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Journal of Clinical Microbiology, April 2002, p. 1244-1248, Vol. 40, No. 4
0095-1137/02/$04.00+0     DOI: 10.1128/JCM.40.4.1244-1248.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

Biofilm Production by Isolates of Candida Species Recovered from Nonneutropenic Patients: Comparison of Bloodstream Isolates with Isolates from Other Sources

Jong Hee Shin,1* Seung Jung Kee,1 Myung Geun Shin,2 Soo Hyun Kim,1 Dong Hyeon Shin,3 Sang Ku Lee,1 Soon Pal Suh,1 and Dong Wook Ryang1

Departments of Clinical Pathology,1 Internal Medicine, Chonnam National University Medical School ,3 Department of Clinical Pathology, Seonam University, College of Medicine, Gwangju, Korea2

Received 8 August 2001/ Returned for modification 22 November 2001/ Accepted 22 January 2002

Biofilm production has been implicated as a potential virulence factor of some Candida species responsible for catheter-related fungemia in patients receiving parenteral nutrition. We therefore compared clinical bloodstream isolates representing seven different Candida species to each other and to those from other anatomical sites for the capacity to form biofilms in glucose-containing medium. Potential associations between the capacity to form biofilms and the clinical characteristics of fungemia were also analyzed. Isolates included the following from nonneutropenic patients: 101 bloodstream isolates (35 C. parapsilosis, 30 C. albicans, 18 C. tropicalis, 8 C. glabrata, and 10 other Candida species isolates) and 259 clinical isolates from other body sites (116 C. albicans, 53 C. glabrata, 43 C. tropicalis, 17 C. parapsilosis, and 30 other Candida species isolates). Organisms were grown in Sabouraud dextrose broth (SDB) containing a final concentration of 8% glucose to induce biofilm formation, as published previously. Biofilm production was determined by both visual and spectrophotometric methods. In this medium, biofilm production by C. albicans isolates was significantly less frequent (8%) than that by non-C. albicans Candida species (61%; P < 0.0001). The overall proportion of non-C. albicans Candida species isolates from the blood that produced biofilms was significantly higher than that of non-C. albicans Candida isolates obtained from other sites (79% versus 52%; P = 0.0001). Bloodstream isolates of C. parapsilosis alone were significantly more likely to be biofilm positive than were C. parapsilosis isolates from other sites (86% versus 47%; P = 0.0032). Non-C. albicans Candida species, including C. parapsilosis, were more likely to be biofilm positive if isolates were derived from patients whose candidemia was central venous catheter (CVC) related (95%; P < 0.0001) and was associated with the use of total parenteral nutrition (TPN) (94%; P < 0.005). These data suggest that the capacity of Candida species isolates to produce biofilms in vitro in glucose-containing SDB may be a reflection of the pathogenic potential of these isolates to cause CVC-related fungemia in patients receiving TPN.

* Corresponding author. Mailing address: Department of Clinical Pathology, Chonnam National University Medical School, 8 Hakdong Dongku, Gwangju 501-757, South Korea. Phone: 82 (62) 220-5342. Fax: 82 (62) 224-2518. E-mail: shinjh{at}chonnam.ac.kr.

Journal of Clinical Microbiology, April 2002, p. 1244-1248, Vol. 40, No. 4
0095-1137/02/$04.00+0     DOI: 10.1128/JCM.40.4.1244-1248.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.



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