OBJECTIVE The formation of Candida glabrata biofilm increases its resistance to antifungal drugs and is one of the important virulence factors. Anidulafungin is an echinocandin antifungal drug, and there is limited research on this drug in China. This study investigated the inhibitory effect of anidulafungin on the formation of C. glabrata biofilm and its eradication effect on mature biofilms, and provided assistance for the clinical treatment of candidemia.

METHODS A retrospective analysis was conducted on 20 cases of bloodstream infection caused by C. glabrata in Beijing Chaoyang Hospital, Capital Medical University, from Jan. 2017 to Jan. 2024. Clinical characteristics of the patients were analyzed. Clinical strains of C. glabrata were collected, and the biofilm formation ability was detected through the crystal violet staining method. The minimum inhibitory concentration (MIC) of C. glabrata was determined with the YeastOne plate fungal susceptibility panel. The minimum biofilm inhibitory concentration (MBIC) and minimum biofilm eradication concentration (MBEC) of anidulafungin against C. glabrata were measured, and the effect of anidulafungin treatment on biofilms was analyzed.

RESULTS The patients′ age was (66.67±19.14) years. The length of hospital stay was (32.00±32.57) days. In addition, 90.00% of patients had one or more underlying diseases, 45.00% were admitted to the intensive care unit (ICU), and 95.00% had undergone invasive procedures. The positivity rate of fungal (1, 3)-β-D-glucan test was 50.00%. The biofilm formation ability of these 20 C. glabrata strains was also tested, with 45.00%, 35.00% and 20.00% of the strains showing strong, moderate and weak biofilm formation abilities, respectively. The MIC of anidulafungin against C. glabrata was ≤0.03 μg/ml, the MBIC ranged from 0.02 to 0.06 μg/ml, and MBEC >32 μg/ml accounted for 70.00%.

CONCLUSIONS Anidulafungin can effectively inhibit the formation of C. glabrata biofilm but has limited eradication effect on mature biofilms. If C. glabrata forms mature biofilms in the body, it may lead to poor treatment outcomes. It is crucial to search for new antifungal drugs that can effectively inhibit the formation of C. glabrata biofilm and eradicate mature biofilms.