A retrospective Thai referral-center study of 146 C. tropicalis candidemia episodes in 145 patients found high biofilm formation in 33.6% and 30-day mortality of 74.0%. Overall mortality did not differ by biofilm category; lower survival only in non-ICU patients is a subgroup finding requiring confirmation, not a stand-alone prognostic marker.
Key findings
- High biofilm formation occurred in 49 isolates (33.6%). Associations included shorter pre-candidemia stay (OR 0.98; 95% CI 0.96-0.999) and recent C. difficile infection (OR 14.55; 95% CI 1.58-133.75). Overall 30-day mortality was 74.0% and did not differ between HBF and non-HBF (77.6% vs 72.2%; p=0.484); poorer survival appeared only in the non-ICU HBF subgroup.
Why this matters globally
The work motivates candidemia surveillance that integrates isolate phenotype, illness severity, and treatment timing rather than biofilm alone, but does not yet change antifungal management.
Thai researcher contribution
Siriraj microbiologists and the University of Aberdeen linked laboratory biofilm testing with patient outcomes in a high-prevalence Thai setting.
Limitations to consider
The single-center 2015-2019 retrospective data are vulnerable to confounding by treatment, source control, susceptibility, severity, and therapy timing. The C. difficile OR has a very wide interval, indicating sparse data. The non-ICU result may reflect subgroup analysis, and no interaction test is reported in the abstract.