In brief, 0.5 cm2 RHE surfaces were infected with 2 × 106 cells in 50 μl of PBS, and as a control 50 μl of PBS without C. albicans cells was used. The inoculated and non-inoculated RHE were incubated in maintenance

medium (SkinEthic Laboratories) at 37°C with 5% CO2 at 100% humidity for up to 48 h. Lactate dehydrogenase assay The RHE tissue damage caused by C. albicans was assessed by determining the LDH activity in the extracellular medium, as described previously [25]. The LDH activity was expressed in IU/l at 37°C and was determined from at least 4 independent experiments, with 2 replicates per experiment (n ≥ 8). Statistical significance of differences between the different time points of infection were determined by One-Way ANOVA using the SPSS 15.0 software (p < 0.05). Cell quantification To enumerate ALK assay the number of culturable sessile cells, plating was used. Silicone disks, RHE filters or polyurethane catheter segments were transferred to 10 ml 0.9% (w/v) NaCl, and sessile cells were removed from the surface by three cycles of 30 sec sonication (Branson 3510,

42 kHz, 100 W; Branson Ultrasonics Corporation, Danbury, CT, USA) and 30 sec vortex mixing. Using this procedure, all cells were removed from the surface and clumps of cells were broken apart, without affecting the viability of the cells (data not shown). Serial tenfold dilutions of the resulting cell GW 572016 suspensions were plated on SDA and plates were incubated for 24 h at 37°C, after which colonies were counted. The experiments were performed at least in triplicate with several replicates per experiment (n ≥ 12). The average number of sessile cells per cm2 (with corresponding SD) was calculated. One-way ANOVA tests were carried out using SPSS 15.0 software to determine whether differences were statistically significant Clomifene (p < 0.05). Solid phase cytometry To determine the percentage of filaments in biofilms grown in the MTP, the CDC and the RHE model, a previously developed method based on solid phase cytometry was used [28]. Biofilms were grown and harvested as described above. Experiments were carried out in three-fold with several

replicates per experiment (n ≥ 12), and the percentage of filaments (mean with corresponding SD) was determined. One-way ANOVA tests were carried out using SPSS 15.0 software to determine whether differences were statistically significant (p < 0.05). Lipase activity assay Planktonic cells and biofilms grown in the MTP and RHE model were cultured as described above. Supernatant from biofilms and planktonic cells was collected and sterilized by filtration through 0.22 μm membranes (Millipore, Billerica, MA, USA). Extracellular lipase activity was determined using a fluorogenic substrate, 4- MU palmitate. 200 μl of sterile supernatant and 20 μl of the 4-MU ester (200 μg/ml in DMSO; Invitrogen, Carlsbad, CA, USA) were added to black 96-well plates (Perkin Elmer, Wellesley, MA, USA).