ABSTRACT
Candida albicans, C. glabrata, C. parapsilosis, and C. tropicalis are able to form biofilms on virtually any biomaterial implanted in a human host. Biofilms are a primary cause of mortality in immunocompromised and hospitalized patients, as they cause recurrent and invasive candidiasis, which is difficult to eradicate. This is due to the fact that the biofilm cells show high resistance to antifungal treatments and the host defense mechanisms, and exhibit an excellent ability to adhere to biomaterials. Elucidation of the mechanisms of antifungal resistance in Candida biofilms is of unquestionable importance; therefore, this review analyzes both the chemical composition of biomaterials used to fabricate the medical devices, as well as the Candida genes and proteins that confer drug resistance.
Subject(s)
Antifungal Agents/pharmacology , Biocompatible Materials/pharmacology , Biofilms , Candida/drug effects , Candida/growth & development , Antifungal Agents/chemistry , Biocompatible Materials/chemistry , Candida/genetics , Candida/physiology , Candidiasis, Invasive/epidemiology , Candidiasis, Invasive/microbiology , Cell Adhesion , Cell Membrane/metabolism , Drug Resistance, Fungal , Fluconazole/pharmacology , Fungal Proteins/genetics , Fungal Proteins/metabolism , Genes, Fungal , Humans , Membrane Transport Proteins/genetics , Membrane Transport Proteins/metabolism , Prostheses and Implants/microbiologyABSTRACT
94 patients with renal allograft from a living related donor were studied in three different groups: 1 Patients with identical histocompatibility (n-32), treated with prednisone (PDN) and azathioprine (Aza); 2 Haploidentical patients (34) who received PDN, Aza and cyclosporine (CsA); 3 Haploidentical patients (28) who previous to the transplantation received specific donor blood transfusions and Aza/PDN after the transplantation. The survival for the patient and the graft after five years was 100% and 96% in group 1; 97% y 89% in group 2 and 82% and 72% in group 3. Five patients in group 1 received CsA also. There was no mortality in group 1, while there were one death in group 2 and two more in group 3. There was no significant difference between CsA and Blood transfusions in the patients and grafts survival.
