Mixed species biofilms of Candida albicans and Staphylococcus epidermidis

J Med Microbiol. 2002 Apr;51(4):344-349. doi: 10.1099/0022-1317-51-4-344.


A simple catheter disk model system was used to study the development in vitro of mixed species biofilms of Candida albicans and Staphylococcus epidermidis, two organisms commonly found in catheter-associated infections. Two strains of S. epidermidis were used: a slime-producing wild type (strain RP62A) and a slime-negative mutant (strain M7). In mixed fungal-bacterial biofilms, both staphylococcal strains showed extensive interactions with C. albicans. The susceptibility of 48-h biofilms to fluconazole, vancomycin and mixtures of the drugs was determined colorimetrically. The results indicated that the extracellular polymer produced by S. epidermidis RP62A could inhibit fluconazole penetration in mixed fungal-bacterial biofilms. Conversely, the presence of C. albicans in a biofilm appeared to protect the slime-negative staphylococcus against vancomycin. Overall, the findings suggest that fungal cells can modulate the action of antibiotics, and that bacteria can affect antifungal activity in mixed fungal-bacterial biofilms.

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Antifungal Agents / pharmacology
  • Biofilms / drug effects
  • Biofilms / growth & development*
  • Candida albicans / drug effects
  • Candida albicans / physiology*
  • Catheters, Indwelling / microbiology
  • Drug Combinations
  • Fluconazole / pharmacology
  • Humans
  • Microscopy, Electron, Scanning
  • Staphylococcus epidermidis / classification
  • Staphylococcus epidermidis / drug effects
  • Staphylococcus epidermidis / physiology*
  • Vancomycin / pharmacology


  • Anti-Bacterial Agents
  • Antifungal Agents
  • Drug Combinations
  • Vancomycin
  • Fluconazole