Synergistic effect of chlorhexidine and azoles on candida biofilm on titanium surface.
Anti-biofilm
Candida
Chlorhexidine
Fluconazole
Orthopedic implants
Journal
Journal de mycologie medicale
ISSN: 1773-0449
Titre abrégé: J Mycol Med
Pays: France
ID NLM: 9425651
Informations de publication
Date de publication:
Nov 2023
Nov 2023
Historique:
received:
06
08
2022
revised:
06
05
2023
accepted:
21
07
2023
medline:
13
11
2023
pubmed:
25
8
2023
entrez:
24
8
2023
Statut:
ppublish
Résumé
Candida infections of orthopedic implants are one of the most detrimental orthopedic implant-related complications with unsuccessful treatment and a poor prognosis. Most orthopedic Candida infections form biofilms and have resistance to the commonly used antifungal agents. This study aimed to develop a novel combination of normally prescribed drugs against Candida biofilm on orthopedic implants. We cultured 26 clinical isolates of Candida strains to form biofilm without titanium sheets or on titanium sheets, which are the most commonly used materials for permanent or orthopedic implants. The checkerboard method was used to evaluate the synergistic effects of chlorhexidine (CHL) and azoles on these Candida biofilms. For the evaluation of synergistic effects, we constructed the cell viability assay by fluorescence staining and CFU reduction hot map of Candida. Twenty-six clinical isolates of Candida strains formed biofilm in 96-well plates without titanium sheets, and we selected 9 of them to form biofilm on titanium sheets in 24-well plates. In Candida biofilm formed in 96-wells, the synergistic rates of CHL with fluconazole, itraconazole, and voriconazole were 61% (16/26), 65% (17/26), and 23% (6/26), respectively. When compared to the blank control group, CHL monotherapy significantly inhibited biofilm formation on titanium sheets (P < 0.05). We demonstrated 100% synergistic rates of the CHL and fluconazole combination against Candida biofilm formation on titanium sheets, and the minimum inhibitory concentration of CHL and FLU decreased four- to eight-fold. We concluded that CHL combined with azoles inhibited the Candida biofilm formation 96-wells or on titanium sheets and has the potential to control the infections of orthopedic implants.
Sections du résumé
BACKGROUND
BACKGROUND
Candida infections of orthopedic implants are one of the most detrimental orthopedic implant-related complications with unsuccessful treatment and a poor prognosis. Most orthopedic Candida infections form biofilms and have resistance to the commonly used antifungal agents. This study aimed to develop a novel combination of normally prescribed drugs against Candida biofilm on orthopedic implants.
METHODS
METHODS
We cultured 26 clinical isolates of Candida strains to form biofilm without titanium sheets or on titanium sheets, which are the most commonly used materials for permanent or orthopedic implants. The checkerboard method was used to evaluate the synergistic effects of chlorhexidine (CHL) and azoles on these Candida biofilms. For the evaluation of synergistic effects, we constructed the cell viability assay by fluorescence staining and CFU reduction hot map of Candida.
RESULTS
RESULTS
Twenty-six clinical isolates of Candida strains formed biofilm in 96-well plates without titanium sheets, and we selected 9 of them to form biofilm on titanium sheets in 24-well plates. In Candida biofilm formed in 96-wells, the synergistic rates of CHL with fluconazole, itraconazole, and voriconazole were 61% (16/26), 65% (17/26), and 23% (6/26), respectively. When compared to the blank control group, CHL monotherapy significantly inhibited biofilm formation on titanium sheets (P < 0.05). We demonstrated 100% synergistic rates of the CHL and fluconazole combination against Candida biofilm formation on titanium sheets, and the minimum inhibitory concentration of CHL and FLU decreased four- to eight-fold.
CONCLUSIONS
CONCLUSIONS
We concluded that CHL combined with azoles inhibited the Candida biofilm formation 96-wells or on titanium sheets and has the potential to control the infections of orthopedic implants.
Identifiants
pubmed: 37619456
pii: S1156-5233(23)00061-6
doi: 10.1016/j.mycmed.2023.101417
pii:
doi:
Substances chimiques
Fluconazole
8VZV102JFY
Azoles
0
Chlorhexidine
R4KO0DY52L
Titanium
D1JT611TNE
Antifungal Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
101417Informations de copyright
Copyright © 2023. Published by Elsevier Masson SAS.
Déclaration de conflit d'intérêts
Declaration of Competing Interest We declare no conflicts of interest.