However, in many critically ill patients with biomaterial- or catheter-related Candida infection, removal and/or replacement of the infected device is difficult or high risk. Biofilm formation represents a major challenge for the treatment of biomaterial-related Candida infections. Despite advances in antifungal therapy, the high attributable mortality rate due to Candida infections has not clearly improved in the last 2 decades.īiofilm formation is a key pathogenic attribute of Candida albicans that enhances its ability to adhere to surfaces and cause disease in humans ( 11). Candida species are now the fourth most common cause of hospital-acquired bloodstream infections. Infections and thromboses are the most common complications associated with CVCs, resulting in increased mortality rates and cost of care. albicans biofilms is warranted.Ĭentral venous catheters (CVCs) are commonly used, particularly in critically ill patients. Investigation of high-dose heparin-based strategies (e.g., heparin locks) in combination with traditional antifungal agents for the treatment and/or prevention of C. albicans mature biofilms, formation of biofilms, and planktonic cells. These data indicated that HP, MP, PP, and Pure-H have in vitro antifungal activity against C. When tested against planktonic cells, each compound inhibited growth in a dose-dependent manner. A complete inhibition of biofilm formation was observed with HP at 5,000 U/ml and higher. Maximal efficacy against the mature biofilm was observed with HP (up to 90%) compared to the individual compounds ( P < 0.0001). Pure-H, MP, and PP caused up to 75, 85, and 60% reductions of metabolic activity of the mature preformed C.
The metabolic activity of the mature biofilm after treatment was assessed using XTT reduction and microscopy. Because HP contains two preservatives, methyl paraben (MP) and propyl paraben (PP), these compounds and heparin sodium without preservatives (Pure-H) were also tested individually. Therefore, we sought to determine the in vitro effect of a heparin sodium preparation (HP) on biofilms and planktonic cells of C. However, the effects of heparin on Candida albicans biofilms and planktonic cells have not been previously studied. Suggested strategies for prevention and management of these complications include the use of heparin-coated catheters, heparin locks, and antimicrobial lock therapy. Infections and thromboses are the most common complications associated with central venous catheters.
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