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Updated: Dec 14, 2025
Author Spotlight: Advancing Research on Candida albicans Biofilm-Associated Prosthetic Joint Infections
Published on: February 2, 2024
A Biodegradable Antifungal-Loaded Sol-Gel Coating for the Prevention and Local Treatment of Yeast Prosthetic-Joint
David Romera1, Beatriz Toirac2, John-Jairo Aguilera-Correa1
1Clinical Microbiology Department, IIS-Fundación Jiménez Díaz, UAM, 28040 Madrid, Spain.
Abstract:
Fungal prosthetic-joint infections are rare but devastating complications following arthroplasty. These infections are highly recurrent and expose the patient to the development of candidemia, which has high mortality rates. Patients with this condition are often immunocompromised and present several comorbidities, and thus pose a challenge for diagnosis and treatment. The most frequently isolated organisms in these infections are Candida albicans and Candida parapsilosis, pathogens that initiate the infection by developing a biofilm on the implant surface. In this study, a novel hybrid organo-inorganic sol-gel coating was developed from a mixture of organopolysiloxanes and organophosphite, to which different concentrations of fluconazole or anidulafungin were added. Then, the capacity of these coatings to prevent biofilm formation and treat mature biofilms produced by reference and clinical strains of C. albicans and C. Parapsilosis was evaluated. Anidulafungin-loaded sol-gel coatings were more effective in preventing C. albicans biofilm formation, while fluconazole-loaded sol-gel prevented C. parapsilosis biofilm formation more effectively. Treatment with unloaded sol-gel was sufficient to reduce C. albicans biofilms, and the sol-gels loaded with fluconazole or anidulafungin slightly enhanced this effect. In contrast, unloaded coatings stimulated C. parapsilosis biofilm formation, and loading with fluconazole reduced these biofilms by up to 99%. In conclusion, these coatings represent a novel therapeutic approach with potential clinical use to prevent and treat fungal prosthetic-joint infections.
Insights
Novel sol-gel coatings effectively prevent and treat fungal prosthetic-joint infections caused by Candida species. These innovative coatings show promise in combating challenging biofilms and reducing infection recurrence.
Area of Science:
- Biomaterials Science
- Mycology
- Infectious Diseases
Background:
- Fungal prosthetic-joint infections are rare but serious complications of arthroplasty.
- These infections, often caused by Candida albicans and Candida parapsilosis, are recurrent and linked to high mortality candidemia.
- Patients are frequently immunocompromised, complicating diagnosis and treatment.
Purpose of the Study:
- To develop and evaluate a novel hybrid organo-inorganic sol-gel coating for preventing and treating fungal prosthetic-joint infections.
- To assess the efficacy of fluconazole- and anidulafungin-loaded sol-gel coatings against Candida biofilms.
Main Methods:
- A hybrid organo-inorganic sol-gel coating was synthesized using organopolysiloxanes and organophosphite.
- Different concentrations of fluconazole or anidulafungin were incorporated into the sol-gel matrix.
- The capacity of these coatings to prevent and treat biofilms formed by reference and clinical strains of Candida albicans and Candida parapsilosis was evaluated.
Main Results:
- Anidulafungin-loaded coatings were more effective against Candida albicans biofilm formation.
- Fluconazole-loaded coatings demonstrated superior efficacy in preventing Candida parapsilosis biofilm formation.
- Unloaded sol-gel reduced Candida albicans biofilms, while fluconazole-loaded coatings significantly reduced Candida parapsilosis biofilms (up to 99%).
Conclusions:
- The developed sol-gel coatings represent a promising novel therapeutic strategy for fungal prosthetic-joint infections.
- These coatings have potential clinical applications in preventing and treating challenging Candida biofilms on prosthetic joints.
- Tailoring antifungal loading (fluconazole vs. anidulafungin) can optimize efficacy against specific Candida species.
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