{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T17:18:48Z","timestamp":1791566328235,"version":"4.3.4"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,1,23]],"date-time":"2020-01-23T00:00:00Z","timestamp":1579737600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Candidaemia is a common life\u2010threatening disease among hospitalised patients, but the effect of the\n                      <jats:italic>Candida<\/jats:italic>\n                      biofilm\u2010forming ability on the clinical outcome remains controversial.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim was to determine the impact of biofilms, specifically focusing on biofilm mass and metabolic activity, on the mortality in candidaemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients\/Methods<\/jats:title>\n                    <jats:p>The clinical data of patients (n\u00a0=\u00a0127) treated at the University of Debrecen, Clinical Centre, between January 2013 and December 2018, were investigated retrospectively. Biofilm formation was assessed using the crystal violet and XTT assays, measuring the biofilm mass and metabolic activity, respectively. Isolates were classified as low, intermediate and high biofilm producers both regarding biofilm mass and metabolic activity. The susceptibility of one\u2010day\u2010old biofilms to fluconazole, amphotericin B, anidulafungin, caspofungin and micafungin was evaluated and compared to planktonic susceptibility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Intermediate\/high biofilm mass was associated with significantly higher mortality (61%). All\n                      <jats:italic>Candida tropicalis<\/jats:italic>\n                      ,\n                      <jats:italic>Candida parapsilosis<\/jats:italic>\n                      and\n                      <jats:italic>Candida glabrata<\/jats:italic>\n                      isolates originating from fatal infections were intermediate\/high biofilm producers, whereas this ratio was 85% for\n                      <jats:italic>Candida albicans<\/jats:italic>\n                      . Solid malignancy was associated with intermediate\/high biofilm producers (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.043). The mortality was significantly higher in infections caused by\n                      <jats:italic>Candida<\/jats:italic>\n                      strains producing biofilms with intermediate\/high metabolic activity (62% vs. 33%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.010). The ratio of concomitant bacteraemia was higher for isolates forming biofilms with low metabolic activity (53% vs 28%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.015).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      This study provides evidence that the\n                      <jats:italic>Candida<\/jats:italic>\n                      biofilms especially with intermediate\/high metabolic activity are related to higher mortality in candidaemia.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/myc.13049","type":"journal-article","created":{"date-parts":[[2020,1,13]],"date-time":"2020-01-13T11:30:27Z","timestamp":1578915027000},"page":"352-360","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":68,"title":["<i>Candida<\/i>\n                    biofilm production is associated with higher mortality in patients with candidaemia"],"prefix":"10.1111","volume":"63","author":[{"given":"Eszter","family":"Vit\u00e1lis","sequence":"first","affiliation":[{"name":"Hospital Hygiene Ward Clinical Centre University of Debrecen Debrecen Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fruzsina","family":"Nagy","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology Faculty of Medicine University of Debrecen Debrecen Hungary"},{"name":"Doctoral School of Pharmaceutical Sciences University of Debrecen Debrecen Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zolt\u00e1n","family":"T\u00f3th","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology Faculty of Medicine University of Debrecen Debrecen Hungary"},{"name":"Doctoral School of Pharmaceutical Sciences University of Debrecen Debrecen Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lajos","family":"Forg\u00e1cs","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology Faculty of Medicine University of Debrecen Debrecen Hungary"},{"name":"Doctoral School of Pharmaceutical Sciences University of Debrecen Debrecen Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aliz","family":"Boz\u00f3","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology Faculty of Medicine University of Debrecen Debrecen Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00e1bor","family":"Kardos","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology Faculty of Medicine University of Debrecen Debrecen Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00e1szl\u00f3","family":"Majoros","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology Faculty of Medicine University of Debrecen Debrecen Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3946-2424","authenticated-orcid":false,"given":"Ren\u00e1t\u00f3","family":"Kov\u00e1cs","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology Faculty of Medicine University of Debrecen Debrecen Hungary"},{"name":"Faculty of Pharmacy University of Debrecen Debrecen Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,1,23]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1086\/421946"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2017.06.009"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0194210"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/21505594.2015.1134072"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis021"},{"key":"e_1_2_8_7_1","first-page":"459","article-title":"Candidemia: species involved, virulence factors and antimycotic susceptibility","volume":"35","author":"De Luca C","year":"2012","journal-title":"New Microbiol"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.12956"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0033705"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2018.00028"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2015.09.018"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.000207"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2018.01.022"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.000237"},{"issue":"47","key":"e_1_2_8_15_1","first-page":"1","article-title":"Microtiter dish biofilm formation assay","author":"O'Toole GA","year":"2011","journal-title":"J Vis Exp"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/nprot.2008.141"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/02681219680000231"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms7030073"},{"key":"e_1_2_8_19_1","volume-title":"Reference Method for Broth Dilution Antifungal Susceptibility Testing of Yeasts. Approved Standard","author":"Clinical and Laboratory Standards Institute","year":"2008"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2016.01.007"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/mmy\/myy108"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/mmy\/myx062"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00262-08"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.03044-13"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drup.2011.01.004"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof3040057"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2019.04.024"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1080\/23744235.2017.1384956"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.40.4.1244-1248.2002"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.micinf.2012.04.002"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12258"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof5020049"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-019-04885-z"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mycmed.2018.01.001"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-017-2879-6"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2016.05.005"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkt099"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1128\/mBio.00526-12"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1620432114"}],"container-title":["Mycoses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/myc.13049","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/myc.13049","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/myc.13049","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T12:13:27Z","timestamp":1694002407000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/myc.13049"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,23]]},"references-count":38,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020,4]]}},"alternative-id":["10.1111\/myc.13049"],"URL":"https:\/\/doi.org\/10.1111\/myc.13049","archive":["Portico"],"relation":{},"ISSN":["0933-7407","1439-0507"],"issn-type":[{"value":"0933-7407","type":"print"},{"value":"1439-0507","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,23]]},"assertion":[{"value":"2019-10-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-01-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-01-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}