Adherence and Biofilm Formation in Candida albicans Strains Isolated from Different Infection Sites in Hospitalized Patients
Adherence of Candida albicans to the cellular and inert substratum contributes to its commensal status, but also plays an essential role in the development of fungal infections, particularly in hospitalized and immunodepressed patients. This study evaluated the adherence capacity and biofilm formation of 109 C. albicans strains isolated from upper respiratory tract secretions, wound secretions, urine culture, blood culture and stool culture taken from patients hospitalized for cardiovascular surgery. The strains were originally identified as C. albicans, based on their morphological characteristics and then confirmed by the Vitek II automatic system. All tested strains adhered to the cellular substratum, the isolates from stool culture, urine and thrush secretion exhibiting the most intensive adhesion capacity, the predominant adherence pattern being the aggregative one. Patient age and gender did not exhibit a significant influence on the adhesion process. The strains with the highest biofilm production capacity were the ones isolated from respiratory tract secretions and urine cultures. Statistically significant correlations could be established among a high number of yeast cells adhered to HeLa cells and i) the aggregative adherence pattern and ii) the moderate to high capacity to form biofilms on the inert substratum. These results could suggest the implication of common fungal structures in the colonization of inert and cellular substrata, while the elucidation of the molecular mechanisms involved in these processes could bring an important benefit to the appropriate management of fungal infections, depending on the isolation source.