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Review of techniques for diagnosis of catheter-related Candida biofilm infections

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Abstract

Recent evidence shows that many hospital-acquired infections, including most device-associated infections, involve the persistence of sessile organisms in the form of biofilms that are attached to a device surface and encased in an extracellular matrix. The cells in this environment exhibit an altered phenotype with respect to antimicrobial resistance and thus are extraordinarily difficult to eradicate without device removal. Although a number of implantable and topical devices are at risk for Candida biofilm formation, this review focuses on the diagnosis of the most common of these infections, biofilm growth on the surface of central venous catheters and urinary catheters.

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References and Recommended Reading

  1. Kondori N, Edebo L, Mattsby-Baltzer I: Circulating beta (1–3) glucan and immunoglobulin G subclass antibodies to Candida albicans cell wall antigens in patients with systemic candidiasis. Clin Diagn Lab Immunol 2004, 11:344–350.

    Article  PubMed  CAS  Google Scholar 

  2. Pickering JW, Sant HW, Bowles CA, et al.: Evaluation of a (1→3)-beta-D-glucan assay for diagnosis of invasive fungal infections. J Clin Microbiol 2005, 43:5957–5962.

    Article  PubMed  CAS  Google Scholar 

  3. Pappas PG, Rex JH, Sobel JD, et al.: Guidelines for treatment of candidiasis. Clin Infect Dis 2004, 38:161–189.

    Article  PubMed  Google Scholar 

  4. Kojic EM, Darouiche RO: Candida infections of medical devices. Clin Microbiol Rev 2004, 17:255–267.

    Article  PubMed  Google Scholar 

  5. Safdar N, Fine JP, Maki DG: Meta-analysis: methods for diagnosing intravascular device-related bloodstream infection. Ann Intern Med 2005, 142:451–466.

    PubMed  Google Scholar 

  6. Pfaller MA, Diekema DJ: Epidemiology of invasive candidiasis: a persistent public health problem. Clin Microbiol Rev 2007, 20:133–163.

    Article  PubMed  CAS  Google Scholar 

  7. Wolf HH, Leithauser M, Maschmeyer G, et al.: Central venous catheter-related infections in hematology and oncology: Guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO). Ann Hematol 2008 (in press).

  8. Trautner BW, Darouiche RO: Role of biofilm in catheterassociated urinary tract infection. Am J Infect Control 2004, 32:177–183.

    Article  PubMed  Google Scholar 

  9. Raad I, Hanna H, Boktour M, et al.: Management of central venous catheters in patients with cancer and candidemia. Clin Infect Dis 2004, 38:1119–1127.

    Article  PubMed  Google Scholar 

  10. Garey KW, Rege M, Pai MP, et al.: Time to initiation of fluconazole therapy impacts mortality in patients with candidemia: a multi-institutional study. Clin Infect Dis 2006, 43:25–31.

    Article  PubMed  CAS  Google Scholar 

  11. Seifert H, Cornely O, Seggewiss K, et al.: Bloodstream infection in neutropenic cancer patients related to short-term nontunnelled catheters determined by quantitative blood cultures, differential time to positivity, and molecular epidemiological typing with pulsed-field gel electrophoresis. J Clin Microbiol 2003, 41:118–123.

    Article  PubMed  Google Scholar 

  12. Mermel LA, Farr BM, Sherertz RJ, et al.: Guidelines for the management of intravascular catheter-related infections. J Intraven Nurs 2001, 24:180–205.

    PubMed  CAS  Google Scholar 

  13. Blot F, Nitenberg G, Chachaty E, et al.: Diagnosis of catheter-related bacteraemia: a prospective comparison of the time to positivity of hub-blood versus peripheral-blood cultures. Lancet 1999, 354:1071–1077.

    Article  PubMed  CAS  Google Scholar 

  14. Flynn PM, Shenep JL, Barrett FF: Differential quantitation with a commercial blood culture tube for diagnosis of catheter-related infection. J Clin Microbiol 1988, 26:1045–1046.

    PubMed  CAS  Google Scholar 

  15. Raad I, Hanna H, Maki D: Intravascular catheter-related infections: advances in diagnosis, prevention, and management. Lancet Infect Dis 2007, 7:645–657.

    Article  PubMed  Google Scholar 

  16. Maki DG, Weise CE, Sarafin HW: A semiquantitative culture method for identifying intravenous-catheter-related infection. N Engl J Med 1977, 296:1305–1309.

    PubMed  CAS  Google Scholar 

  17. Raad I, Costerton W, Sabharwal U, et al.: Ultrastructural analysis of indwelling vascular catheters: a quantitative relationship between luminal colonization and duration of placement. J Infect Dis 1993, 168:400–407.

    PubMed  CAS  Google Scholar 

  18. Raad II, Sabbagh MF, Rand KH, et al.: Quantitative tip culture methods and the diagnosis of central venous catheter-related infections. Diagn Microbiol Infect Disease 1992, 15:13–20.

    Article  CAS  Google Scholar 

  19. Kobayashi N, Bauer TW, Tuohy MJ, et al.: Brief ultrasonication improves detection of biofilm-formative bacteria around a metal implant. Clin Orthopaed Related Res 2007, 457:210–213.

    Google Scholar 

  20. Zufferey J, Rime B, Francioli P, et al.: Simple method for rapid diagnosis of catheter-associated infection by direct acridine orange staining of catheter tips. J Clin Microbiol 1988, 26:175–177.

    PubMed  CAS  Google Scholar 

  21. Cooper GL, Hopkins CC: Rapid diagnosis of intravascular catheter-associated infection by direct Gram staining of catheter segments. N Engl J Med 1985, 312:1142–1147.

    Article  PubMed  CAS  Google Scholar 

  22. Passerini L, Lam K, Costerton JW, et al.: Biofilms on indwelling vascular catheters. Crit Care Med 1992, 20:665–673.

    Article  PubMed  CAS  Google Scholar 

  23. Sbarbati A, Fanos V, Bernardi P, et al.: Rapid diagnosis of fungal infection of intravascular catheters in newborns by scanning electron microscopy. Scanning 2001, 23:376–378.

    PubMed  CAS  Google Scholar 

  24. Chatzinikolaou I, Hanna H, Hachem R, et al.: Differential quantitative blood cultures for the diagnosis of catheter-related bloodstream infections associated with short-and long-term catheters: a prospective study. Diagn Microbiol Infect Dis 2004, 50:167–172.

    Article  PubMed  Google Scholar 

  25. Capdevila JA, Planes AM, Palomar M, et al.: Value of differential quantitative blood cultures in the diagnosis of catheter-related sepsis. Eur J Clin Microbiol Infect Dis 1992, 11:403–407.

    Article  PubMed  CAS  Google Scholar 

  26. Douard MC, Clementi E, Arlet G, et al.: Negative cathetertip culture and diagnosis of catheter-related bacteremia. Nutrition 1994, 10:397–404.

    PubMed  CAS  Google Scholar 

  27. Telenti A, Steckelberg JM, Stockman L, et al.: Quantitative blood cultures in candidemia. Mayo Clin Proc 1991, 66:1120–1123.

    PubMed  CAS  Google Scholar 

  28. Catton JA, Dobbins BM, Kite P, et al.: In situ diagnosis of intravascular catheter-related bloodstream infection: a comparison of quantitative culture, differential time to positivity, and endoluminal brushing. Crit Care Med 2005, 33:787–791.

    Article  PubMed  Google Scholar 

  29. Raad I, Hanna HA, Alakech B, et al.: Differential time to positivity: a useful method for diagnosing catheter-related bloodstream infections. Ann Intern Med 2004, 140:18–25.

    PubMed  Google Scholar 

  30. Malgrange VB, Escande MC, Theobald S: Validity of earlier positivity of central venous blood cultures in comparison with peripheral blood cultures for diagnosing catheter-related bacteremia in cancer patients. J Clin Microbiol 2001, 39:274–278.

    Article  PubMed  CAS  Google Scholar 

  31. Abdelkefi A, Achour W, Ben Othman T, et al.: Difference in time to positivity is useful for the diagnosis of catheter-related bloodstream infection in hematopoietic stem cell transplant recipients. Bone Marrow Transplant 2005, 35:397–401.

    Article  PubMed  CAS  Google Scholar 

  32. Gaur AH, Flynn PM, Giannini MA, et al.: Difference in time to detection: a simple method to differentiate catheter-related from non-catheter-related bloodstream infection in immunocompromised pediatric patients. Clin Infect Dis 2003, 37:469–475.

    Article  PubMed  Google Scholar 

  33. Rijnders BJ, Verwaest C, Peetermans WE, et al.: Difference in time to positivity of hub-blood versus nonhub-blood cultures is not useful for the diagnosis of catheter-related bloodstream infection in critically ill patients. Crit Care Med 2001, 29:1399–1403.

    Article  PubMed  CAS  Google Scholar 

  34. Bouza E, Alvarado N, Alcala L, et al.: A randomized and prospective study of 3 procedures for the diagnosis of catheter-related bloodstream infection without catheter withdrawal. Clin Infect Dis 2007, 44:820–826.

    Article  PubMed  Google Scholar 

  35. Ben-Ami R, Weinberger M, Orni-Wasserlauff R, et al.: Time to blood culture positivity as a marker for catheter-related candidemia. J Clin Microbiol 2008, 46:2222–2226.

    Article  PubMed  Google Scholar 

  36. Kite P, Dobbins BM, Wilcox MH, et al.: Evaluation of a novel endoluminal brush method for in situ diagnosis of catheter related sepsis. J Clin Pathol 1997, 50:278–282.

    Article  PubMed  CAS  Google Scholar 

  37. Dobbins BM, Kite P, Catton JA, et al.: In situ endoluminal brushing: a safe technique for the diagnosis of catheter-related bloodstream infection. J Hosp Infect 2004, 58:233–237.

    Article  PubMed  CAS  Google Scholar 

  38. Kite P, Dobbins BM, Wilcox MH, et al.: Rapid diagnosis of central-venous-catheter-related bloodstream infection without catheter removal. Lancet 1999, 354:1504–1507.

    Article  PubMed  CAS  Google Scholar 

  39. Farina C, Bonanomi E, Benetti G, et al.: Acridine orange leukocyte cytospin test for central venous catheter—related bloodstream infection: a pediatric experience. Diagn Microbiol Infect Disease 2005, 52:337–339.

    Article  Google Scholar 

  40. Krause R, Auner HW, Gorkiewicz G, et al.: Detection of catheter-related bloodstream infections by the differential-time-to-positivity method and Gram stain-acridine orange leukocyte cytospin test in neutropenic patients after hematopoietic stem cell transplantation. J Clin Microbiol 2004, 42:4835–4837.

    Article  PubMed  CAS  Google Scholar 

  41. Abdelkefi A, Achour W, Torjman L, et al.: Detection of catheter-related bloodstream infections by the Gram stainacridine orange leukocyte cytospin test in hematopoietic stem cell transplant recipients. Bone Marrow Transplant 2006, 37:595–599.

    Article  PubMed  CAS  Google Scholar 

  42. Kauffman CA: Candiduria. Clin Infect Dis 2005, 41(Suppl 6):S371–S376.

    Article  PubMed  Google Scholar 

  43. Tambyah PA: Catheter-associated urinary tract infections: diagnosis and prophylaxis. Int J Antimicrob Agent 2004, 24(Suppl 1):S44–S48.

    Article  CAS  Google Scholar 

  44. Stickler DJ, Jones SM, Adusei GO, et al.: A clinical assessment of the performance of a sensor to detect crystalline biofilm formation on indwelling bladder catheters. BJU Int 2006, 98:1244–1249.

    Article  PubMed  Google Scholar 

  45. Yeo SF, Wong B: Current status of nonculture methods for diagnosis of invasive fungal infections. Clin Microbiol Rev 2002, 15:465–484.

    Article  PubMed  Google Scholar 

  46. Philip A, Odabasi Z, Matiuzzi G, et al.: Syscan3, a kit for detection of anti-Candida antibodies for diagnosis of invasive candidiasis. J Clin Microbiol 2005, 43:4834–4835.

    Article  PubMed  CAS  Google Scholar 

  47. Alam FF, Mustafa AS, Khan ZU: Comparative evaluation of (1, 3)-beta-D-glucan, mannan and anti-mannan antibodies, and Candida species-specific snPCR in patients with candidemia. BMC Infect Dis 2007, 7:103.

    Article  PubMed  CAS  Google Scholar 

  48. Mitsutake K, Miyazaki T, Tashiro T, et al.: Enolase antigen, mannan antigen, Cand-Tec antigen, and beta-glucan in patients with candidemia. J Clin Microbiol 1996, 34:1918–1921.

    PubMed  CAS  Google Scholar 

  49. Kohno S, Mitsutake K, Maesaki S, et al.: An evaluation of serodiagnostic tests in patients with candidemia: beta-glucan, mannan, candida antigen by Cand-Tec and D-arabinitol. Microbiol Immunol 1993, 37:207–212.

    PubMed  CAS  Google Scholar 

  50. Yeo SF, Huie S, Sofair AN, et al.: Measurement of serum D-arabinitol/creatinine ratios for initial diagnosis and for predicting outcome in an unselected, population-based sample of patients with Candida fungemia. J Clin Microbiol 2006, 44:3894–3899.

    Article  PubMed  CAS  Google Scholar 

  51. Fujita S, Takamura T, Nagahara M, et al.: Evaluation of a newly developed down-flow immunoassay for detection of serum mannan antigens in patients with candidaemia. J Med Microbiol 2006, 55:537–543.

    Article  PubMed  CAS  Google Scholar 

  52. Hui M, Cheung SW, Chin ML, et al.: Development and application of a rapid diagnostic method for invasive Candidiasis by the detection of D-/L-arabinitol using gas chromatography/mass spectrometry. Diagn Microbiol Infect Dis 2004, 49:117–123.

    Article  PubMed  CAS  Google Scholar 

  53. Eisen DP, Bartley PB, Hope W, et al.: Urine D-arabinitol/Larabinitol ratio in diagnosing Candida infection in patients with haematological malignancy and HIV infection. Diagn Microbiol Infect Dis 2002, 42:39–42.

    Article  PubMed  CAS  Google Scholar 

  54. Oliveri S, Trovato L, Betta P, et al.: Experience with the Platelia Candida ELISA for the diagnosis of invasive candidosis in neonatal patients. Clin Microbiol Infect 2008, 14:391–393.

    Article  PubMed  CAS  Google Scholar 

  55. Pazos C, Moragues MD, Quindos G, et al.: Diagnostic potential of (1,3)-beta-D-glucan and anti-Candida albicans germ tube antibodies for the diagnosis and therapeutic monitoring of invasive candidiasis in neutropenic adult patients. Rev Iberoam Micol 2006, 23:209–215.

    Article  PubMed  Google Scholar 

  56. Odabasi Z, Mattiuzzi G, Estey E, et al.: Beta-D-glucan as a diagnostic adjunct for invasive fungal infections: validation, cutoff development, and performance in patients with acute myelogenous leukemia and myelodysplastic syndrome. Clin Infect Dis 2004, 39:199–205.

    Article  PubMed  CAS  Google Scholar 

  57. Miyazaki T, Kohno S, Mitsutake K, et al.: Plasma (1—>3)-beta-D-glucan and fungal antigenemia in patients with candidemia, aspergillosis, and cryptococcosis. J Clin Microbiol 1995, 33:3115–3118.

    PubMed  CAS  Google Scholar 

  58. Ahmad S, Khan Z, Mustafa AS, et al.: Seminested PCR for diagnosis of candidemia: comparison with culture, antigen detection, and biochemical methods for species identification. J Clin Microbiol 2002, 40:2483–2489.

    Article  PubMed  CAS  Google Scholar 

  59. McMullan R, Metwally L, Coyle PV, et al.: A prospective clinical trial of a real-time polymerase chain reaction assay for the diagnosis of candidemia in nonneutropenic, critically ill adults. Clin Infect Dis 2008, 46:890–896.

    Article  PubMed  CAS  Google Scholar 

  60. Dunyach C, Bertout S, Phelipeau C, et al.: Detection and identification of Candida spp. in human serum by LightCycler real-time polymerase chain reaction. Diagn Microbiol Infect Dis 2008, 60:263–271.

    Article  PubMed  CAS  Google Scholar 

  61. Spiess B, Seifarth W, Hummel M, et al.: DNA microarraybased detection and identification of fungal pathogens in clinical samples from neutropenic patients. J Clin Microbiol 2007, 45:3743–3753.

    Article  PubMed  CAS  Google Scholar 

  62. Maaroufi Y, Heymans C, De Bruyne JM, et al.: Rapid detection of Candida albicans in clinical blood samples by using a TaqMan-based PCR assay. J Clin Microbiol 2003, 41:3293–3298.

    Article  PubMed  CAS  Google Scholar 

  63. Nett J, Lincoln L, Marchillo K, et al.: Beta-1,3 glucan as a test for central venous catheter biofilm infection. J Infect Dis 2007, 195:1705–1712.

    Article  PubMed  CAS  Google Scholar 

  64. Nett J, Lincoln L, Marchillo K, et al.: Putative role of beta-1,3 glucans in Candida albicans biofilm resistance. Antimicrob Agents Chemother 2007, 51:510–520.

    Article  PubMed  CAS  Google Scholar 

  65. Miceli MH, Jones Jackson LB, Walker RC, et al.: Diagnosis of infection of implantable central venous catheters by [18F]. fluorodeoxyglucose positron emission tomography. Nucl Med Commun 2004, 25:813–818.

    Article  PubMed  Google Scholar 

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Nett, J.E., Andes, D. Review of techniques for diagnosis of catheter-related Candida biofilm infections. Curr Fungal Infect Rep 2, 237–243 (2008). https://doi.org/10.1007/s12281-008-0035-x

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