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

The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index.

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
DOI 10.1128/aac.00860-09PMC PMC2798516
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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.

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  1. Ghannoum, M. A., and S. S. Radwan. 1990. The adherence process, p. 106-154. InCandida adherence to epithelial cells. CRC Press, Boca Raton, FL.

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Metadata

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
ORCID
Lewis, Kim
Venue
Antimicrobial Agents and Chemotherapy
Publisher
American Society for Microbiology
Published
2010-01
Volume
54
Issue
1
Pages
39-44
ISSN
  • 0066-4804 (ISSN-L)
  • 1098-6596
DOI
10.1128/aac.00860-09
PMC
PMC2798516
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
Licence
journals.asm.org/non-commercial-tdm-license (tdm)
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

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