Efficacy of anidulafungin in the treatment of experimental Candida parapsilosis catheter infection using an antifungal-lock technique
Basas J (1), Morer A (1), Ratia C (1), Martín MT (2), Del Pozo JL (3), Gomis X (1), Rojo-Molinero E (4), Torrents E (5), Almirante B (1), Gavaldà J (6).
(1) Infectious Diseases Research Laboratory, Vall d'Hebron Research Institute, VHIR, Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
(2) Microbiology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
(3) Infectious Disease Division, Laboratory of Microbial Biofilms, Clínica Universidad de Navarra, Navarra, Spain.
(4) Servicio de Microbiología and Unidad de Investigación, Hospital Universitario Son Espases, Instituto de Investigación Sanitaria de Palma (IdISPa), Palma de Mallorca, Spain.
(5) Institute for Bioengineering of Catalonia (IBEC), Bacterial Infections and Antimicrobial Therapies, Barcelona, Spain.
(6) Infectious Diseases Research Laboratory, Vall d'Hebron Research Institute, VHIR, Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
The effectiveness of anidulafungin versus liposomal amphotericin B (LAmB) for treating experimental Candida parapsilosis catheter-related infection by an antifungal-lock technique was assessed.
Two clinical strains of C. parapsilosis (CP12 and CP54) were studied. In vitro studies were used to determine the biofilm MICs (MBIC50 and MBIC90) by XTT reduction assay and LIVE/DEAD biofilm viability for anidulafungin and LAmB on 96-well microtitre polystyrene plates and silicone discs.
An intravenous catheter was implanted in New Zealand white rabbits. Infection was induced by locking the catheter for 48 h with the inoculum. The 48 h antifungal-lock treatment groups included control, 3.3 mg/mL anidulafungin and 5.5 mg/mL LAmB.
Anidulafungin showed better in vitro activity than LAmB against C. parapsilosis growing in biofilm on silicone discs. MBIC90 of LAmB: CP12, >1024 mg/L; CP54, >1024 mg/L. MBIC90 of anidulafungin: CP12, 1 mg/L; CP54, 1 mg/L (P ≤ 0.05). Moreover, only anidulafungin (1 mg/L) showed >90% non-viable cells in the LIVE/DEAD biofilm viability assay on silicone discs.
No differences were observed between the in vitro susceptibility of anidulafungin or LAmB when 96-well plates were used. Anidulafungin achieved significant reductions relative to LAmB in log10 cfu recovered from the catheter tips for both strains (P ≤ 0.05). Only anidulafungin achieved negative catheter tip cultures (CP12 63%, CP54 73%, P ≤ 0.05).
Silicone discs may be a more reliable substrate for the study of in vitro biofilm susceptibility of C. parapsilosis. Anidulafungin-lock therapy showed the highest activity for experimental catheter-related infection with C. parapsilosis.
CITATION J Antimicrob Chemother. 2016 Jul 4. pii: dkw251