Assessing the bioactive profile of anti-fungal loaded calcium sulfate against fungal biofilms

Butcher,C. M. Brown, L. J. Hansom, D. Wilson-Van Os,R. Delury, C. Laycock, A. P. Ramage, G. Antimicrob Agents Chemother. 2021 May 18;65(6):e02551-20. doi: 10.1128/AAC.02551-20. Print 2021 May 18.
Products: STIMULAN®
While PJI is most commonly associated with Gram-positive bacteria, accounting for approximately 50% of cases, fungal driven infection is responsible for 1% of cases. It is likely this is an underestimation due to the lack of literature pertaining to polymicrobial PJI infections, coupled with the fact that, in addition to Candida spp., other yeasts and filamentous fungi have been increasingly associated with biofilm infections. The primary aims of this study were to assess the mixing and setting of a range of antifungal agents with STIMULAN Rapid Cure to determine their antibiofilm properties against a panel of yeasts and fungi. STIMULAN was mixed with a range of antifungal agents including Fluconazole (FLZ), Amphotericin B (AMB) and Caspofungin (CSP) and assessed against a range of 15 fungal and yeast species. In general, antifungals released from STIMULAN loaded beads were all effective at inhibiting planktonic fungi over 7-days in vitro. A significant reduction of pre-grown fungal biofilms was observed following exposure to AMB and CSP loaded STIMULAN loaded beads. While concentrations of FLZ released from STIMULAN beads were sufficient to inhibit planktonic cells, there was some resistance for treating established biofilms. The assessment of biofilm inhibition also revealed reductions in total and viable cells across all organisms tested. Antifungal loaded STIMULAN beads provide a mechanism for release of sustained, biofilm inhibitory doses of antifungal compounds. The abstract can be read, and the full paper can be obtained  here.

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