Echinocandins in the control of infections associated to polymicrobial biofilms of Candida spp. and bacteria such as Stapholococcus aureus and Pseudomonas aeruginosa

Abstract

Fungi and bacteria often coexist in polymicrobial biofilms and represent a clinically relevant health problem. Among fungal species Candida albicans is the most frequent in the hospital setting and it is estimated that 27% of C. albicans bloodstream infections (BIs) are polymicrobial, wherein Stapholococcus aureus and Pseudomonas aeruginosa sre the common bacterial species isolated together with C albicans. In Brazil, the mortality rate of patients diagnosed with polymicrobial BIs reaches 45.7%. The treatment of polymicrobial infections is difficult to diagnose and has implications for the selection of antimicrobial therapy and the expected response to treatment, especially when it involves the presence of multiresistant microorganisms and the formation of biofilms. Biofilm formation is an important virulence factor, as it is generally related to the chronicity of infection and increased antimicrobial tolerance. Polymers of ² (1,3) D-glucan, component of the fungal cell wall, and the major component of the extracellular matrix of C. albicans biofilms; is also expressed as periplasmic glucan of P. aeruginosa and extracellular matrix component of S. aureus and P. aeruginosa biofilms. Strategies such as the use of echinocandins, inhibitors of ² (1,3) D-glucan synthesis, in the treatment of polymicrobial infections of C. albicans and P. aeruginosa / S. aureus can improve the outcomes of these infections, reduce side effects and costs, and is an innovative choice for the treatment of mixed infection. In this context, we aim to evaluate the effect of echinocandins on monomicrobial and mixed biofilms of C. albicans and bacteria such as P. aeruginosa and S. aureus. (AU)