ANIDULAFUNGIN AND HUMAN MONOCYTES REDUCE Candida spp. BIOFILM WITH DIFFERENT FUNGAL BIOMASS

ABSTRACT Introduction Candida spp. bloodstream infection is a frequent form of mycosis with high mortality rates. Biofilm formation is a potent virulence factor for Candida albicans and Candida parapsilosis , that confers significant resistance to antifungal agents and to the innate immune response. Echinocandins such as anidulafungin are new drugs that broaden the available therapeutic arsenal for invasive fungal infection treatment. Here we evaluated the effect of anidulafungin, human-Monocytes and combined treatment on mature biofilms of clinical isolates of Candida albicans and Candida parapsilosis with different intrinsic capacity to form biofilm, and on biofilm with low (LB) and high biomass (HB). Methods Yeasts from blood isolates were molecularly identified. Lipase and acid aspartic protease production, adhesion capacity, and ability to form biofilm were evaluated; strains were classified as Weak, Moderate or Strong biofilm forming capacity. Mature biofilm with LB and HB were incubated with anidulafungin, THP-1 cell alone or exposed to both, for 22 h. Fungal damage induced by antifungal agents and/or monocytes was determined by XTT[2,3-bis(2-methoxy-4-nitro-5-sulfophenyl) 2H-tetrazolium-5-carboxanilide] metabolic assay. Results Our results showed that anidulafungin alone could be effective to reduce mature biofilms with LB of most of the C. parapsilosis sensu stricto isolates, independent of intrinsic BF capacity of the strain. Anidulafungin in combination with human-Monocytes was effective in biofilm with LB of C. albicans and C. parapsilosis sensu stricto clinical isolates. Conclusions The effectiveness of ANF treatment in biofilm with LB seems to be species specific, since the antifungal agent and monocytes exhibits synergistic activity on C. albicans and C. parapsilosis sensu stricto biofilm.