Anti-Candida activity of antimicrobial impregnated central venous catheters

L Cobrado,M M Azevedo,A Silva-Dias,A Rodrigues

doi:10.1186/s13756-017-0269-x

Abstract

BackgroundWhenever the rate of central line-associated bloodstream infections (CLABSIs) remains high even after the implementation of preventive strategies, the use of chlorhexidine/silver sulfadiazine (CSS) or minocycline/rifampin (MR)-impregnated central venous catheters (CVCs) is currently recommended. Nevertheless, the efficacy of such CVCs against Candida albicans and other emerging non-albicans spp. has been insufficiently studied. This study aims to compare the activity of CSS and MR-impregnated CVCs against the yeasts most frequently isolated from CLABSIs.MethodsFor biofilm formation assays, type strains and clinical isolates of C. albicans, C. glabrata and C. parapsilosis sensu stricto were used. Segments of standard polyurethane, MR and second-generation CSS-CVCs were tested. The biofilm metabolic activity was measured by a semi-quantitative XTT reduction assay.ResultsCSS catheter segments significantly reduced the biofilm metabolic activity by all tested Candida spp., with inhibition ranging from 60% to 100%. The MR catheter segments promoted C. albicans and C. parapsilosis biofilm formation and exhibited an inconspicuous effect against C. glabrata.ConclusionsAmong the recommended antimicrobial CVCs, CSS-CVCs proved to be superior in the inhibition of biofilm formation by the most frequent yeasts causing CLABSIs. Data from this in vitro study may suggest that patients at high risk for invasive candidosis could benefit from the use of CSS-CVCs.

Highlights

Whenever the rate of central line-associated bloodstream infections (CLABSIs) remains high even after the implementation of preventive strategies, the use of chlorhexidine/silver sulfadiazine (CSS) or minocycline/rifampin (MR)-impregnated central venous catheters (CVCs) is currently recommended
Strains Type strains belonging to the American Type Culture Collection (ATCC) or to the Centraalbureau voor Schimmelcultures (CBS) were used, along with clinical isolates of C. albicans, C. glabrata and C. parapsilosis sensu stricto previously collected from patients admitted at a tertiary university hospital and identified using the Vitek 2 system (Table 1)
C. glabrata and C. parapsilosis exhibited the higher values of biofilm formation at this period

Summary

Introduction

Whenever the rate of central line-associated bloodstream infections (CLABSIs) remains high even after the implementation of preventive strategies, the use of chlorhexidine/silver sulfadiazine (CSS) or minocycline/rifampin (MR)-impregnated central venous catheters (CVCs) is currently recommended. Through the colonization of the skin, manipulation of the catheter hub, contamination of infusates or from a distant focus of infection, Candida cells may adhere to the CVC surface and produce extracellular polymers, providing a structural matrix that will further facilitate adhesion [7]. In such biofilm, Candida cells display an increased resistance to antifungal agents and, from such strategic anchorage point, yeasts may disperse into the bloodstream, leading to serious infection [7,8,9]. Risk factors for invasive candidosis include the presence of a CVC, prolonged

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