Candida albicans Airway Colonization Facilitates Subsequent Acinetobacter baumannii Pneumonia in a Rat Model
The objective of the study was to determine the effects ofCandida albicansrespiratory tract colonization onAcinetobacter baumanniipneumonia in a rat model. Rats were colonized withC. albicansby instillation of 3 × 106CFU into their airways, while sterile saline was instilled in the control group. The colonized rats were further divided into two groups: treated with amphotericin B or not. The rats were subsequently infected withA. baumannii(108CFU by tracheobronchial instillation).A. baumanniilung CFU counts, cytokine lung levels, and rates ofA. baumanniipneumonia were compared between groups.In vitroexpression ofA. baumanniivirulence genes was measured by reverse transcription (RT)-PCR after 24-hour incubation withC. albicansor with Mueller-Hinton (MH) broth alone. Rats withCandidacolonization developedA. baumanniipneumonia more frequently and had higherA. baumanniiCFU burdens and heavier lungs than controls. AfterA. baumanniiinfection, lung interleukin 17 (IL-17) concentrations were lower and gamma interferon (IFN-γ) concentrations were higher inCandida-colonized rats than in controls.Candida-colonized rats treated with amphotericin B had a decreased rate ofA. baumanniipneumonia and lower IFN-γ levels but higher IL-17 levels than untreated rats. Expression ofbasC,barB,bauA,ptk,plc2, andpld2was induced while expression ofompAandabaIwas suppressed inA. baumanniicultured in the presence ofC. albicans.C. albicanscolonization facilitated the development ofA. baumanniipneumonia in a rat model. AmongCandida-colonized rats, antifungal treatment lowered the incidence ofA. baumanniipneumonia. These findings could be due to modification of the host immune response and/or expression ofA. baumanniivirulence genes byCandidaspp.