title: Experimental biofilm-related Candida infections.
abstract: OBJECTIVE
  We investigated the pathogenic role of biofilm and the therapeutic efficacy of anidulafungin in experimental infections of the wax moth Galleria mellonella by Candida albicans clinical strains.
  
  
  METHODS
  On the basis of the in vitro propensity to form biofilm, five biofilm-producer (BP) and four nonproducer (NP) C. albicans clinical strains were used in this study. For each strain, we assessed the virulence by infecting G. mellonella larvae and observing survival. Anidulafungin was administered 2 h after yeast inoculum at 0.6 µg, according to the therapeutic dose recommended for humans.
  
  
  RESULTS
  Biofilm-forming ability highly influenced the larva-killing rate. A significant (p < 0.0001) survival decrease was observed in the BP group, with 80% of the infected larvae dying within 72 h. NP isolates did not reach the same killing rate, even at the end of experiments (216 h). Larval survival was enhanced (p < 0.0001) by anidulafungin administration in both groups. Survival rate at 72 h was similar in both groups (BP 78.5% and NP 87.5%); whereas there were still differences at the end of the experiments, with a higher survival in the NP group (75 vs 48%).
  
  
  CONCLUSIONS
  Our data confirm the pathogenic role of biofilm in C. albicans infections. Its importance was further enhanced by a lack of contribution from extracellular enzymes, detected in both NP and BP strains. In addition, we demonstrated anidulafungin efficacy in treating biofilm-related invasive candidiasis.
authors.affiliation: Department of Health Sciences, Università degli Studi di Milano, via A di Rudinì, 8, 20142 Milan, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Cirasola
authors.forename: Rita
authors.initials: R
authors.lastname: Sciota
authors.forename: Loredana
authors.initials: L
authors.lastname: Vizzini
authors.forename: Valentina
authors.initials: V
authors.lastname: Ricucci
authors.forename: Giulia
authors.initials: G
authors.lastname: Morace
authors.forename: Elisa
authors.initials: E
authors.lastname: Borghi
mesh_terms: D000077612:Anidulafungin; D000818:Animals; D000935:Antifungal Agents / Q000008:administration & dosage; D018441:Biofilms / Q000254:growth & development*; D002176:Candida albicans / Q000472:pathogenicity / Q000502:physiology*; D002177:Candidiasis / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology*; D004195:Disease Models, Animal; D054714:Echinocandins / Q000008:administration & dosage; D007814:Larva / Q000382:microbiology; D007915:Lepidoptera / Q000254:growth & development / Q000382:microbiology; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D000077612:Anidulafungin