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Drug Resist Updat. 2004 Aug-Oct;7(4-5):301-9.

Candida biofilm resistance.

Author information

1
Department of Dermatology, Center for Medical Mycology, Case Western Reserve University, 11100 Euclid Avenue, LKS-5028 Cleveland, OH 44106-5028, USA. pkm@cwru.edu

Abstract

Device-related infections in most nosocomial diseases can be traced to the formation of biofilms (microbial communities encased within polysaccharide-rich extracellular matrix) by pathogens on surfaces of these devices. Candida species are the most common fungi isolated from these infections, and biofilms formed by these fungal organisms are associated with drastically enhanced resistance against most antimicrobial agents. This enhanced resistance contributes to the persistence of this fungus despite antifungal therapy. Candida biofilms exhibit enhanced resistance against most antifungal agents, except echinocandins and lipid formulations of AmB. The expression of drug efflux pumps during the early phase of biofilm formation and alterations in membrane sterol composition contribute to resistance of these biofilms against azoles. Metabolic dormancy and ECM do not appear to contribute to resistance, although in a mixed-species biofilm, ECM does retard the diffusion of drugs across biofilm. These multifactorial mechanisms of resistance in fungal biofilms constitute a broad-spectrum defense that is effective against many types of antifungal agents, and represent a common theme present across microbial biofilms.

PMID:
15533767
DOI:
10.1016/j.drup.2004.09.002
[Indexed for MEDLINE]

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