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Updated: Jul 15, 2025
Candida albicans Biofilm Development on Medically-relevant Foreign Bodies in a Mouse Subcutaneous Model Followed by Bioluminescence Imaging
Published on: January 27, 2015
Reappraisal of intra-abdominal candidiasis: insights from peritoneal fluid analysis
Emmanuel Novy1,2, Mathieu Esposito3,4, Julien Birckener3
1Service d'anesthésie-Réanimation et Médecine Péri-Opératoire, CHRU Nancy, Hôpitaux de Brabois, 54500, Vandœuvre-Lès-Nancy, France. manunovy@gmail.com.
Background:
The understanding of high mortality associated with intra-abdominal candidiasis (IAC) remains limited. While Candida is considered a harmless colonizer in the digestive tract, its role as a true pathogen in IAC is still debated. Evidence regarding Candida virulence in the human peritoneal fluid are lacking. We hypothesized that during IAC, Candida albicans develops virulence factors to survive to new environmental conditions. The objective of this observational exploratory monocentric study is to investigate the influence of peritoneal fluid (PF) on the expression of C. albicans virulence using a multimodal approach.
Materials And Methods:
A standardized inoculum of a C. albicans (3.106 UFC/mL) reference strain (SC5314) was introduced in vitro into various PF samples obtained from critically ill patients with intra-abdominal infection. Ascitic fluids (AFs) and Sabouraud medium (SBD) were used as control groups. Optical microscopy and conventional culture techniques were employed to assess the morphological changes and growth of C. albicans. Reverse transcriptase qPCR was utilized to quantify the expression levels of five virulence genes. The metabolic production of C. albicans was measured using the calScreener™ technology.
Results:
A total of 26 PF samples from patients with secondary peritonitis were included in the study. Critically ill patients were mostly male (73%) with a median age of 58 years admitted for urgent surgery (78%). Peritonitis was mostly hospital-acquired (81%), including 13 post-operative peritonitis (50%). The infected PF samples predominantly exhibited polymicrobial composition. The findings revealed substantial variability in C. albicans growth and morphological changes in the PF compared to ascitic fluid. Virulence gene expression and metabolic production were dependent on the specific PF sample and the presence of bacterial coinfection.
Conclusions:
This study provides evidence of C. albicans virulence expression in the peritoneal fluid. The observed variability in virulence expression suggests that it is influenced by the composition of PF and the presence of bacterial coinfection. These findings contribute to a better understanding of the complex dynamics of intra-abdominal candidiasis and advocate for personalized approach for IAC patients. Trial registration https://clinicaltrials.gov/ (NCT05264571; February 22, 2022).
Insights
Candida albicans exhibits variable virulence in peritoneal fluid, influenced by fluid composition and bacterial coinfection. This research aids understanding of intra-abdominal candidiasis and personalized patient care.
Area of Science:
- Microbiology
- Infectious Diseases
- Critical Care Medicine
Background:
- Intra-abdominal candidiasis (IAC) has high mortality, but Candida's role as a pathogen is debated.
- Evidence on Candida virulence factors in human peritoneal fluid is limited.
- This study investigates if Candida albicans adapts virulence in peritoneal fluid.
Purpose of the Study:
- To explore the influence of peritoneal fluid on Candida albicans virulence.
- To investigate Candida albicans morphological and genetic changes in peritoneal fluid.
- To understand the impact of peritoneal fluid composition on fungal virulence.
Main Methods:
- In vitro study using Candida albicans in peritoneal fluid from infected patients.
- Compared Candida growth and morphology in peritoneal fluid vs. controls (ascitic fluid, Sabouraud medium).
- Quantified virulence gene expression (qPCR) and metabolic output (calScreener™).
Main Results:
- Significant variability in Candida albicans growth and morphology observed in peritoneal fluid.
- Virulence gene expression and metabolic activity were sample-dependent.
- Bacterial coinfection and peritoneal fluid composition influenced Candida virulence.
Conclusions:
- Candida albicans expresses virulence factors within the peritoneal fluid.
- Peritoneal fluid composition and bacterial coinfection modulate Candida virulence.
- Findings support a personalized approach to managing intra-abdominal candidiasis.
