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Official websites use. Share sensitive information only on official, secure websites. Corresponding author. Phone: Fax: E-mail: carolina. Wild-type and efflux pump-deficient cells of Candida albicans adhering to silicone were compared with planktonic cells by flow cytometry for their relative resistance to fluconazole FCZ. Flow cytometry data on cells carrying a fusion of green fluorescent protein to efflux pump promoters confirmed that enhanced tolerance of attached cells to FCZ was due in part to increased expression of CaMDR1 and CDR1 promoters.
Within 2 h of their attachment to silicone, the adherent cells demonstrated levels of FCZ tolerance shown by cells from h biofilms. Following their mechanical detachment, this subset of cells retained a four- to eightfold increase in tolerance compared with the tolerance of planktonic cells for at least two generations. Enhanced efflux pump tolerance to FCZ appeared to be induced within the initial 15 min of attachment in a subset of cells that were firmly attached to the substrata.
Candida albicans is an adventitious pathogen commonly found as a commensal in healthy individuals Medical implants provide adequate substrata for yeast attachment and biofilm formation and are associated with a high incidence of systemic candidiasis 3 , 5 , 7 , Chandra et al.
The progression in drug resistance was associated with a concomitant increase in metabolic activity tetrazolium reduction of the developing biofilm. Biofilm structure, particularly on polymethylmethacrylate, was biphasic, being composed of an adherent blastospore layer covered by more sparse hyphal elements. In the later biofilm stages on silicone elastomer disks, the hyphal elements pervaded the matrix. Similarly, Kalya and Ahearn 15 reported higher MICs and minimal fungicidal concentrations of amphotericin B, miconazole, ketoconazole, fluconazole FCZ , and itraconazole for cells of C.
The protective nature of the biofilm exopolymeric matrix has been proposed as a mechanism for biofilm resistance 2 ; nevertheless, cells of Candida spp. FCZ has been the antifungal agent of choice for the treatment of mucosal and systemic C. The wide use of FCZ for the treatment of C. The most prevalent group of resistance mechanisms found in C. Most studies of FCZ resistance have involved planktonic cells. Studies of fungal biofilms usually involve mature biofilms, and sparse information is available on the physiology and phenotype of fungal cells in the initial stages of biofilm formation.