title: Antifungal activity against planktonic and biofilm Candida albicans in an experimental model of foreign-body infection.
abstract: OBJECTIVE
  The treatment of Candida implant-associated infections remains challenging. We investigated the antifungal activity against planktonic and biofilm Candida albicans in a foreign-body infection model.
  
  
  METHODS
  Teflon cages were subcutaneously implanted in guinea pigs, infected with C. albicans (ATCC 90028). Animals were treated intraperitoneally 12 h after infection for 4 days once daily with saline, fluconazole (16 mg/kg), amphotericin B (2.5 mg/kg), caspofungin (2.5 mg/kg) or anidulafungin (20 mg/kg). Planktonic Candida was quantified, the clearance rate and cure rate determined.
  
  
  RESULTS
  In untreated animals, planktonic Candida was cleared from cage fluid in 25% (infected with 4.5 × 10(3) CFU/cage), 8% (infected with 4.8 × 10(4) CFU/cage) and 0% (infected with 6.2 × 10(5) CFU/cage). Candida biofilm persisted on all explanted cages. Compared to untreated controls, caspofungin reduced the number of planktonic C. albicans to 0.22 and 0.0 CFU/ml, respectively, and anidulafungin to 0.11 and 0.13 CFU/ml, respectively. Fluconazole cured 2/12 cages (17%), amphotericin B and anidulafungin 1/12 cages (8%) and caspofungin 3/12 cages (25%).
  
  
  CONCLUSIONS
  Echinocandins showed superior activity against planktonic C. albicans. Caspofungin showed the highest cure rate of C. albicans biofilm. However, no antifungal exceeded 25% cure rate, demonstrating the difficulty of eradicating Candida biofilms from implants.
authors.affiliation: Charité - University Medicine Berlin, Center for Musculoskeletal Surgery, Berlin, Germany; Septic Surgical Unit, Department of Surgery and Anesthesiology, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Elena Maryka
authors.initials: EM
authors.lastname: Maiolo
authors.affiliation: Septic Surgical Unit, Department of Surgery and Anesthesiology, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Oliva
authors.affiliation: Septic Surgical Unit, Department of Surgery and Anesthesiology, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Ulrika
authors.initials: U
authors.lastname: Furustrand Tafin
authors.affiliation: Department of Hospital Pharmacy, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Nancy
authors.initials: N
authors.lastname: Perrotet
authors.affiliation: Septic Surgical Unit, Department of Surgery and Anesthesiology, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Olivier
authors.initials: O
authors.lastname: Borens
authors.affiliation: Charité - University Medicine Berlin, Center for Musculoskeletal Surgery, Berlin, Germany. Electronic address: andrej.trampuz@charite.de.
authors.forename: Andrej
authors.initials: A
authors.lastname: Trampuz
mesh_terms: D000818:Animals; D000935:Antifungal Agents / Q000008:administration & dosage* / Q000494:pharmacology; D018441:Biofilms / Q000187:drug effects*; D002176:Candida albicans / Q000187:drug effects* / Q000502:physiology; D002177:Candidiasis / Q000188:drug therapy* / Q000382:microbiology*; D015169:Colony Count, Microbial; D004195:Disease Models, Animal; D005547:Foreign Bodies / Q000150:complications*; D006168:Guinea Pigs; D007274:Injections, Intraperitoneal; D008297:Male; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents
keywords: Animal model; Antifungals; Biofilm; Candida spp.; Foreign-body infection