title: Strength in numbers: antifungal strategies against fungal biofilms.
abstract: Pathogenic fungi have the capacity to form tenacious biofilm structures that are notoriously unresponsive to antifungal therapies. Fungal biofilms are ubiquitous, located all over the human host, including the oral cavity, respiratory tract, gastrointestinal tract, urinary tract, wounds and upon biomedical devices. This latter category represents one of the greatest hurdles in clinical management, where the presence of inert substrates such as a catheter provides a reservoir for fungal biofilm development. Here, Candida albicans is the most adept at forming biofilms and is the principal nosocomial fungal pathogen based on its high rates of mortality, which are often associated with the biofilm lifestyle. This review will summarise some of the key fungal biofilm-forming organisms and their clinical significance and will discuss current and novel strategies to manage these hard-to-treat infections based on in vitro and in vivo studies.
authors.affiliation: Infection and Immunity Research Group, Glasgow Dental School and Hospital, School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, 378 Sauchiehall Street, Glasgow G2 3JZ, UK. Electronic address: gordon.ramage@glasgow.ac.uk.
authors.forename: Gordon
authors.initials: G
authors.lastname: Ramage
authors.affiliation: Infection and Immunity Research Group, Glasgow Dental School and Hospital, School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, 378 Sauchiehall Street, Glasgow G2 3JZ, UK; Institute of Healthcare Associated Infections, School of Health, Nursing and Midwifery, University of the West of Scotland, Glasgow, UK.
authors.forename: Shaun N
authors.initials: SN
authors.lastname: Robertson
authors.affiliation: Institute of Healthcare Associated Infections, School of Health, Nursing and Midwifery, University of the West of Scotland, Glasgow, UK.
authors.forename: Craig
authors.initials: C
authors.lastname: Williams
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use*; D018441:Biofilms / Q000187:drug effects* / Q000254:growth & development*; D005658:Fungi / Q000187:drug effects* / Q000502:physiology*; D006801:Humans
chemical_list: D000935:Antifungal Agents
keywords: Antifungal; Biofilm; Candida; Echinocandin; Liposomal amphotericin B