The International journal of artificial organs
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Candida species have two distinct lifestyles: planktonic, and surface-attached communities called biofilms. Mature C. albicans biofilms show a complex three-dimensional architecture with extensive spatial heterogeneity, and consist of a dense network of yeast, hyphae, and pseudohyphae encased within a matrix of exopolymeric material. Several key processes are likely to play vital roles at the different stages of biofilm development, such as cell-substrate and cell-cell adherence, hyphal development, and quorum sensing. ⋯ The traditional approach to the management of these infections has been to explant the affected device. There is a strong medical but also economical motivation for the development of novel anti-fungal biofilm strategies due to the constantly increasing resistance of Candida biofilms to conventional antifungals, and the high mortality caused by related infections. A better description of the extent and role of yeast in biofilms may be critical for developing novel therapeutic strategies in the clinical setting.
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Indwelling vascular catheters are the most common cause of nosocomial bloodstream infections. One approach to infection prevention is the use of antimicrobial catheter lock solutions, although their widespread use is limited due to concern regarding the emergence of antimicrobial resistance. The primary purpose of this study was to determine the efficacy of N-acetylcysteine (NAC) lock solution in preventing peripheral bacteremia using an in vivo model of catheter-associated infection. ⋯ These promising data encourage further clinical evaluation of an NAC lock solution for prevention of catheter-associated bacteremia in patients.