Cited by 237Antifungal resistance and susceptibilityFungal and yeast genetics researchBacterial biofilms and quorum sensing

Patients with Long-Term Oral Carriage Harbor High-Persister Mutants of Candida albicans

Open access
LaFleur, Michael D., Qi, Qingguo, Lewis, Kim·2010·Antimicrobial Agents and Chemotherapy

Abstract

Fungal biofilms produce a small number of persister cells which can tolerate high concentrations of fungicidal agents. Persisters form upon attachment to a surface, an important step in the pathogenesis of Candida strains. The periodic application of antimicrobial agents may select for strains with increased levels of persister cells. In order to test this possibility, 150 isolates of Candida albicans and C. glabrata were obtained from cancer patients who were at high risk for the development of oral candidiasis and who had been treated with topical chlorhexidine once a day. Persister levels were measured by exposing biofilms growing in the wells of microtiter plates to high concentrations of amphotericin B and plating for survivors. The persister levels of the isolates varied from 0.2 to 9%, and strains isolated from patients with long-term carriage had high levels of persisters. High-persister strains were isolated from every patient with Candida carriage of more than 8 consecutive weeks but from no patients with transient carriage. All of the high-persister isolates had an amphotericin B MIC that was the same as that for the wild type, indicating that these strains were drug-tolerant rather than drug-resistant mutants. Biofilms of the majority of high-persister strains also showed an increased tolerance to chlorhexidine and had the same MIC for this antimicrobial as the wild type. This study suggests that persister cells are clinically relevant, and antimicrobial therapy selects for high-persister strains in vivo. The drug tolerance of persisters may be a critical but overlooked component responsible for antimicrobial drug failure and relapsing infections.

Integrity signals

Registry

Crossref · 10.1128/aac.00860-09

Cites

32 of 32 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

We couldn’t retrieve this paper’s full text, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Isolates from cancer patients with long-term C. albicans oral colonization displayed significantly higher levels of persistence compared to those from short-term carriers.

    “LaFleur and colleagues reported that isolates from cancer patients with long-term C. albicans oral colonization displayed significantly higher levels of persistence compared to those from short-term carriers [13].”

    From Antifungal persistence: Clinical relevance and mechanisms (2025) · cites this paper as [13]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Authors
LaFleur, M. D., Qi, Q., & Lewis, K.
Affiliations
  • Northeastern University (US)
  • Antimicrobial Discovery Center and Department of Biology, Northeastern University, 360 Huntington Avenue, Boston, Massachusetts 02115
Corresponding author
Lewis, Kim
Venue
Antimicrobial Agents and Chemotherapy
Published
2010-01
Volume
54
Issue
1
Pages
39-44
ISSN
  • 0066-4804 (ISSN-L)
  • 1098-6596
OpenAlex
W2115712103
Cited by
237
References
32
Citations by year
2026: 4 · 2025: 7 · 2024: 14 · 2023: 9 · 2022: 16 · 2021: 21 · 2020: 18 · 2019: 16 · 2018: 9 · 2017: 15 · 2016: 21 · 2015: 24 · 2014: 12 · 2013: 24 · 2012: 17
FWCI
6.21
Type
journal article
Language
en
Open access
Locations
  • Antimicrobial Agents and Chemotherapy (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Natural Science Foundation of China (30400498)
  • National Institute of General Medical Sciences (R01GM061162)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Fungal and yeast genetics research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bacterial biofilms and quorum sensing
Keywords
Candida albicans, Candida glabrata, persister cells, fungal biofilms, oral candidiasis, drug tolerance, antimicrobial selection, cancer patients, infection relapse
MeSH terms
Adult, Aged, Candida albicans, Candidiasis, Carrier State, Chlorhexidine, Dose-Response Relationship, Drug, Female, Genes, Fungal, Humans, Male, Microbial Sensitivity Tests, Middle Aged, Mouth, Mouthwashes, Mutation, Neoplasms, Biofilms, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review