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 JoVE Immunology and Infection

A 96 Well Microtiter Plate-based Method for Monitoring Formation and Antifungal Susceptibility Testing of Candida albicans Biofilms

1,2, 1,2, 1,2, 1,2

1Department of Biology, University of Texas San Antonio - UTSA, 2South Texas Center for Emerging Infectious Diseases, University of Texas San Antonio - UTSA

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    Summary

    We describe a simple, rapid and robust method for the formation of Candida albicans biofilms using 96 well microtiter plates and its utility in antifungal susceptibility testing of cells within biofilms.

    Date Published: 10/21/2010, Issue 44; doi: 10.3791/2287

    Cite this Article

    Pierce, C. G., Uppuluri, P., Tummala, S., Lopez-Ribot, J. L. A 96 Well Microtiter Plate-based Method for Monitoring Formation and Antifungal Susceptibility Testing of Candida albicans Biofilms. J. Vis. Exp. (44), e2287, doi:10.3791/2287 (2010).

    Abstract

    Candida albicans remains the most frequent cause of fungal infections in an expanding population of compromised patients and candidiasis is now the third most common infection in US hospitals. Different manifestations of candidiasis are associated with biofilm formation, both on host tissues and/or medical devices (i.e. catheters). Biofilm formation carries negative clinical implications, as cells within the biofilms are protected from host immune responses and from the action of antifungals. We have developed a simple, fast and robust in vitro model for the formation of C. albicans biofilms using 96 well microtiter-plates, which can also be used for biofilm antifungal susceptibility testing. The readout of this assay is colorimetric, based on the reduction of XTT (a tetrazolium salt) by metabolically active fungal biofilm cells. A typical experiment takes approximately 24 h for biofilm formation, with an additional 24 h for antifungal susceptibility testing. Because of its simplicity and the use of commonly available laboratory materials and equipment, this technique democratizes biofilm research and represents an important step towards the standardization of antifungal susceptibility testing of fungal biofilms.

    Protocol

    1. Preparation of C. albicans

    C. albicans is a Risk Group 1/BSL1 microorganism. Always remember to use good aseptic/sterile techniques for work with this microorganism and follow institutional procedures for proper disposal of biohazard materials.

    1. Prepare an overnight culture of C. albicans in YPD (Yeast Peptone Dextrose) liquid medium by inoculating a single colony of C. albicans into 25 mL of YPD.
    2. Incubate culture in an orbital shaker (about 180 rpm) at 30 °C overnight. Most C. albicans strains will grow as yeast cells under these conditions.
    3. Centrifuge the overnight cultures (about 3,000 rpm, 5-10 minutes), wash cells twice with sterile PBS, and resuspend the final pellet in about 20-25 mL of RPMI 1640 medium buffered with 165 mM morpholinepropanesulfonic acid to pH 7.0 and pre-warmed at 37 °C (from now on this medium is referred to as simply "RPMI 1640").
    4. Count cells using an hemacytometer. After counting, prepare a suspension of cells at a final density of 1.0 x 106 cells/ mL in RPMI 1640.
      Note: Because cells have a tendency to aggregate, it is important to vortex vigorously between washings and before pipetting.

    2. Setting Up the 96-well Microtiter Plate for the Formation of the Biofilm

    1. Using a multichannel pipette add 100 μL of C. albicans suspension into selected wells of the 96-well microtiter plate(-s). Do not add cells to wells in column 12, as these will serve as negative controls.
    2. Cover the entire microtiter plate with its original lid, seal with parafilm, place inside an incubator and incubate for 24 h at 37 °C. The length of incubation can be adapted to the specific experimental design. For example, it is possible to examine the kinetics of biofilm formation over a period of 24 - 48 hours by seeding multiple plates and processing each plate at different time points (i.e. 2, 4, 8, 12, 24 and 48 h)
    3. After biofilm formation, using a multichannel pipette aspirate the medium carefully as not to touch and disrupt the biofilms that have formed in each of the wells.
    4. Using a multichannel pipette wash plates three times in sterile PBS (200 μL per well). Alternatively, use an automated microtiter plate washer. Between washes, and particularly after the last wash, drain the plates in an inverted position by blotting with paper towels to remove any residual PBS. At this point biofilms formed on the bottom of the wells should be clearly visible even by the naked eye and can also be visualized using an inverted microscope (Figure 1). Biofilms are now ready to be processed for antifungal susceptibility testing assays.
      (If the main purpose of the experiment is to assess the extent of biofilm formation, the plates are ready to be processed using the colorimetric method. For this, the XTT/menadione reagent (see Step 3 below) can be added and the resulting color read using a microtiter plate reader).

    3. Antifungal Susceptibility Testing of Biofilms

    1. From stock solutions or powder, prepare a working solution in RPMI 1640 medium of each antifungal to be tested. Typical high concentrations are 1,024 μg/ mL for fluconazole, and 16 μg/ mL for both amphotericin B and caspofungin. Other concentrations may be used for different agents.
    2. Using a multichannel pipette, add 200 μL of the high working concentration of antifungal to the corresponding wells in column 1 of each microtiter plate containing fungal biofilms.
    3. Add 100 μL of RPMI 1640 to each well in columns 2 to 10.
    4. Add 100 μL of RPMI 1640 to wells in column 11.
    5. Remove 100 μL of antifungal agent from the wells of column 1 and add to the adjacent wells in column 2 (already containing 100 μL of medium).
    6. Mix the contents well by pipetting up and down to perform a serial doubling dilution, and remove the tips.
    7. Repeat moving right until the wells of column 10, after which the final 100 μL volume from the wells of column 10 after mixing is discarded. In this way, a series of doubling dilutions of your agent(-s) of interest have been created; from most concentrated in wells of column 1 to least concentrated in wells of column 10. Unchallenged biofilms in column 11 will serve as positive controls, and empty wells in column 12 will serve as negative controls.
    8. Cover the plates with their lids, seal with parafilm and incubate for 24 -48 h at 37 °C.
    9. After the incubation period wash the plates as in Step 2.4 before (3 x PBS).
    10. Using a multichannel pipette add 100 μL of XTT/menadione solution to each well containing a pre-washed biofilm as well as to negative control wells for the measurement of background XTT-colorimetric levels.
      1. The XTT is prepared as a saturated solution at 0.5 g/L in sterile Ringer's lactate, PBS or saline, which needs to be filter-sterilized using a 0.22 μm-pore size filter. The XTT solution is light sensitive, so it should be covered with aluminum foil during preparation. Once prepared and filter-sterilized, aliquot into 10 mL working volumes, and store at -70 °C. Protect the tubes from light using aluminum foil. Thaw only as many tubes as needed for a particular experiment just prior to use.
      2. Menadione is prepared as a 10 mM stock solution in 100% acetone, aliquoted into smaller volumes (about 50 μL) and stored at -70°C. Prepare the XTT/menadione solution just prior to use, by adding 1 μL of the stock solution of menadione to a tube containing 10 mL of the thawed XTT solution.
    11. Cover the plates in aluminum foil and incubate in the dark for 2 h at 37 °C.
    12. Uncover the plates. Using a multichannel pipette remove 80 μL of the resulting colored supernatant from each well and transfer into the corresponding wells of a new microtiter plate.
    13. Read the plate(-s) in a microtiter plate reader at 490 nm.
    14. Calculate the sessile minimum inhibitory concentrations SMIC50 and SMIC80, which are the antifungal concentrations at which a 50% or 80% decrease in colorimetric readings are detected in comparison to the control biofilms formed in the absence of antifungal drug (in this case values for column 11, remember also to subtract values from negative controls from wells in column 12 containing XTT only). SMIC results can be presented as a Table (i.e. multiple isolates against multiple antifungals) or alternatively, results for each individual fungal isolate against each antifungal can be presented as a graph by plotting percent inhibition versus antifungal concentration.

    Example: After subtracting the values in the negative control, the average O.D. of control biofilms formed in column 11 is 1.32. The SMIC50 is the lowest antifungal concentration leading to > 50% reduction in colorimetric readings, in this case less than 1.32 x 50/100 = 0.66. Likewise, the SMIC80 is the lowest antifungal concentration leading to > 80% reduction in colorimetric readings, in this case less than 1.32 x 20/100 = 0.264.

    4. Representative Results

    Figure 1 shows a microphotograph of a C. albicans biofilm formed on the bottom of a well in a 96 well microtiter plate taken using an inverted microscope. Figure 2 shows XTT-colorimetric readings (OD490 values) for each of 11 biofilms of a C. albicans wild type strain formed in each of the 8 different rows of the same 96 well microtiter plate. Figure 3 shows the activity of amphotericin B at different concentrations against C. albicans biofilms; arrows indicate SMIC50 and SMIC80 values.

    Figure 1
    Figure 1.(A) Panel A shows a microphotograph taken using a camera attached to an inverted microscope of a C. albicans biofilm formed on the bottom of the well after aspiration of RPMI medium and subsequent washings with PBS. (B) A micrograph of a typical C. albicans biofilm visualized using scanning electron microscopy. Bars are 100 μm and 10 μm for panels A and B respectively.

    Figure 2
    Figure 2. Formation of multiple equivalent C. albicans biofilms in 96-well microtiter plates. Colorimetric readings (OD490 values) from XTT-reduction assays of biofilms formed by a C. albicans wild type in wells of microtiter plates. Values are for 11 independent biofilms formed in each of 8 different rows of the same 96 well microtiter plate. Results for the different rows were compared by one-way analysis of variance and using the Bartlett's test for homogeneity of variances and the Bonferroni's multiple comparison post-test. No statistically significant differences were noted when comparing all pairs of rows to each other (P > 0.05).

    Figure 3
    Figure 3. Typical results of antifungal susceptibility testing against C. albicans biofilms. Graph depicting typical results of the efficacy of different amphotericin B concentrations against biofilms of a C. albicans wild type strain. Values are expressed as average percent colorimetric readings for XTT-reduction assays compared to control wells. SMIC50 and SMIC80 values are indicated by arrows.

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    Discussion

    Here we describe a simple, rapid, economical and highly reproducible 96 well microtiter plate model for the formation of Candida biofilms coupled with a colorimetric method that measures the metabolic activities of cells within the biofilm using XTT. This 96 well microtiter plate model for biofilm formation was originally developed for C. albicans but can be used for other Candida spp. and easily adapted for other fungal organisms. The method can be used to examine multiple parameters and factors influencing biofilm formation and to estimate the biofilm-forming ability of multiple fungal isolates and/or mutant strains. But perhaps most importantly, this method is very useful for the determination of antifungal susceptibility testing of cells within biofilms.

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    Disclosures

    JLL-R owns equity in MicrobeHTS Technologies, Inc., which is developing antifungal agents. MicrobeHTS Technologies, Inc. provided no financial support for these studies.

    Acknowledgements

    Biofilm-related work in the laboratory is funded by grants numbered R21DE017294 and R21AI080930 from the National Institute of Dental & Craniofacial Research and the National Institute for Allergy and Infectious Diseases (to J.L.L.-R.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIDCR, the NIAID or the NIH.

    Materials

    Name Company Catalog Number Comments
    Sabouraud-dextrose agar BD Biosciences 211584 To prepare plates for fresh subcultures of fungal isolates
    YPD: Yeast peptone dextrose US Biological Y2076 Medium for propagation of overnight liquid cultures
    RPMI-1640 without sodium bicarbonate supplemented with L-glutamine Cellgro 50-020-PB Liquid medium for biofilm formation
    Morpholinepropanesulfonic acid (MOPS) Fisher Scientific BP308 To buffer RPMI 1640
    Phosphate buffered saline, PBS Sigma-Aldrich P4417 Buffer for washes
    XTT sodium salt Sigma-Aldrich X4251 See above for preparation instructions
    Ringer’s lactate Hospira Inc. NDC0409-7953-09 For preparation of XTT solution
    Menadione Sigma-Aldrich M5625 Caution: hazardous by skin contact, inhalation or ingestion
    Petri dishes Fisher Scientific 08-757-12
    15 ml conical centrifuge tubes Corning 430790
    50 ml conical centrifuge tubes Corning 430828
    96 well microtiter plates: Polystyrene, flat-bottomed, tissue culture treated Corning 3595
    Multichannel pipette and tips Eppendorf
    Incubator Any Supplier
    Microtiter plate reader Any Supplier

    References

    1. Bachmann, S.P. et al. In vitro activity of caspofungin against Candida albicans biofilms. Antimicrob Agents Chemother 46, 3591-3596. (2002).
    2. Hawser, S.P., Norris, H., Jessup, C.J. & Ghannoum, M.A. Comparison of a 2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-5-[(phenylamino)carbonyl]-2H-t etrazolium hydroxide (XTT) colorimetric method with the standardized National Committee for Clinical Laboratory Standards method of testing clinical yeast isolates for susceptibility to antifungal agents. J Clin Microbiol 36, 1450-1452 (1998).
    3. Kuhn, D.M., Balkis, M., Chandra, J., Mukherjee, P.K. & Ghannoum, M.A. Uses and limitations of the XTT assay in studies of Candida growth and metabolism. J Clin Microbiol 41, 506-508 (2003).
    4. Kuhn, D.M., George, T., Chandra, J., Mukherjee, P.K. & Ghannoum, M.A. Antifungal susceptibility of Candida biofilms: Unique efficacy of amphotericin B lipid formulations and echinocandins. Antimicrob. Agents Chemother. 46, 1773-1780 (2002).
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    6. Ramage, G., Saville, S.P., Thomas, D.P. & Lopez-Ribot, J.L. Candida biofilms: an update. Eukaryot Cell 4, 633-638. (2005).
    7. Ramage, G., Vande Walle, K., Wickes, B.L. & Lopez-Ribot, J.L. Standardized method for in vitro antifungal susceptibility testing of Candida albicans biofilms. Antimicrob Agents Chemother 45, 2475-2479. (2001).
    8. Bachmann, S.P. et al. Antifungal combinations against Candida albicans biofilms in vitro. Antimicrob Agents Chemother 47, 3657-3659. (2003).
    9. Ramage, G., VandeWalle, K., Bachmann, S.P., Wickes, B.L. & Lopez-Ribot, J.L. In vitro pharmacodynamic properties of three antifungal agents against preformed Candida albicans biofilms determined by time-kill studies. Antimicrob Agents Chemother 46, 3634-3636. (2002).
    10. Ramage, G., VandeWalle, K., Wickes, B.L. & López-Ribot, J.L.. Characteristics of biofilm formation by Candida albicans. Rev. Iberoam. Micol. 18, 163-170 (2001).
    11. Tellier, R., Krajden, M., Grigoriew, G.A. & Campbell, I. Innovative endpoint determination system for antifungal susceptibility testing of yeasts. Antimicrob Agents Chemother 36, 1619-1625 (1992).
    12. Nett J. & Andes D. Candida albicans biofilm development, modeling a host-pathogen interaction. Curr Opin Microbiol. 9, 340-5 (2006).

    Comments

    2 Comments

    thanks
    Reply

    Posted by: AnonymousDecember 17, 2011, 6:36 PM

    I am currently doing my research on antifungal. So, I would like to see this video.





















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    Posted by: Karun S.March 17, 2013, 10:26 AM

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