016/j.riam.2017.01.005

Abstract Background Candidemia is one of the most common nosocomial infections globally and it is associated with considerable excess mortality and costs. Abreast, biofilm-forming strains are associated with even higher mortality rates and poor prognosis for the patient. Aims To evaluate a possible association between the biofilm-forming capability of Candida bloodstream isolates and the clinical evolution in patients with candidemia. Methods An observational, retrospective study was conducted at a tertiary care university hospital during 9 years (2006–2015). The biofilm quantitation of the Candida bloodstream isolates was determined by crystal violet staining and XTT reduction assay. Results A total of 218 cases of candidemia had been diagnosed and 89 isolates were obtained. The mortality rate was 36% and the main risk factors were antibiotic exposure and the use of catheters. Candida tropicalis (52.8%) was the most frequent species, followed by Candida albicans (30.4%), Candida parapsilosis sensu stricto (10.1%), Candida orthopsilosis (3.4%), Candida krusei (2.2%) and Candida glabrata sensu stricto (1.1%). All the strains were biofilm producers, which is an important contribution to the patient's mortality. C. tropicalis showed the highest production of biomass biofilm, whereas C. glabrata exhibited the highest metabolic activity. Conclusions This study contributes to expand the knowledge about the local epidemiology of candidemia and highlights the impact of Candida biofilm on patient's outcome.