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Masoumi A, Soleimani M, Azizkhani M, Izadi A, Cheraqpour K, Tabatabaei SA, Khodavaisy S, Aminzadeh M. Clinical Features, Risk Factors, and Management of Candida Keratitis. Ocul Immunol Inflamm 2024; 32:1169-1174. [PMID: 37141453 DOI: 10.1080/09273948.2023.2203752] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND/AIMS To determine the clinical features, predisposing factors, and management of infectious keratitis caused by Candida spp. METHODS Retrospective chart review. RESULTS The medical records of 52 patients (54 eyes) with Candida keratitis were available for statistical analysis. Thinning of the corneal stroma was identified in 34 eyes (63.0%), and corneal perforation occurred in 16 eyes (29.6%). Corneal thinning and perforation were more common in Candida albicans compared with non-albicans (P-val < .001, P = .09, respectively). The most common predisposing factors for Candida keratitis were topical steroid use (21 patients, 40.4%), previous corneal transplantation (17 patients, 32.7%), and preexisting ocular surface disease (15 patients, 28.8%). Fourteen eyes (25.9%) required cyanoacrylate glue application and 10 eyes (18.5%) underwent therapeutic penetrating keratoplasty (TPK). CONCLUSION Local immunosuppression and ocular surface disease play an important role in Candida keratitis. C. albicans appears to be more invasive compared with non-albicans spp.
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Affiliation(s)
- Ahmad Masoumi
- Ophthalmology Department and Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Soleimani
- Ophthalmology Department and Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Momeneh Azizkhani
- Ophthalmology Department and Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Izadi
- Ophthalmology Department and Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kasra Cheraqpour
- Ophthalmology Department and Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Tabatabaei
- Ophthalmology Department and Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sadegh Khodavaisy
- Ophthalmology Department and Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Aminzadeh
- Ophthalmology Department and Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
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2
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Martinez M, Garsin DA, Lorenz MC. Vertebrate and invertebrate animal infection models of Candida auris pathogenicity. Curr Opin Microbiol 2024; 80:102506. [PMID: 38925077 DOI: 10.1016/j.mib.2024.102506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/06/2024] [Accepted: 06/07/2024] [Indexed: 06/28/2024]
Abstract
Candida auris is an emerging fungal pathogen with several concerning qualities. First recognized in 2009, it has arisen in multiple geographically distinct genomic clades nearly simultaneously. C. auris strains are typically multidrug resistant and colonize the skin much better than most other pathogenic fungi; it also persists on abiotic surfaces, enabling outbreaks due to transmission in health care facilities. All these suggest a biology substantially different from the 'model' fungal pathogen, Candida albicans and support intensive investigation of C. auris biology directly. To uncover novel virulence mechanisms in this species requires the development of appropriate animal infection models. Various studies using mice, the definitive model, are inconsistent due to differences in mouse and fungal strains, immunosuppressive regimes, doses, and outcome metrics. At the same time, developing models of skin colonization present a route to new insights into an aspect of fungal pathogenesis that has not been well studied in other species. We also discuss the growing use of nonmammalian model systems, including both vertebrates and invertebrates, such as zebrafish, C. elegans, Drosophila, and Galleria mellonella, that have been productively employed in virulence studies with other fungal species. This review will discuss progress in developing appropriate animal models, outline current challenges, and highlight opportunities in demystifying this curious species.
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Affiliation(s)
- Melissa Martinez
- Department of Microbiology and Molecular Genetics, University of Texas McGovern Medical School and the University of Texas Graduate School of Biomedical Sciences, USA
| | - Danielle A Garsin
- Department of Microbiology and Molecular Genetics, University of Texas McGovern Medical School and the University of Texas Graduate School of Biomedical Sciences, USA
| | - Michael C Lorenz
- Department of Microbiology and Molecular Genetics, University of Texas McGovern Medical School and the University of Texas Graduate School of Biomedical Sciences, USA.
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3
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Kim HY, Nguyen TA, Kidd S, Chambers J, Alastruey-Izquierdo A, Shin JH, Dao A, Forastiero A, Wahyuningsih R, Chakrabarti A, Beyer P, Gigante V, Beardsley J, Sati H, Morrissey CO, Alffenaar JW. Candida auris-a systematic review to inform the world health organization fungal priority pathogens list. Med Mycol 2024; 62:myae042. [PMID: 38935900 PMCID: PMC11210622 DOI: 10.1093/mmy/myae042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 03/15/2024] [Accepted: 04/29/2024] [Indexed: 06/29/2024] Open
Abstract
The World Health Organization (WHO) in 2022 developed a fungal priority pathogen list. Candida auris was ultimately ranked as a critical priority pathogen. PubMed and Web of Science were used to find studies published from 1 January 2011 to 18 February 2021, reporting on predefined criteria including: mortality, morbidity (i.e., hospitalization and disability), drug resistance, preventability, yearly incidence, and distribution/emergence. Thirty-seven studies were included in the final analysis. The overall and 30-day mortality rates associated with C. auris candidaemia ranged from 29% to 62% and 23% to 67%, respectively. The median length of hospital stay was 46-68 days, ranging up to 140 days. Late-onset complications of C. auris candidaemia included metastatic septic complications. Resistance rates to fluconazole were as high as 87%-100%. Susceptibility to isavuconazole, itraconazole, and posaconazole varied with MIC90 values of 0.06-1.0 mg/l. Resistance rates to voriconazole ranged widely from 28% to 98%. Resistance rates ranged between 8% and 35% for amphotericin B and 0%-8% for echinocandins. Over the last ten years, outbreaks due to C. auris have been reported in in all WHO regions. Given the outbreak potential of C. auris, the emergence and spread of MDR strains, and the challenges associated with its identification, and eradication of its environmental sources in healthcare settings, prevention and control measures based on the identified risk factors should be evaluated for their effectiveness and feasibility. Global surveillance studies could better inform the incidence rates and distribution patterns to evaluate the global burden of C. auris infections.
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Affiliation(s)
- Hannah Yejin Kim
- Sydney Infectious Disease Institute, The University of Sydney, Sydney, NSW, Australia
- Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney, New South Wales, Australia
- Westmead Hospital, NSW Health, Westmead, New South Wales, Australia
| | - Thi Anh Nguyen
- Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney, New South Wales, Australia
| | - Sarah Kidd
- National Mycology Reference Centre, Microbiology and Infectious Diseases, SA Pathology, Adelaide, South Australia, Australia
| | - Joshua Chambers
- Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney, New South Wales, Australia
| | - Ana Alastruey-Izquierdo
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Jong-Hee Shin
- Chonnam National University Medical School, Gwangju, Korea
| | - Aiken Dao
- Sydney Infectious Disease Institute, The University of Sydney, Sydney, NSW, Australia
- Westmead Institute for Medical Research, Sydney, Australia
| | - Agustina Forastiero
- Antimicrobial Resistance Special Program, Communicable Diseases and Environmental Determinants of Health, Pan American Health Organization/World Health Organization (PAHO/WHO), Washington, DC, United States of America
| | - Retno Wahyuningsih
- Department of Parasitology, Division of Mycology, Faculty of Medicine of the Universitas Indonesia and Universitas Kristen Indonesia, Jakarta, Indonesia
| | | | | | | | - Justin Beardsley
- Sydney Infectious Disease Institute, The University of Sydney, Sydney, NSW, Australia
- Westmead Hospital, NSW Health, Westmead, New South Wales, Australia
- Westmead Institute for Medical Research, Sydney, Australia
| | | | - C Orla Morrissey
- Department of Infectious Diseases, Alfred Health, Melbourne, Victoria, Australia
- Monash University, Department of Infectious Diseases, Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Melbourne, Victoria, Australia
| | - Jan-Willem Alffenaar
- Sydney Infectious Disease Institute, The University of Sydney, Sydney, NSW, Australia
- Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney, New South Wales, Australia
- Westmead Hospital, NSW Health, Westmead, New South Wales, Australia
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4
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Izadi A, Paknia F, Roostaee M, Mousavi SAA, Barani M. Advancements in nanoparticle-based therapies for multidrug-resistant candidiasis infections: a comprehensive review. NANOTECHNOLOGY 2024; 35:332001. [PMID: 38749415 DOI: 10.1088/1361-6528/ad4bed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 05/15/2024] [Indexed: 05/31/2024]
Abstract
Candida auris, a rapidly emerging multidrug-resistant fungal pathogen, poses a global health threat, with cases reported in over 47 countries. Conventional detection methods struggle, and the increasing resistance ofC. auristo antifungal agents has limited treatment options. Nanoparticle-based therapies, utilizing materials like silver, carbon, zinc oxide, titanium dioxide, polymer, and gold, show promise in effectively treating cutaneous candidiasis. This review explores recent advancements in nanoparticle-based therapies, emphasizing their potential to revolutionize antifungal therapy, particularly in combatingC. aurisinfections. The discussion delves into mechanisms of action, combinations of nanomaterials, and their application against multidrug-resistant fungal pathogens, offering exciting prospects for improved clinical outcomes and reduced mortality rates. The aim is to inspire further research, ushering in a new era in the fight against multidrug-resistant fungal infections, paving the way for more effective and targeted therapeutic interventions.
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Affiliation(s)
- Alireza Izadi
- Department of Medical Parasitology and Mycology, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
- Medical Mycology and Bacteriology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Fatemeh Paknia
- Department of Nanobiotechnology, Faculty of Biological Sciences, Tarbiat Modares University, Tehran 14115-154, Iran
| | - Maryam Roostaee
- Department of Chemistry, Faculty of Sciences, Vali-e-Asr University of Rafsanjan, Rafsanjan, Iran
| | - Seyed Amin Ayatollahi Mousavi
- Department of Medical Parasitology and Mycology, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
- Medical Mycology and Bacteriology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahmood Barani
- Department of Chemistry, Faculty of Nano and Bio Science and Technology, Persian Gulf University, Bushehr 75168, Iran
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5
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Areitio M, Antoran A, Rodriguez-Erenaga O, Aparicio-Fernandez L, Martin-Souto L, Buldain I, Zaldibar B, Ruiz-Gaitan A, Pemán J, Rementeria A, Ramirez-Garcia A. Identification of the Most Immunoreactive Antigens of Candida auris to IgGs from Systemic Infections in Mice. J Proteome Res 2024; 23:1634-1648. [PMID: 38572994 PMCID: PMC11077488 DOI: 10.1021/acs.jproteome.3c00752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 03/14/2024] [Accepted: 03/18/2024] [Indexed: 04/05/2024]
Abstract
The delay in making a correct diagnosis of Candida auris causes concern in the healthcare system setting, and immunoproteomics studies are important to identify immunoreactive proteins for new diagnostic strategies. In this study, immunocompetent murine systemic infections caused by non-aggregative and aggregative phenotypes of C. auris and by Candida albicans and Candida haemulonii were carried out, and the obtained sera were used to study their immunoreactivity against C. auris proteins. The results showed higher virulence, in terms of infection signs, weight loss, and histopathological damage, of the non-aggregative isolate. Moreover, C. auris was less virulent than C. albicans but more than C. haemulonii. Regarding the immunoproteomics study, 13 spots recognized by sera from mice infected with both C. auris phenotypes and analyzed by mass spectrometry corresponded to enolase, phosphoglycerate kinase, glyceraldehyde-3-phosphate dehydrogenase, and phosphoglycerate mutase. These four proteins were also recognized by sera obtained from human patients with disseminated C. auris infection but not by sera obtained from mice infected with C. albicans or Aspergillus fumigatus. Spot identification data are available via ProteomeXchange with the identifier PXD049077. In conclusion, this study showed that the identified proteins could be potential candidates to be studied as new diagnostic or even therapeutic targets for C. auris.
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Affiliation(s)
- Maialen Areitio
- Department
of Immunology, Microbiology and Parasitology, Faculty of Science and
Technology, University of the Basque Country
(UPV/EHU), 48940 Leioa, Spain
| | - Aitziber Antoran
- Department
of Immunology, Microbiology and Parasitology, Faculty of Science and
Technology, University of the Basque Country
(UPV/EHU), 48940 Leioa, Spain
| | - Oier Rodriguez-Erenaga
- Department
of Immunology, Microbiology and Parasitology, Faculty of Science and
Technology, University of the Basque Country
(UPV/EHU), 48940 Leioa, Spain
| | - Leire Aparicio-Fernandez
- Department
of Immunology, Microbiology and Parasitology, Faculty of Science and
Technology, University of the Basque Country
(UPV/EHU), 48940 Leioa, Spain
| | - Leire Martin-Souto
- Department
of Immunology, Microbiology and Parasitology, Faculty of Science and
Technology, University of the Basque Country
(UPV/EHU), 48940 Leioa, Spain
| | - Idoia Buldain
- Department
of Immunology, Microbiology and Parasitology, Faculty of Pharmacy, University of the Basque Country (UPV/EHU), 01006 Vitoria-Gasteiz, Spain
| | - Beñat Zaldibar
- CBET
Research Group, Department of Zoology and Animal Cell Biology, Faculty
of Science and Technology, Research Centre for Experimental Marine
Biology and Biotechnology PIE, University
of the Basque Country (UPV/EHU), 48940 Leioa, Spain
| | - Alba Ruiz-Gaitan
- Microbiology
Department, University and Polytechnic La
Fe Hospital, 46026 Valencia, Spain
| | - Javier Pemán
- Microbiology
Department, University and Polytechnic La
Fe Hospital, 46026 Valencia, Spain
| | - Aitor Rementeria
- Department
of Immunology, Microbiology and Parasitology, Faculty of Science and
Technology, University of the Basque Country
(UPV/EHU), 48940 Leioa, Spain
| | - Andoni Ramirez-Garcia
- Department
of Immunology, Microbiology and Parasitology, Faculty of Science and
Technology, University of the Basque Country
(UPV/EHU), 48940 Leioa, Spain
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6
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Jones CR, Neill C, Borman AM, Budd EL, Cummins M, Fry C, Guy RL, Jeffery K, Johnson EM, Manuel R, Mirfenderesky M, Moore G, Patel B, Schelenz S, Staniforth K, Taori SK, Brown CS. The laboratory investigation, management, and infection prevention and control of Candida auris: a narrative review to inform the 2024 national guidance update in England. J Med Microbiol 2024; 73:001820. [PMID: 38771623 PMCID: PMC11165919 DOI: 10.1099/jmm.0.001820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 03/11/2024] [Indexed: 05/22/2024] Open
Abstract
The emergent fungal pathogen Candida auris is increasingly recognised as an important cause of healthcare-associated infections globally. It is highly transmissible, adaptable, and persistent, resulting in an organism with significant outbreak potential that risks devastating consequences. Progress in the ability to identify C. auris in clinical specimens is encouraging, but laboratory diagnostic capacity and surveillance systems are lacking in many countries. Intrinsic resistance to commonly used antifungals, combined with the ability to rapidly acquire resistance to therapy, substantially restricts treatment options and novel agents are desperately needed. Despite this, outbreaks can be interrupted, and mortality avoided or minimised, through the application of rigorous infection prevention and control measures with an increasing evidence base. This review provides an update on epidemiology, the impact of the COVID-19 pandemic, risk factors, identification and typing, resistance profiles, treatment, detection of colonisation, and infection prevention and control measures for C. auris. This review has informed a planned 2024 update to the United Kingdom Health Security Agency (UKHSA) guidance on the laboratory investigation, management, and infection prevention and control of Candida auris. A multidisciplinary response is needed to control C. auris transmission in a healthcare setting and should emphasise outbreak preparedness and response, rapid contact tracing and isolation or cohorting of patients and staff, strict hand hygiene and other infection prevention and control measures, dedicated or single-use equipment, appropriate disinfection, and effective communication concerning patient transfers and discharge.
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Affiliation(s)
- Christopher R. Jones
- HCAI, Fungal, AMR, AMU, and Sepsis Division, UK Health Security Agency, London, UK
| | - Claire Neill
- HCAI, Fungal, AMR, AMU, and Sepsis Division, UK Health Security Agency, London, UK
| | - Andrew M. Borman
- UKHSA Mycology Reference Laboratory, National Infection Services, UKHSA South West Laboratory, Science Quarter, Southmead Hospital, Bristol, UK
- MRC Centre for Medical Mycology, University of Exeter, Geoffrey Pope Building, Stocker Road, Exeter, UK
| | - Emma L. Budd
- HCAI, Fungal, AMR, AMU, and Sepsis Division, UK Health Security Agency, London, UK
| | - Martina Cummins
- Department of Microbiology and Infection Control, Barts Health NHS Trust, London, UK
| | - Carole Fry
- HCAI, Fungal, AMR, AMU, and Sepsis Division, UK Health Security Agency, London, UK
| | - Rebecca L. Guy
- HCAI, Fungal, AMR, AMU, and Sepsis Division, UK Health Security Agency, London, UK
| | - Katie Jeffery
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Elizabeth M. Johnson
- UKHSA Mycology Reference Laboratory, National Infection Services, UKHSA South West Laboratory, Science Quarter, Southmead Hospital, Bristol, UK
- MRC Centre for Medical Mycology, University of Exeter, Geoffrey Pope Building, Stocker Road, Exeter, UK
| | - Rohini Manuel
- Public Health Laboratory London, Science Group, UK Health Security Agency, London, UK
| | | | - Ginny Moore
- Research and Evaluation, UK Health Security Agency, Porton Down, Salisbury, UK
| | - Bharat Patel
- Public Health Laboratory London, Science Group, UK Health Security Agency, London, UK
| | - Silke Schelenz
- Department of Microbiology, King’s College Hospital NHS Foundation Trust, London, UK
| | - Karren Staniforth
- HCAI, Fungal, AMR, AMU, and Sepsis Division, UK Health Security Agency, London, UK
| | | | - Colin S. Brown
- HCAI, Fungal, AMR, AMU, and Sepsis Division, UK Health Security Agency, London, UK
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK
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7
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Angiolella L, Rojas F, Giammarino A, Bellucci N, Giusiano G. Identification of Virulence Factors in Isolates of Candida haemulonii, Candida albicans and Clavispora lusitaniae with Low Susceptibility and Resistance to Fluconazole and Amphotericin B. Microorganisms 2024; 12:212. [PMID: 38276197 PMCID: PMC10819056 DOI: 10.3390/microorganisms12010212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/15/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open
Abstract
Emerging life-threatening multidrug-resistant (MDR) species such as the C. haemulonii species complex, Clavispora lusitaniae (sin. C. lusitaniae), and other Candida species are considered as an increasing risk for human health in the near future. (1) Background: Many studies have emphasized that the increase in drug resistance can be associated with several virulence factors in Candida and its knowledge is also essential in developing new antifungal strategies. (2) Methods: Hydrophobicity, adherence, biofilm formation, lipase activity, resistance to osmotic stress, and virulence 'in vivo' on G. mellonella larvae were studied in isolates of C. haemulonii, C. albicans, and C. lusitaniae with low susceptibility and resistance to fluconazole and amphotericin B. (3) Results: Intra- and interspecies variability were observed. C. haemulonii showed high hydrophobicity and the ability to adhere to and form biofilm. C. lusitaniae was less hydrophobic, was biofilm-formation-strain-dependent, and did not show lipase activity. Larvae inoculated with C. albicans isolates displayed significantly higher mortality rates than those infected with C. haemulonii and C. lusitaniae. (4) Conclusions: The ability to adhere to and form biofilms associated with their hydrophobic capacity, to adapt to stress, and to infect within an in vivo model, observed in these non-wild-type Candida and Clavispora isolates, shows their marked virulence features. Since factors that define virulence are related to the development of the resistance of these fungi to the few antifungals available for clinical use, differences in the physiology of these cells must be considered to develop new antifungal therapies.
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Affiliation(s)
- Letizia Angiolella
- Department of Public Health and Infectious Diseases “Sapienza”, University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy; (A.G.); (N.B.)
| | - Florencia Rojas
- Departamento de Micología, Instituto de Medicina Regional, Universidad Nacional del Nordeste, CONICET, Resistencia 3500, Argentina; (F.R.); (G.G.)
| | - Andrea Giammarino
- Department of Public Health and Infectious Diseases “Sapienza”, University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy; (A.G.); (N.B.)
| | - Nicolò Bellucci
- Department of Public Health and Infectious Diseases “Sapienza”, University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy; (A.G.); (N.B.)
| | - Gustavo Giusiano
- Departamento de Micología, Instituto de Medicina Regional, Universidad Nacional del Nordeste, CONICET, Resistencia 3500, Argentina; (F.R.); (G.G.)
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Li L, Huang X, Chen H. Unveiling the hidden players: exploring the role of gut mycobiome in cancer development and treatment dynamics. Gut Microbes 2024; 16:2328868. [PMID: 38485702 PMCID: PMC10950292 DOI: 10.1080/19490976.2024.2328868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 03/06/2024] [Indexed: 03/19/2024] Open
Abstract
The role of gut fungal species in tumor-related processes remains largely unexplored, with most studies still focusing on fungal infections. This review examines the accumulating evidence suggesting the involvement of commensal and pathogenic fungi in cancer biological process, including oncogenesis, progression, and treatment response. Mechanisms explored include fungal influence on host immunity, secretion of bioactive toxins/metabolites, interaction with bacterial commensals, and migration to other tissues in certain types of cancers. Attempts to utilize fungal molecular signatures for cancer diagnosis and fungal-derived products for treatment are discussed. A few studies highlight fungi's impact on the responsiveness and sensitivity to chemotherapy, radiotherapy, immunotherapy, and fecal microbiota transplant. Given the limited understanding and techniques in fungal research, the studies on gut fungi are still facing great challenges, despite having great potentials.
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Affiliation(s)
- Lingxi Li
- State Key Laboratory of Systems Medicine for Cancer, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai Cancer Institute, Shanghai, China
| | - Xiaowen Huang
- State Key Laboratory of Systems Medicine for Cancer, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai Cancer Institute, Shanghai, China
| | - Haoyan Chen
- State Key Laboratory of Systems Medicine for Cancer, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai Cancer Institute, Shanghai, China
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9
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Wang Q, Cheng S, Wang Y, Li F, Chen J, Du W, Kang H, Wang Z. Global characteristics and trends in research on Candida auris. Front Microbiol 2023; 14:1287003. [PMID: 38125576 PMCID: PMC10731253 DOI: 10.3389/fmicb.2023.1287003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/13/2023] [Indexed: 12/23/2023] Open
Abstract
Introduction Candida auris, a fungal pathogen first reported in 2009, has shown strong resistance to azole antifungal drugs and has caused severe nosocomial outbreaks. It can also form biofilms, which can colonize patients' skin and transmit to others. Despite numerous reports of C. auris isolation in various countries, many studies have reported contradictory results. Method A bibliometric analysis was conducted using VOSviewer to summarize research trends and provide guidance for future research on controlling C. auris infection. The analysis revealed that the United States and the US CDC were the most influential countries and research institutions, respectively. For the researchers, Jacques F. Meis published the highest amount of related articles, and Anastasia P. Litvintseva's articles with the highest average citation rate. The most cited publications focused on clade classification, accurate identification technologies, nosocomial outbreaks, drug resistance, and biofilm formation. Keyword co-occurrence analysis revealed that the top five highest frequencies were for 'drug resistance,' 'antifungal susceptibility test,' 'infection,' 'Candida auris,' and 'identification.' The high-frequency keywords clustered into four groups: rapid and precise identification, drug resistance research, pathogenicity, and nosocomial transmission epidemiology studies. These clusters represent different study fields and current research hotspots of C. auris. Conclusion The bibliometric analysis identified the most influential country, research institution, and researcher, indicating current research trends and hotspots for controlling C. auris.
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Affiliation(s)
- Qihui Wang
- Laboratory of Microbiology, Department of Clinical Laboratory, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Shitong Cheng
- Laboratory of Microbiology, Department of Clinical Laboratory, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yinling Wang
- Laboratory of Microbiology, Department of Clinical Laboratory, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Fushun Li
- Laboratory of Microbiology, Department of Clinical Laboratory, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Jingjing Chen
- Laboratory of Microbiology, Department of Clinical Laboratory, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Wei Du
- National Clinical Research Center for Laboratory Medicine, Department of Clinical Laboratory, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Hui Kang
- Laboratory of Microbiology, Department of Clinical Laboratory, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Zhongqing Wang
- Department of Information Centre, The First Hospital of China Medical University, Shenyang, Liaoning, China
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10
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Lockhart SR, Chowdhary A, Gold JAW. The rapid emergence of antifungal-resistant human-pathogenic fungi. Nat Rev Microbiol 2023; 21:818-832. [PMID: 37648790 DOI: 10.1038/s41579-023-00960-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2023] [Indexed: 09/01/2023]
Abstract
During recent decades, the emergence of pathogenic fungi has posed an increasing public health threat, particularly given the limited number of antifungal drugs available to treat invasive infections. In this Review, we discuss the global emergence and spread of three emerging antifungal-resistant fungi: Candida auris, driven by global health-care transmission and possibly facilitated by climate change; azole-resistant Aspergillus fumigatus, driven by the selection facilitated by azole fungicide use in agricultural and other settings; and Trichophyton indotineae, driven by the under-regulated use of over-the-counter high-potency corticosteroid-containing antifungal creams. The diversity of the fungi themselves and the drivers of their emergence make it clear that we cannot predict what might emerge next. Therefore, vigilance is critical to monitoring fungal emergence, as well as the rise in overall antifungal resistance.
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Affiliation(s)
- Shawn R Lockhart
- Mycotic Diseases Branch, Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Anuradha Chowdhary
- Medical Mycology Unit, Department of Microbiology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
- National Reference Laboratory for Antimicrobial Resistance in Fungal Pathogens, Medical Mycology Unit, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
| | - Jeremy A W Gold
- Mycotic Diseases Branch, Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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11
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Horton MV, Holt AM, Nett JE. Mechanisms of pathogenicity for the emerging fungus Candida auris. PLoS Pathog 2023; 19:e1011843. [PMID: 38127686 PMCID: PMC10735027 DOI: 10.1371/journal.ppat.1011843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Candida auris recently emerged as an urgent public health threat, causing outbreaks of invasive infections in healthcare settings throughout the world. This fungal pathogen persists on the skin of patients and on abiotic surfaces despite antiseptic and decolonization attempts. The heightened capacity for skin colonization and environmental persistence promotes rapid nosocomial spread. Following skin colonization, C. auris can gain entrance to the bloodstream and deeper tissues, often through a wound or an inserted medical device, such as a catheter. C. auris possesses a variety of virulence traits, including the capacity for biofilm formation, production of adhesins and proteases, and evasion of innate immune responses. In this review, we highlight the interactions of C. auris with the host, emphasizing the intersection of laboratory studies and clinical observations.
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Affiliation(s)
- Mark V. Horton
- Department of Medicine, University of Wisconsin, Madison, Wisconsin, United States of America
- Department of Medical Microbiology & Immunology, University of Wisconsin, Madison, Wisconsin, United States of America
| | - Ashley M. Holt
- Department of Medicine, University of Wisconsin, Madison, Wisconsin, United States of America
- Department of Medical Microbiology & Immunology, University of Wisconsin, Madison, Wisconsin, United States of America
| | - Jeniel E. Nett
- Department of Medicine, University of Wisconsin, Madison, Wisconsin, United States of America
- Department of Medical Microbiology & Immunology, University of Wisconsin, Madison, Wisconsin, United States of America
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12
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Kurakado S, Matsumoto Y, Sugita T. Comparing the virulence of four major clades of Candida auris strains using a silkworm infection model: Clade IV isolates had higher virulence than the other clades. Med Mycol 2023; 61:myad108. [PMID: 37898558 DOI: 10.1093/mmy/myad108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/21/2023] [Accepted: 10/27/2023] [Indexed: 10/30/2023] Open
Abstract
Candida auris is an emerging fungal pathogen that is feared to spread of infection because of its propensity for multidrug resistance and high mortality rate. This pathogenic yeast is classified into four major clades by phylogenetic analyses, which are referred to the South Asia clade (clade I), East Asia clade (clade II), South Africa clade (clade III), and South America clade (clade IV), based on the location of the initial isolate. In this study, we evaluated the virulence of C. auris strains belonging to four major clades and the therapeutic effects of micafungin in a silkworm infection model. The highest mortality rate at 21 h after C. auris inoculation was observed for strains from clade IV (80% or more). In contrast, it was 20% or less in those from other clades. Antifungal susceptibility tests indicated resistance to fluconazole and sensitivity to echinocandins in the blood-derived strains. Micafungin prolonged the survival of blood-derived C. auris infected silkworms. These results suggest that the silkworm infection model is useful for evaluating the virulence of C. auris and determining its therapeutic effects.
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Affiliation(s)
- Sanae Kurakado
- Department of Microbiology, Meiji Pharmaceutical University, 2-522-1, Noshio, Kiyose, Tokyo 204-8588, Japan
| | - Yasuhiko Matsumoto
- Department of Microbiology, Meiji Pharmaceutical University, 2-522-1, Noshio, Kiyose, Tokyo 204-8588, Japan
| | - Takashi Sugita
- Department of Microbiology, Meiji Pharmaceutical University, 2-522-1, Noshio, Kiyose, Tokyo 204-8588, Japan
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13
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Reis NF, de Jesus MCS, de Souza LCDSV, Alcântara LM, Rodrigues JADC, Brito SCP, Penna PDA, Vieira CS, Silva JRS, Penna BDA, Machado RLD, Mora-Montes HM, Baptista ARDS. Sporothrix brasiliensis Infection Modulates Antimicrobial Peptides and Stress Management Gene Expression in the Invertebrate Biomodel Galleria mellonella. J Fungi (Basel) 2023; 9:1053. [PMID: 37998858 PMCID: PMC10672515 DOI: 10.3390/jof9111053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/25/2023] [Accepted: 10/24/2023] [Indexed: 11/25/2023] Open
Abstract
Sporothrix brasiliensis is the most pathogenic species, responsible for the Brazilian cat-transmitted sporotrichosis hyperendemic. In this scenario, an investigation of the pathogen-host interaction can provide relevant information for future treatment strategies. To this end, the invertebrate Galleria mellonella has proven to be a suitable alternative for evaluating the virulence of pathogenic fungi, since the insect immune system is similar to the mammalian innate immune response. The aim of this work was to investigate phenotypic and molecular aspects of the immune response of G. mellonella throughout the S. brasiliensis infection. Hemocyte density and the evolution of the fungal load were evaluated. In parallel, RT-qPCR expression analysis of genes encoding antimicrobial peptides (Gallerimycin and Galiomycin) and stress management genes (C7 Contig 15362 and C8 Contig 19101) was conducted. The fungal load and hemocyte densities increased simultaneously and proportionally to the deleterious morphological events and larvae mortality. Gallerimycin, C7 Contig 15362 and C8 Contig 19101 genes were positively regulated (p < 0.05) at distinct moments of S. brasiliensis infection, characterizing a time-dependent and alternately modulated profile. Galiomycin gene expression remained unchanged. Our results contribute to the future proposal of potential alternative pathways for treating and consequently controlling S. brasiliensis zoonosis, a major public health issue in Latin America.
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Affiliation(s)
- Nathália Faria Reis
- Center for Microorganisms’ Investigation, Department of Microbiology and Parasitology, Biomedical Institute, Federal Fluminense University, Niterói 24020-141, RJ, Brazil; (N.F.R.); (M.C.S.d.J.); (L.C.d.S.V.d.S.); (L.M.A.); (J.A.d.C.R.); (S.C.P.B.); (R.L.D.M.)
| | - Myrela Conceição Santos de Jesus
- Center for Microorganisms’ Investigation, Department of Microbiology and Parasitology, Biomedical Institute, Federal Fluminense University, Niterói 24020-141, RJ, Brazil; (N.F.R.); (M.C.S.d.J.); (L.C.d.S.V.d.S.); (L.M.A.); (J.A.d.C.R.); (S.C.P.B.); (R.L.D.M.)
| | - Lais Cavalcanti dos Santos Velasco de Souza
- Center for Microorganisms’ Investigation, Department of Microbiology and Parasitology, Biomedical Institute, Federal Fluminense University, Niterói 24020-141, RJ, Brazil; (N.F.R.); (M.C.S.d.J.); (L.C.d.S.V.d.S.); (L.M.A.); (J.A.d.C.R.); (S.C.P.B.); (R.L.D.M.)
| | - Lucas Martins Alcântara
- Center for Microorganisms’ Investigation, Department of Microbiology and Parasitology, Biomedical Institute, Federal Fluminense University, Niterói 24020-141, RJ, Brazil; (N.F.R.); (M.C.S.d.J.); (L.C.d.S.V.d.S.); (L.M.A.); (J.A.d.C.R.); (S.C.P.B.); (R.L.D.M.)
| | - Julia Andrade de Castro Rodrigues
- Center for Microorganisms’ Investigation, Department of Microbiology and Parasitology, Biomedical Institute, Federal Fluminense University, Niterói 24020-141, RJ, Brazil; (N.F.R.); (M.C.S.d.J.); (L.C.d.S.V.d.S.); (L.M.A.); (J.A.d.C.R.); (S.C.P.B.); (R.L.D.M.)
| | - Simone Cristina Pereira Brito
- Center for Microorganisms’ Investigation, Department of Microbiology and Parasitology, Biomedical Institute, Federal Fluminense University, Niterói 24020-141, RJ, Brazil; (N.F.R.); (M.C.S.d.J.); (L.C.d.S.V.d.S.); (L.M.A.); (J.A.d.C.R.); (S.C.P.B.); (R.L.D.M.)
| | - Patrícia de Azambuja Penna
- Laboratory of Insect Biology, Federal Fluminense University, Niterói 24220-900, RJ, Brazil; (P.d.A.P.); (C.S.V.)
| | - Cecília Stahl Vieira
- Laboratory of Insect Biology, Federal Fluminense University, Niterói 24220-900, RJ, Brazil; (P.d.A.P.); (C.S.V.)
| | - José Rodrigo Santos Silva
- Department of Statistics and Actuarial Sciences, Federal University of Sergipe, São Cristóvão 49107-230, SE, Brazil;
| | - Bruno de Araújo Penna
- Laboratory of Gram-Positive Cocci, Biomedical Institute, Fluminense Federal University, Niterói 24020-141, RJ, Brazil;
| | - Ricardo Luiz Dantas Machado
- Center for Microorganisms’ Investigation, Department of Microbiology and Parasitology, Biomedical Institute, Federal Fluminense University, Niterói 24020-141, RJ, Brazil; (N.F.R.); (M.C.S.d.J.); (L.C.d.S.V.d.S.); (L.M.A.); (J.A.d.C.R.); (S.C.P.B.); (R.L.D.M.)
| | - Hector M. Mora-Montes
- Department of Biology, Division of Natural and Exact Sciences, Campus Guanajuato, University of Guanajuato, Guanajuato 36050, Mexico;
| | - Andréa Regina de Souza Baptista
- Center for Microorganisms’ Investigation, Department of Microbiology and Parasitology, Biomedical Institute, Federal Fluminense University, Niterói 24020-141, RJ, Brazil; (N.F.R.); (M.C.S.d.J.); (L.C.d.S.V.d.S.); (L.M.A.); (J.A.d.C.R.); (S.C.P.B.); (R.L.D.M.)
- Rede Micologia RJ—Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ), Rio de Janeiro 21941-630, RJ, Brazil
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Raza S, Wdowiak M, Grotek M, Adamkiewicz W, Nikiforow K, Mente P, Paczesny J. Enhancing the antimicrobial activity of silver nanoparticles against ESKAPE bacteria and emerging fungal pathogens by using tea extracts. NANOSCALE ADVANCES 2023; 5:5786-5798. [PMID: 37881701 PMCID: PMC10597549 DOI: 10.1039/d3na00220a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 08/12/2023] [Indexed: 10/27/2023]
Abstract
The sale of antibiotics and antifungals has skyrocketed since 2020. The increasing threat of pathogens like ESKAPE bacteria (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.), which are effective in evading existing antibiotics, and yeasts like Candida auris or Cryptococcus neoformans is pressing to develop efficient antimicrobial alternatives. Nanoparticles, especially silver nanoparticles (AgNPs), are believed to be promising candidates to supplement or even replace antibiotics in some applications. Here, we propose a way to increase the antimicrobial efficiency of silver nanoparticles by using tea extracts (black, green, or red) for their synthesis. This allows for using lower concentrations of nanoparticles and obtaining the antimicrobial effect in a short time. We found that AgNPs synthesized using green tea extract (G-TeaNPs) are the most effective, causing approximately 80% bacterial cell death in Gram-negative bacteria within only 3 hours at a concentration of 0.1 mg mL-1, which is better than antibiotics. Ampicillin at the same concentration (0.1 mg mL-1) and within the same duration (3 h) causes only up to 40% decrease in the number of S. aureus and E. cloacae cells (non-resistant strains). The tested silver nanoparticles also have antifungal properties and are effective against C. auris and C. neoformans, which are difficult to eradicate using other means. We established that silver nanoparticles synthesized with tea extracts have higher antibacterial properties than silver nanoparticles alone. Such formulations using inexpensive tea extracts and lower concentrations of silver nanoparticles show a promising solution to fight various pathogens.
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Affiliation(s)
- Sada Raza
- Institute of Physical Chemistry, Polish Academy of Sciences Kasprzaka 44/52 01-224 Warsaw Poland +48 22 343 2071
| | - Mateusz Wdowiak
- Institute of Physical Chemistry, Polish Academy of Sciences Kasprzaka 44/52 01-224 Warsaw Poland +48 22 343 2071
| | - Mateusz Grotek
- Institute of Physical Chemistry, Polish Academy of Sciences Kasprzaka 44/52 01-224 Warsaw Poland +48 22 343 2071
- Military University of Technology gen. Sylwestra Kaliskiego 2 00-908 Warsaw Poland
| | - Witold Adamkiewicz
- Institute of Physical Chemistry, Polish Academy of Sciences Kasprzaka 44/52 01-224 Warsaw Poland +48 22 343 2071
| | - Kostiantyn Nikiforow
- Institute of Physical Chemistry, Polish Academy of Sciences Kasprzaka 44/52 01-224 Warsaw Poland +48 22 343 2071
| | - Pumza Mente
- Institute of Physical Chemistry, Polish Academy of Sciences Kasprzaka 44/52 01-224 Warsaw Poland +48 22 343 2071
| | - Jan Paczesny
- Institute of Physical Chemistry, Polish Academy of Sciences Kasprzaka 44/52 01-224 Warsaw Poland +48 22 343 2071
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15
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Wei Y, Qiu J, Han Z, Wang X, Zhang H, Hou X, Lv X, Mao X. Antifungal bio-coating of endotracheal tube built by overexpressing the MCP1 gene of Saccharomyces boulardii and employing hydrogel as a "house" to antagonize Candida albicans. Biomater Res 2023; 27:97. [PMID: 37798667 PMCID: PMC10557164 DOI: 10.1186/s40824-023-00443-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/01/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND For some ICU patients, an artificial airway must be established with an endotracheal tube, but Candida albicans can easily adhere to the tube surface and form a biofilm, leading to potentially life threatening fungal infections. Therefore, it is urgent to prevent and reduce C. albicans infections introduced by the endotracheal tube. However, there are few antifungal drugs effective against C. albicans, and each of these drugs may have adverse effects on human cells. Saccharomyces boulardii is regarded as an alternative strategy to inhibit the adhesion of C. albicans, but it is affected by environmental stress. We hypothesized that it is feasible to strengthen the antagonistic ability of S. boulardii via encapsulating and genetically modification. METHODS In this study, a bioactive material carrying the overexpressed MCP1 gene of Saccharomyces boulardii was constructed based on one-step photo-crosslinking. This material achieved spatial growth control of S. boulardii by encapsulating each S. boulardii cell within a hydrogel pore. The bioactive material was coated on an endotracheal tube and tested for its ability to inhibit the adhesion of C. albicans. Additionally, the material's antagonistic activity towards C. albicans was evaluated by detecting intracellular Adenosine-triphosphate content, reactive oxygen species level and the activity of antioxidative enzymes. Tissue invasion experiment was executed to further evaluate the anti-adhesion ability of S. boulardii bio-coating. RESULTS Encapsulating the overexpression of MCP1 by S. boulardii in hydrogel pores enhanced the viability of probiotics in the presence of high salt and oxidation stress. When used as the coating of an endotracheal tube, the S. boulardii bioactive material efficiently inhibited the adhesion of C. albicans by impairing the activities of superoxide dismutase and catalase and disturbing mitochondrial functions. In vivo, the S. boulardii bioactive material coating displayed good biocompatibility and reduced the host tissue invasion and virulence of C. albicans. CONCLUSIONS The integration of genetic modification and immobilization model breaks the bottleneck of previous application of microorganisms, and provides a new way to prevent fungal infections introduced by endotracheal tubes.
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Affiliation(s)
- Yunyun Wei
- School of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Tai'an, 271016, China
- School of Radiology, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai'an, 271000, China
| | - Jianfeng Qiu
- School of Radiology, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai'an, 271000, China
- Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250000, China
| | - Ziqiang Han
- School of Laboratory Animal & Shandong Laboratory Animal Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, 250000, China
| | - Xuanyi Wang
- Department of Clinical Medicine, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250000, China
| | - Hui Zhang
- School of Laboratory Animal & Shandong Laboratory Animal Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, 250000, China
| | - Xinya Hou
- Department of Clinical Medicine, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250000, China
| | - Xiangwei Lv
- Department of Clinical Medicine, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250000, China
| | - Xiaolong Mao
- School of Laboratory Animal & Shandong Laboratory Animal Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, 250000, China.
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16
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Malinovská Z, Čonková E, Váczi P. Biofilm Formation in Medically Important Candida Species. J Fungi (Basel) 2023; 9:955. [PMID: 37888211 PMCID: PMC10607155 DOI: 10.3390/jof9100955] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 08/01/2023] [Accepted: 08/18/2023] [Indexed: 10/28/2023] Open
Abstract
Worldwide, the number of infections caused by biofilm-forming fungal pathogens is very high. In human medicine, there is an increasing proportion of immunocompromised patients with prolonged hospitalization, and patients with long-term inserted drains, cannulas, catheters, tubes, or other artificial devices, that exhibit a predisposition for colonization by biofilm-forming yeasts. A high percentage of mortality is due to candidemia caused by medically important Candida species. Species of major clinical significance include C. albicans, C. glabrata, C. tropicalis, C. parapsilosis, C. krusei, and C. auris. The association of these pathogenic species in the biofilm structure is a serious therapeutic problem. Candida cells growing in the form of a biofilm are able to resist persistent therapy thanks to a combination of their protective mechanisms and their ability to disseminate to other parts of the body, thus representing a threat from the perspective of a permanent source of infection. The elucidation of the key mechanisms of biofilm formation is essential to progress in the understanding and treatment of invasive Candida infections.
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Affiliation(s)
- Zuzana Malinovská
- Department of Pharmacology and Toxicology, University of Veterinary Medicine and Pharmacy, Komenského 73, 041 81 Košice, Slovakia; (E.Č.); (P.V.)
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Nikoomanesh F, Falahatinejad M, Černáková L, Dos Santos ALS, Mohammadi SR, Rafiee M, Rodrigues CF, Roudbary M. Combination of Farnesol with Common Antifungal Drugs: Inhibitory Effect against Candida Species Isolated from Women with RVVC. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59040743. [PMID: 37109701 PMCID: PMC10143126 DOI: 10.3390/medicina59040743] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/29/2023] [Accepted: 03/31/2023] [Indexed: 04/29/2023]
Abstract
Background and Objectives: Vulvovaginal candidiasis (VVC) is a mucous membrane infection, with an increased rate of antifungal resistance of Candida species. In this study, the in vitro efficacy of farnesol alone or in combination with traditional antifungals was assessed against resistant Candida strains recovered from women with VVC. Materials and Methods: Eighty Candida isolates were identified by multiplex polymerase chain reaction (PCR), and the antifungal susceptibility to amphotericin B (AMB), fluconazole (FLU), itraconazole (ITZ), voriconazole (VOR), clotrimazole (CTZ), and farnesol was tested by the standard microdilution method. The combinations of farnesol with each antifungal were calculated based on the fractional inhibitory concentration index (FICI). Result: Candida glabrata was the predominant species (48.75%) isolated from vaginal discharges, followed by C. albicans (43.75%), C. parapsilosis (3.75%), a mixed infection of C. albicans and C. glabrata (2.5%) and C. albicans and C. parapsilosis (1%). C. albicans and C. glabrata isolates had lower susceptibility to FLU (31.4% and 23.0%, respectively) and CTZ (37.1% and 33.3%, respectively). Importantly, there was "synergism" between farnesol-FLU and farnesol-ITZ against C. albicans and C. parapsilosis (FICI = 0.5 and 0.35, respectively), reverting the original azole-resistant profile. Conclusion: These findings indicate that farnesol can revert the resistance profile of azole by enhancing the activity of FLU and ITZ in resistant Candida isolates, which is a clinically promising result.
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Affiliation(s)
- Fatemeh Nikoomanesh
- Infectious Disease Research Center, Birjand University of Medical Sciences, Birjand 9717853577, Iran
| | - Mahsa Falahatinejad
- Department of Medical Mycology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran 14115111, Iran
| | - Lucia Černáková
- Department of Microbiology and Virology, Faculty of Natural Sciences, Comenius University in Bratislava, 842 15 Bratislava, Slovakia
| | - André Luis Souza Dos Santos
- Department of General Microbiology, Microbiology Institute Paulo de Góes, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-901, RJ, Brazil
| | - Shahla Roudbar Mohammadi
- Department of Medical Mycology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran 14115111, Iran
| | - Mitra Rafiee
- Department of Immunology, School of Medicine, Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand 9717853577, Iran
| | - Célia Fortuna Rodrigues
- LEPABE-Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal
- ALiCE-Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal
- TOXRUN-Toxicology Research Unit, Cooperativa de Ensino Superior Politécnico e Universitário-CESPU, 4585-116 Gandra PRD, Portugal
| | - Maryam Roudbary
- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran 1449614535, Iran
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18
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Wang X, Zhang W, Wu W, Wu S, Young A, Yan Z. Is Candida albicans a contributor to cancer? A critical review based on the current evidence. Microbiol Res 2023; 272:127370. [PMID: 37028206 DOI: 10.1016/j.micres.2023.127370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 03/23/2023] [Accepted: 03/26/2023] [Indexed: 04/01/2023]
Abstract
The association between Candida albicans (C. albicans) and cancer has been noticed for decades. Whether C. albicans infection is a complication of cancer status or as a contributor to cancer development remains to be discussed. This review systematically summarized the up-to-date knowledge about associations between C. albicans and various types of cancer, and discussed the role of C. albicans in cancer development. Most of the current clinical and animal evidence support the relationship between C. albicans and oral cancer development. However, there is insufficient evidence to demonstrate the role of C. albicans in other types of cancer. Moreover, this review explored the underlying mechanisms for C. albicans promoting cancer. It was hypothesized that C. albicans may promote cancer progression by producing carcinogenic metabolites, inducing chronic inflammation, remodeling immune microenvironment, activating pro-cancer signals, and synergizing with bacteria.
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Simon SP, Li R, Silver M, Andrade J, Tharian B, Fu L, Villanueva D, Abascal DG, Mayer A, Truong J, Figueroa N, Ghitan M, Chapnick E, Lin YS. Comparative Outcomes of Candida auris Bloodstream Infections: A Multicenter Retrospective Case-Control Study. Clin Infect Dis 2023; 76:e1436-e1443. [PMID: 36062367 DOI: 10.1093/cid/ciac735] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/29/2022] [Accepted: 09/01/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This study was performed to compare clinical characteristics and outcomes between patients with bloodstream infections (BSIs) caused by Candida auris and those with BSIs caused by other Candida spp. METHODS A multicenter retrospective case-control study was performed at 3 hospitals in Brooklyn, New York, between 2016 and 2020. The analysis included patients ≥18 years of age who had a positive blood culture for any Candida spp. and were treated empirically with an echinocandin. The primary outcome was the 30-day mortality rate. Secondary outcomes were 14-day clinical failure, 90-day mortality rate, 60-day microbiologic recurrence, and in-hospital mortality rate. RESULTS A total of 196 patients were included in the final analysis, including 83 patients with candidemia caused by C. auris. After inverse propensity adjustment, C. auris BSI was not associated with increased 30-day (adjusted odds ratio, 1.014 [95% confidence interval, .563-1.828]); P = .96) or 90-day (0.863 [.478-1.558]; P = .62) mortality rates. A higher risk for microbiologic recurrence within 60 days of completion of antifungal therapy was observed in patients with C. auris candidemia (adjusted odds ratio, 4.461 [95% confidence interval, 1.033-19.263]; P = .045). CONCLUSIONS C. auris BSIs are not associated with a higher mortality risk than BSIs caused by other Candida spp. The rate of microbiologic recurrence was higher in the C. auris group.
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Affiliation(s)
| | - Rosanna Li
- Maimonides Medical Center, Brooklyn, New York, USA
| | | | | | | | - Lung Fu
- Maimonides Medical Center, Brooklyn, New York, USA
| | | | | | - Ariel Mayer
- Maimonides Medical Center, Brooklyn, New York, USA
| | - James Truong
- The Brooklyn Hospital Center, Brooklyn, New York, USA
| | | | | | | | - Yu Shia Lin
- Maimonides Medical Center, Brooklyn, New York, USA
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Candida auris as an Emergent Public Health Problem: A Current Update on European Outbreaks and Cases. Healthcare (Basel) 2023; 11:healthcare11030425. [PMID: 36767000 PMCID: PMC9914380 DOI: 10.3390/healthcare11030425] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/26/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
Candida auris is considered to be an emerging fungal pathogen and is related to high mortality rates, persistent candidemia, inconsistencies in susceptibility testing results and misidentification by available commercial identification systems. Multidrug-resistant (MDR) and pandrug-resistant (PDR) strains are increasingly detected. In Europe, hospital outbreaks caused by C. auris have been reported in the United Kingdom (UK), Italy and Spain; however, several cases have been sporadically detected in all European countries. C. auris is difficult to control despite enhanced control measures due to its ability to survive for a long time in environments and colonize patients for prolonged periods. An adequate laboratory diagnostic capacity and national surveillance are fundamental to rapidly detect new C. auris cases and to apply the correct measures to circumscribe them and prevent their spread. Our narrative review aims to highlight the primary C. auris outbreaks and case reports that have occurred in Europe.
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Rabaan AA, Eljaaly K, Alfouzan WA, Mutair AA, Alhumaid S, Alfaraj AH, Aldawood Y, Alsaleh AA, Albayat H, Azmi RA, AlKaabi N, Alzahrani SJ, AlBahrani S, Sulaiman T, Alshukairi AN, Abuzaid AA, Garout M, Ahmad R, Muhammad J. Psychogenetic, genetic and epigenetic mechanisms in Candida auris: Role in drug resistance. J Infect Public Health 2023; 16:257-263. [PMID: 36608452 DOI: 10.1016/j.jiph.2022.12.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 10/28/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
In recent years, we are facing the challenge of drug resistance emergence in fungi. The availability of limited antifungals and development of multi-drug resistance in fungal pathogens has become a serious concern in the past years in the health sector. Although several cellular, molecular, and genetic mechanisms have been proposed to explain the drug resistance mechanism in fungi, but a complete understanding of the molecular and genetic mechanisms is still lacking. Besides the genetic mechanism, epigenetic mechanisms are pivotal in the fungal lifecycle and disease biology. However, very little is understood about the role of epigenetic mechanisms in the emergence of multi-drug resistance in fungi, especially in Candida auris (C. auris). The current narrative review summaries the clinical characteristics, genomic organization, and molecular/genetic/epigenetic mechanisms underlying the emergence of drug resistance in C. auris. A very few studies have attempted to evaluate the role of epigenetic mechanisms in C. auris. Furthermore, advanced genetic tools such as the CRISP-Cas9 system can be utilized to elucidate the epigenetic mechanisms and their role in the emergence of multi-drug resistance in C. auris.
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Affiliation(s)
- Ali A Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia; Department of Public Health and Nutrition, The University of Haripur, Haripur 22610, Pakistan.
| | - Khalid Eljaaly
- Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia; Pharmacy Practice and Science Department, College of Pharmacy, University of Arizona, Tucson, AZ, USA
| | - Wadha A Alfouzan
- Department of Microbiology, Faculty of Medicine, Kuwait University, Safat 13110, Kuwait; Microbiology Unit, Department of Laboratories, Farwania Hospital, Farwania 85000, Kuwait
| | - Abbas Al Mutair
- Research Center, Almoosa Specialist Hospital, Al-Ahsa 36342, Saudi Arabia; College of Nursing, Princess Norah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia; School of Nursing, Wollongong University, Wollongong, NSW 2522, Australia; Nursing Department, Prince Sultan Military College of Health Sciences, Dhahran 33048, Saudi Arabia
| | - Saad Alhumaid
- Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 31982, Saudi Arabia
| | - Amal H Alfaraj
- Pediatric Department, Abqaiq General Hospital, First Eastern Health Cluster, Abqaiq 33261, Saudi Arabia
| | - Yahya Aldawood
- Clinical Laboratory Science Department, Mohammed Al-Mana College for Medical Sciences, Dammam 34222, Saudi Arabia
| | - Abdulmonem A Alsaleh
- Clinical Laboratory Science Department, Mohammed Al-Mana College for Medical Sciences, Dammam 34222, Saudi Arabia
| | - Hawra Albayat
- Infectious Disease Department, King Saud Medical City, Riyadh 7790, Saudi Arabia
| | - Reyouf Al Azmi
- Infection Prevention and Control, Eastern Health Cluster, Dammam 32253, Saudi Arabia
| | - Nawal AlKaabi
- Sheikh Khalifa Medical City, Abu Dhabi Health Services Company (SEHA), Abu Dhabi, 51900, United Arab Emirates; College of Medicine and Health Science, Khalifa University, Abu Dhabi, 127788, United Arab Emirates
| | - Samira J Alzahrani
- Molecular Diagnostic Laboratory, King Fahd Military Medical Complex, Dhahran 31932, Saudi Arabia
| | - Salma AlBahrani
- Infectious Disease Unit, Specialty Internal Medicine, King Fahd Military Medical Complex, Dhahran 31932, Saudi Arabia
| | - Tarek Sulaiman
- Infectious Diseases Section, Medical Specialties Department, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Abeer N Alshukairi
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia; Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Abdulmonem A Abuzaid
- Medical Microbiology Department, Security Forces Hospital Programme, Dammam 32314, Saudi Arabia
| | - Mohammed Garout
- Department of Community Medicine and Health Care for Pilgrims, Faculty of Medicine, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Rafiq Ahmad
- Department of Microbiology, The University of Haripur, Haripur 22610, Pakistan
| | - Javed Muhammad
- Department of Microbiology, The University of Haripur, Haripur 22610, Pakistan.
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22
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Cao C, Bing J, Liao G, Nobile CJ, Huang G. Candida haemulonii species complex: emerging fungal pathogens of the Metschnikowiaceae clade. ZOONOSES (BURLINGTON, MASS.) 2023; 3:43. [PMID: 39238892 PMCID: PMC11376483 DOI: 10.15212/zoonoses-2023-0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/07/2024]
Abstract
Candida species represent the most common fungal pathogens of humans, causing not only superficial infections but also life-threatening invasive infections, especially in immunocompromised individuals. While Candida albicans remains the most frequent cause of candidiasis, infections caused by non-albicans Candida species have been increasingly reported in clinical settings over the past two decades. Recently, species of the Metschnikowiaceae clade including the "superbug" Candida auris and other members of the Candida haemulonii species complex have attracted significant attention due to their multidrug resistance and high rates of transmission in clinical settings. In this review, we summarize the epidemiology, biology, virulence, and drug resistance of the C. haemulonii species complex and discuss potential reasons for the recent increase in prevalence of infections caused by non-albicans species in clinical settings.
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Affiliation(s)
- Chengjun Cao
- The Medical Research Institute, College of Pharmaceutical Sciences, Southwest University, Chongqing, 400715, China
- Shanghai Institute of Infectious Disease and Biosecurity, Department of Infectious Diseases, Huashan Hospital and State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, 200438, China
| | - Jian Bing
- Shanghai Institute of Infectious Disease and Biosecurity, Department of Infectious Diseases, Huashan Hospital and State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, 200438, China
| | - Guojian Liao
- The Medical Research Institute, College of Pharmaceutical Sciences, Southwest University, Chongqing, 400715, China
| | - Clarissa J Nobile
- Department of Molecular and Cell Biology, University of California, Merced, CA 95343, USA
- Health Sciences Research Institute, University of California, Merced, CA 95343, USA
| | - Guanghua Huang
- The Medical Research Institute, College of Pharmaceutical Sciences, Southwest University, Chongqing, 400715, China
- Shanghai Institute of Infectious Disease and Biosecurity, Department of Infectious Diseases, Huashan Hospital and State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, 200438, China
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Gómez-Gaviria M, Martínez-Álvarez JA, Chávez-Santiago JO, Mora-Montes HM. Candida haemulonii Complex and Candida auris: Biology, Virulence Factors, Immune Response, and Multidrug Resistance. Infect Drug Resist 2023; 16:1455-1470. [PMID: 36942024 PMCID: PMC10024503 DOI: 10.2147/idr.s402754] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 03/06/2023] [Indexed: 03/16/2023] Open
Abstract
There is worldwide concern about the constant increase in infections caused by Candida species that are multiresistant to antifungal drugs. The most common candidiasis is caused by Candida albicans, however, the species of the Candida haemulonii complex and Candida auris are emerging opportunistic pathogens, which isolation from clinical samples has significantly increased in the past years. The special interest in the study of these species lies in their ability to evade the action of antifungal drugs, such as amphotericin B, azoles, and echinocandins. In addition, the phenotypic changes of these species have given them the ability to easily adapt to environmental changes, including the host milieu and immunity. In this paper, a detailed review of the current literature on the C. haemulonii complex and C. auris is shown, analyzing aspects such as biology, immune response, putative virulence factors, infection, treatment, and the current strategies for diagnosis.
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Affiliation(s)
- Manuela Gómez-Gaviria
- Departamento de Biología, División de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, Guanajuato, Gto, México
- Correspondence: Manuela Gómez-Gaviria; Héctor M Mora-Montes, Departamento de Biología, División de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, Noria Alta s/n, Col. Noria Alta, Guanajuato, Gto, C. P. 36050, México, Tel +52 473-7320006 Ext. 8193, Fax +52 473-7320006 Ext. 8153, Email ;
| | - José A Martínez-Álvarez
- Departamento de Biología, División de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, Guanajuato, Gto, México
| | - Joaquín O Chávez-Santiago
- Departamento de Biología, División de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, Guanajuato, Gto, México
| | - Héctor M Mora-Montes
- Departamento de Biología, División de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, Guanajuato, Gto, México
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Garcia-Bustos V, Pemán J, Ruiz-Gaitán A, Cabañero-Navalon MD, Cabanilles-Boronat A, Fernández-Calduch M, Marcilla-Barreda L, Sigona-Giangreco IA, Salavert M, Tormo-Mas MÁ, Ruiz-Saurí A. Host-pathogen interactions upon Candida auris infection: fungal behaviour and immune response in Galleria mellonella. Emerg Microbes Infect 2022; 11:136-146. [PMID: 34890523 PMCID: PMC8725852 DOI: 10.1080/22221751.2021.2017756] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 12/08/2021] [Indexed: 02/07/2023]
Abstract
Candida auris has globally emerged as a multidrug-resistant fungus linked to healthcare-associated outbreaks. There is still limited evidence on its virulence, pathogenicity determinants, and complex host-pathogen interactions. This study analyzes the in vivo fungal behaviour, immune response, and host-pathogen interactions upon C. auris infection compared to C. albicans and C. parapsilosis in G. mellonella. This was performed by immunolabelling fungal structures and larval plasmatocytes and using a quantitative approach incorporating bioinformatic morphometric techniques into the study of microbial pathogenesis. C. auris presents a remarkably higher immunogenic activity than expected at its moderate degree of tissue invasion. It induces a greater inflammatory response than C. albicans and C. parapsilosis at the expense of plasmatocyte nodule formation, especially in non-aggregative strains. It specifically invades the larval respiratory system, in a pattern not previously observed in other Candida species, and presents inter-phenotypic tissue tropism differences. C. auris filaments in vivo less frequently than C. albicans or C. parapsilosis mostly through pseudohyphal growth. Filamentation might not be a major pathogenic determinant in C. auris, as less virulent aggregative phenotypes form pseudohyphae to a greater extent. C. auris has important both interspecific and intraspecific virulence and phenotype heterogeneity, with aggregative phenotypes of C. auris sharing characteristics with low pathogenic species such as C. parapsilosis. Our work suggests that C. auris owns an important morphogenetic plasticity that distinguishes it from other yeasts of the genus. Routine phenotypic identification of aggregative or non-aggregative phenotypes should be performed in the clinical setting as it may impact patient management.
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Affiliation(s)
- Victor Garcia-Bustos
- Department of Internal Medicine and Infectious Diseases, University and Polytechnic La Fe Hospital, Valencia, Spain
- Severe Infection Research Group, Health Research Institute La Fe, Valencia, Spain
- Department of Pathology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Javier Pemán
- Severe Infection Research Group, Health Research Institute La Fe, Valencia, Spain
- Department of Medical Microbiology, University and Polytechnic La Fe Hospital, Valencia, Spain
| | - Alba Ruiz-Gaitán
- Severe Infection Research Group, Health Research Institute La Fe, Valencia, Spain
| | - Marta Dafne Cabañero-Navalon
- Department of Internal Medicine and Infectious Diseases, University and Polytechnic La Fe Hospital, Valencia, Spain
| | - Ana Cabanilles-Boronat
- Department of Pathology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - María Fernández-Calduch
- Department of Pathology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Lucía Marcilla-Barreda
- Department of Pathology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Ignacio A. Sigona-Giangreco
- Severe Infection Research Group, Health Research Institute La Fe, Valencia, Spain
- Department of Medical Microbiology, University and Polytechnic La Fe Hospital, Valencia, Spain
| | - Miguel Salavert
- Department of Internal Medicine and Infectious Diseases, University and Polytechnic La Fe Hospital, Valencia, Spain
- Severe Infection Research Group, Health Research Institute La Fe, Valencia, Spain
| | | | - Amparo Ruiz-Saurí
- Department of Pathology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
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25
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Hoenigl M, Lewis R, van de Veerdonk FL, Verweij PE, Cornely OA. Liposomal amphotericin B—the future. J Antimicrob Chemother 2022; 77:ii21-ii34. [PMID: 36426674 PMCID: PMC9693803 DOI: 10.1093/jac/dkac353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 09/26/2022] [Indexed: 11/26/2022] Open
Abstract
Advances in medicine have led to a growing number of people with compromised or suppressed immune systems who are susceptible to invasive fungal infections. In particular, severe fungal infections are becoming increasingly common in ICUs, affecting people within and outside of traditional risk groups alike. This is exemplified by the emergence of severe viral pneumonia as a significant risk factor for invasive pulmonary aspergillosis, and the recognition of influenza-associated pulmonary aspergillosis and, more recently, COVID-19-associated pulmonary aspergillosis. The treatment landscape for haematological malignancies has changed considerably in recent years, and some recently introduced targeted agents, such as ibrutinib, are increasing the risk of invasive fungal infections. Consideration must also be given to the risk of drug–drug interactions between mould-active azoles and small-molecule kinase inhibitors. At the same time, infections caused by rare moulds and yeasts are increasing, and diagnosis continues to be challenging. There is growing concern about azole resistance among both moulds and yeasts, mandating continuous surveillance and personalized treatment strategies. It is anticipated that the epidemiology of fungal infections will continue to change and that new populations will be at risk. Early diagnosis and appropriate treatment remain the most important predictors of survival, and broad-spectrum antifungal agents will become increasingly important. Liposomal amphotericin B will remain an essential therapeutic agent in the armamentarium needed to manage future challenges, given its broad antifungal spectrum, low level of acquired resistance and limited potential for drug–drug interactions.
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Affiliation(s)
- M Hoenigl
- Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz , Graz , Austria
- BioTechMed-Graz , Graz , Austria
- European Confederation of Medical Mycology (ECMM) Excellence Center, Medical University of Graz , Graz , Austria
| | - R Lewis
- Department of Medical and Surgical Sciences, Infectious Diseases Hospital, IRCSS S’Orsola-Malpighi, University of Bologna , Bologna , Italy
| | - F L van de Veerdonk
- Department of Internal Medicine, Radboud Center for Infectious Diseases, Radboud University Medical Center , Nijmegen , The Netherlands
| | - P E Verweij
- Department of Medical Microbiology, Radboud University Medical Center—CWZ Center of Expertise for Mycology , Nijmegen , The Netherlands
- Center for Infectious Disease Research, Diagnostics and Laboratory Surveillance, National Institute for Public Health and the Environment (RIVM) , Bilthoven , The Netherlands
| | - O A Cornely
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD) , Cologne , Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM) , Cologne , Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne , Cologne , Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln) , Cologne , Germany
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Similarities and Differences among Species Closely Related to Candida albicans: C. tropicalis, C. dubliniensis, and C. auris. Cell Microbiol 2022. [DOI: 10.1155/2022/2599136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Although Candida species are widespread commensals of the microflora of healthy individuals, they are also among the most important human fungal pathogens that under certain conditions can cause diseases (candidiases) of varying severity ranging from mild superficial infections of the mucous membranes to life-threatening systemic infections. So far, the vast majority of research aimed at understanding the molecular basis of pathogenesis has been focused on the most common species—Candida albicans. Meanwhile, other closely related species belonging to the CTG clade, namely, Candida tropicalis and Candida dubliniensis, are becoming more important in clinical practice, as well as a relatively newly identified species, Candida auris. Despite the close relationship of these microorganisms, it seems that in the course of evolution, they have developed distinct biochemical, metabolic, and physiological adaptations, which they use to fit to commensal niches and achieve full virulence. Therefore, in this review, we describe the current knowledge on C. tropicalis, C. dubliniensis, and C. auris virulence factors, the formation of a mixed species biofilm and mutual communication, the environmental stress response and related changes in fungal cell metabolism, and the effect of pathogens on host defense response and susceptibility to antifungal agents used, highlighting differences with respect to C. albicans. Special attention is paid to common diagnostic problems resulting from similarities between these species and the emergence of drug resistance mechanisms. Understanding the different strategies to achieve virulence, used by important opportunistic pathogens of the genus Candida, is essential for proper diagnosis and treatment.
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Watkins RR, Gowen R, Lionakis MS, Ghannoum M. Update on the Pathogenesis, Virulence, and Treatment of Candida auris. Pathog Immun 2022; 7:46-65. [PMID: 36329818 PMCID: PMC9620957 DOI: 10.20411/pai.v7i2.535] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 09/26/2022] [Indexed: 11/23/2022] Open
Abstract
Candida auris is an emerging, multi-drug resistant fungal pathogen that causes considerable morbidity and mortality. First identified in Japan in 2009, it has since been reported in more than 40 countries. C. auris can persist for long periods on different environmental surfaces as well as the skin. Clinical isolates are typically resistant to commonly prescribed antifungal drugs. Increasingly recognized as a cause of infections and outbreaks in nosocomial settings, C. auris is difficult to identify using traditional microbiological methods. One of the main reasons for the ongoing spread of C. auris is the multitude of virulence factors it possesses and uses against its human host that enables fungal persistence on the skin surface. Yet, many of the virulence mechanisms are unknown or remain incompletely understood. In this review, we summarize the evolution of virulence of C. auris, offer recommendations for combating this important human pathogen, and suggest directions for further research.
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Affiliation(s)
- Richard R. Watkins
- Department of Medicine, Division of Infectious Diseases, Northeast Ohio Medical University, Rootstown, Ohio
- CORRESPONDING AUTHOR: Richard R. Watkins, MD, MS, FACP, FIDSA, FISAC;
| | - Rachael Gowen
- Center for Medical Mycology, Department of Dermatology, Case Western Reserve University, Cleveland, Ohio
| | - Michail S. Lionakis
- Fungal Pathogenesis Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy & Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Mahmoud Ghannoum
- Center for Medical Mycology, Department of Dermatology, Case Western Reserve University, Cleveland, Ohio
- University Hospitals Cleveland Medical Center, Cleveland, Ohio
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28
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The Menace of Candida auris Epidemic Amidst the COVID-19 Pandemic: A Systematic Review. Diseases 2022; 10:diseases10030058. [PMID: 36135214 PMCID: PMC9497911 DOI: 10.3390/diseases10030058] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/13/2022] [Accepted: 08/05/2022] [Indexed: 11/17/2022] Open
Abstract
Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), the causative agent for the Coronavirus Disease 2019 (COVID-19) pandemic, has sparked a medical emergency worldwide. With the rise in COVID-19 infections and an eventual increase in hospitalized critically ill patients, a trend of bacterial, fungal, and viral superinfection has been noted. One important agent of co-infection identified is Candida auris. Due to its multidrug-resistant nature and easy transmissibility, C. auris is difficult to manage in COVID-positive patients. Patients with comorbidities, immunosuppressive states, intubated and on ventilators are more likely to contract the fungal infection. Therefore, it is essential to the first screen, diagnose, and isolate patients with C. auris infection and manage and treat them while preventing the spread of the disease. Failure to recognize and prevent its spread may lead to an eventual epidemic or even a pandemic during the current COVID-pandemic, which the exhausted healthcare system can most definitely not handle. This systematic review investigates the prevalence of C. auris, its pathophysiology, diagnosis, prevention, and treatment during the COVID-19 pandemic.
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Jafarian H, Gharaghani M, Asnafi AA, Hardani AK, Zarei‐Mahmoudabadi A. Phenotype, genotype, and mating type determination in oral
Candida albicans
isolates from pediatric patients with neutropenia. J Clin Lab Anal 2022; 36:e24664. [PMID: 36082467 PMCID: PMC9459309 DOI: 10.1002/jcla.24664] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/01/2022] [Accepted: 08/04/2022] [Indexed: 11/08/2022] Open
Abstract
Background The most frequent species of Candida to infect and colonize patients with neutropenia is still Candida albicans. This study aimed to provide detailed information on the phenotype, genotype, and mating type of oral C. albicans isolated from neutropenic pediatric patients, and to investigate how these characteristics are related. Methods Two hundred fifty‐four oral samples from patients under 18 years old with neutropenia and malignancies were collected from January to October 2021. Samples were cultured on CHROMagar Candida. Isolates of C. albicans were identified with the germ tube test, chlamydospore production on cornmeal agar, and PCR‐RFLP. Genotyping of C. albicans isolates was carried out by amplifying the 25S rDNA gene with specific CAINT‐L and CA‐INT‐R primers. MTLa1 and MTLα1 primers were used to identify each mating type. Yeast peptone dextrose supplemented with phloxine B was used to identify different phenotypes. Results Ninety‐two (36%) patients were positive for C. albicans. The mean age of patients was 7.85. Fifty‐three (58.9%) isolates demonstrated type A, 15 (16.7%) type B, 15 (16.7%) types D/E, and 7 (7.7%) type C. Three isolates each (3.3%) were homozygous for MTLa or homozygous for MTLα. All of the MTL‐homozygous isolates were genotype A. There was a significant correlation between patients' underlying disease and genotype (p = 0.036). There was a significant correlation between mating type and genotype (p = 0.000). Conclusion Most of the isolates exhibited a white phenotype, noted in the literature as the most virulent. Moreover, heterozygous strains were frequent and may play a role in Candida colonization.
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Affiliation(s)
- Hadis Jafarian
- Department of Medical Mycology, School of Medicine Ahvaz Jundishapur University of Medical Sciences Ahvaz Iran
- Infectious and Tropical Diseases Research Center, Health Research Institute Ahvaz Jundishapur University of Medical Sciences Ahvaz Iran
| | - Maral Gharaghani
- Medicinal Plants Research Center Yasuj University of Medical Sciences Yasuj Iran
| | - Ali Amin Asnafi
- Thalassemia and Hemoglobinopathy Research Center, Health Research Institute Ahvaz Jundishapur University of Medical Sciences Ahvaz Iran
| | - Amir Kamal Hardani
- Department of Pediatrics, School of Medicine, Abuzar Children Hospital Ahvaz Jundishapur University of Medical Sciences Ahvaz Iran
| | - Ali Zarei‐Mahmoudabadi
- Department of Medical Mycology, School of Medicine Ahvaz Jundishapur University of Medical Sciences Ahvaz Iran
- Infectious and Tropical Diseases Research Center, Health Research Institute Ahvaz Jundishapur University of Medical Sciences Ahvaz Iran
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30
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Xia J, Huang W, Lu F, Li M, Wang B. Comparative Analysis of Epidemiological and Clinical Characteristics Between Invasive Candida Infection versus Colonization in Critically Ill Patients in a Tertiary Hospital in Anhui, China. Infect Drug Resist 2022; 15:3905-3918. [PMID: 35909934 PMCID: PMC9329706 DOI: 10.2147/idr.s368792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 07/12/2022] [Indexed: 11/26/2022] Open
Abstract
Objective Invasive infections due to Candida spp. have unique epidemiology, strain distribution, antimicrobial susceptibility, and clinical features. This study aimed to compare and evaluate these characteristic variables between invasive Candida infection and colonization of critically ill patients in local China to potentially improve differential diagnosis and therapy. Methods A total of 193 critically ill patients were recruited and followed up for the study, and 133 Candida isolates were obtained from invasive Candida-infected or -colonized subjects. The strains were identified to species level through matrix-assisted laser desorption/ionization–time-of-flight mass spectrometry, assisted by DNA sequencing. Candida susceptibility to common antifungals, including azoles, was determined by microbroth ATB Fungus 3 methodology. Azole resistance–related gene sequencing and homologous 3D-structure modeling were employed. Patient demographics and clinical risk factors were documented and comparatively analyzed from the hospital information-management system. Results Non–C. albicans Candida (56%) principally caused invasive Candida infections, while C. albicans (55.17%) contributed more to Candida colonization in critically ill patients. Additional risk factors exerted significant impact on both Candida cohorts, primarily including invasive interventions, cancers, and concurrent infections in common. Most colonized Candida spp. harbored relatively higher sensitivity to azoles. ERG11 gene mutations of T348A and A1309G, A395T and C461T, and a novel G1193T to our knowledge were identified in azole-resistant C. albicans, C. tropicalis, and C. parapsilosis respectively, and their corresponding homologous 3D-structure modeling was putatively achieved. Conclusion Distinct epidemiological and clinical characteristics existed between invasive Candida infection and colonization in critically ill patients. Multiple risk factors significantly involved both the Candida cohorts. Colonized Candida exhibited generally higher azole sensitivity than invasively infectious counterparts. ERG11 point mutations had mechanistically potential ties with local Candida resistance to azoles.
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Affiliation(s)
- Jinxing Xia
- Department of Clinical Laboratory, First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Wei Huang
- Department of Oncology, First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Fanbo Lu
- Department of Clinical Laboratory, First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Moyan Li
- Department of Clinical Laboratory, First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Bo Wang
- Department of Clinical Laboratory, First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
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31
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Mendoza-Reyes DF, Gómez-Gaviria M, Mora-Montes HM. Candida lusitaniae: Biology, Pathogenicity, Virulence Factors, Diagnosis, and Treatment. Infect Drug Resist 2022; 15:5121-5135. [PMID: 36068831 PMCID: PMC9441179 DOI: 10.2147/idr.s383785] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 08/25/2022] [Indexed: 12/30/2022] Open
Abstract
The incidence of fungal infections is increasing at an alarming rate and has posed a great challenge for science in recent years. The rise in these infections has been related to the increase in immunocompromised patients and the resistance of different species to antifungal drugs. Infections caused by the different Candida species, especially Candida albicans, are one of the most common mycoses in humans, and the etiological agents are considered opportunistic pathogens associated with high mortality rates when disseminated infections occur. Candida lusitaniae is considered an emerging opportunistic pathogen that most frequently affects immunocompromised patients with some comorbidity. Although it is a low-frequency pathogen, and the mortality rate of C. lusitaniae-caused candidemia does not exceed 5%, some isolates are known to be resistant to antifungals such as amphotericin B, 5-fluorocytosine, and fluconazole. In this paper, a detailed review of the current literature on this organism and its different aspects, such as its biology, possible virulence factors, pathogen-host interaction, diagnosis, and treatment of infection, is provided. Of particular interest, through Blastp analysis we predicted possible virulence factors in this species.
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Affiliation(s)
- Diana F Mendoza-Reyes
- Departamento de Biología, División de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, Guanajuato, Gto, C.P. 36050, México
| | - Manuela Gómez-Gaviria
- Departamento de Biología, División de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, Guanajuato, Gto, C.P. 36050, México
- Correspondence: Manuela Gómez-Gaviria; Héctor M Mora-Montes, Departamento de Biología, División de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, Noria Alta s/n, col. Noria Alta, Guanajuato, Gto, C.P. 36050, México, Tel +52 473-7320006 Ext. 8193, Fax +52 473-7320006 Ext. 8153, Email ;
| | - Héctor M Mora-Montes
- Departamento de Biología, División de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, Guanajuato, Gto, C.P. 36050, México
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Grizante Barião PH, Tonani L, Brancini GTP, Nascimento E, Braga GÚL, Wainwright M, von Zeska Kress MR. In vitro and in vivo photodynamic efficacies of novel and conventional phenothiazinium photosensitizers against multidrug-resistant Candida auris. Photochem Photobiol Sci 2022; 21:1807-1818. [PMID: 35816272 DOI: 10.1007/s43630-022-00258-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 06/10/2022] [Indexed: 10/17/2022]
Abstract
The fast-emerging and multidrug-resistant Candida auris is the first fungal pathogen to be considered a threat to global public health. Thus, there is a high unmet medical need to develop new therapeutic strategies to control this species. Antimicrobial photodynamic therapy (APDT) is a promising alternative that simultaneously targets and damages numerous microbial biomolecules. Here, we investigated the in vitro and in vivo effects of APDT with four phenothiazinium photosensitizers: (i) methylene blue (MB), (ii) toluidine blue (TBO), and two MB derivatives, (iii) new methylene blue (NMBN) and (iv) the pentacyclic derivative S137, against C. auris. To measure the in vitro efficacy of each PS, minimal inhibitory concentrations (MICs) and survival fraction were determined. Also, the efficiency of APDT was evaluated in vivo with the Galleria mellonella insect model for infection and treatment. Although the C. auris strain used in our study was shown to be resistant to the most-commonly used clinical antifungals, it could not withstand the damages imposed by APDT with any of the four photosensitizers. However, for the in vivo model, only APDT performed with S137 allowed survival of infected G. mellonella larvae. Our results show that structural and chemical properties of the photosensitizers play a major role on the outcomes of in vivo APDT and underscore the need to synthesize and develop novel photosensitizing molecules against multidrug-resistant microorganisms.
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Affiliation(s)
- Patrícia Helena Grizante Barião
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, 14040-903, Brazil
| | - Ludmilla Tonani
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, 14040-903, Brazil
| | - Guilherme Thomaz Pereira Brancini
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, 14040-903, Brazil
| | - Erika Nascimento
- Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, 14048-900, Brazil
| | - Gilberto Úbida Leite Braga
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, 14040-903, Brazil
| | - Mark Wainwright
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | - Marcia Regina von Zeska Kress
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, 14040-903, Brazil.
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Häring M, Amann V, Kissmann AK, Herberger T, Synatschke C, Kirsch-Pietz N, Perez-Erviti JA, Otero-Gonzalez AJ, Morales-Vicente F, Andersson J, Weil T, Stenger S, Rodríguez A, Ständker L, Rosenau F. Combination of Six Individual Derivatives of the Pom-1 Antibiofilm Peptide Doubles Their Efficacy against Invasive and Multi-Resistant Clinical Isolates of the Pathogenic Yeast Candida albicans. Pharmaceutics 2022; 14:pharmaceutics14071332. [PMID: 35890228 PMCID: PMC9319270 DOI: 10.3390/pharmaceutics14071332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/14/2022] [Accepted: 06/21/2022] [Indexed: 11/17/2022] Open
Abstract
In previous studies, derivatives of the peptide Pom-1, which was originally extracted from the freshwater mollusk Pomacea poeyana, showed an exceptional ability to specifically inhibit biofilm formation of the laboratory strain ATCC 90028 as a model strain of the pathogenic yeast Candida albicans. In follow-up, here, we demonstrate that the derivatives Pom-1A to Pom-1F are also active against biofilms of invasive clinical C. albicans isolates, including strains resistant against fluconazole and/or amphotericin B. However, efficacy varied strongly between the isolates, as indicated by large deviations in the experiments. This lack of robustness could be efficiently bypassed by using mixtures of all peptides. These mixed peptide preparations were active against biofilm formation of all the isolates with uniform efficacies, and the total peptide concentration could be halved compared to the original MIC of the individual peptides (2.5 µg/mL). Moreover, mixing the individual peptides restored the antifungal effect of fluconazole against fluconazole-resistant isolates even at 50% of the standard therapeutic concentration. Without having elucidated the reason for these synergistic effects of the peptides yet, both the gain of efficacy and the considerable increase in efficiency by combining the peptides indicate that Pom-1 and its derivatives in suitable formulations may play an important role as new antibiofilm antimycotics in the fight against invasive clinical infections with (multi-) resistant C. albicans.
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Affiliation(s)
- Michelle Häring
- Institute of Pharmaceutical Biotechnology, Ulm University, Albert-Einstein-Allee 11, 89081 Ulm, Germany; (M.H.); (V.A.)
| | - Valerie Amann
- Institute of Pharmaceutical Biotechnology, Ulm University, Albert-Einstein-Allee 11, 89081 Ulm, Germany; (M.H.); (V.A.)
| | - Ann-Kathrin Kissmann
- Institute of Pharmaceutical Biotechnology, Ulm University, Albert-Einstein-Allee 11, 89081 Ulm, Germany; (M.H.); (V.A.)
- Max Planck Institute for Polymer Research Mainz, Ackermannweg 10, 55128 Mainz, Germany; (T.H.); (C.S.); (N.K.-P.); (T.W.)
- Correspondence: (A.-K.K.); (F.R.)
| | - Tilmann Herberger
- Max Planck Institute for Polymer Research Mainz, Ackermannweg 10, 55128 Mainz, Germany; (T.H.); (C.S.); (N.K.-P.); (T.W.)
| | - Christopher Synatschke
- Max Planck Institute for Polymer Research Mainz, Ackermannweg 10, 55128 Mainz, Germany; (T.H.); (C.S.); (N.K.-P.); (T.W.)
| | - Nicole Kirsch-Pietz
- Max Planck Institute for Polymer Research Mainz, Ackermannweg 10, 55128 Mainz, Germany; (T.H.); (C.S.); (N.K.-P.); (T.W.)
| | - Julio A. Perez-Erviti
- Center for Protein Studies, Faculty of Biology, University of Havana, 25 Street, Havana 10400, Cuba; (J.A.P.-E.); (A.J.O.-G.)
| | - Anselmo J. Otero-Gonzalez
- Center for Protein Studies, Faculty of Biology, University of Havana, 25 Street, Havana 10400, Cuba; (J.A.P.-E.); (A.J.O.-G.)
| | - Fidel Morales-Vicente
- Synthetic Peptides Group, Center for Genetic Engineering and Biotechnology, Havana 10600, Cuba;
| | - Jakob Andersson
- AIT Austrian Institute of Technology GmbH, Giefinggasse 4, 1210 Vienna, Austria;
| | - Tanja Weil
- Max Planck Institute for Polymer Research Mainz, Ackermannweg 10, 55128 Mainz, Germany; (T.H.); (C.S.); (N.K.-P.); (T.W.)
| | - Steffen Stenger
- Institute for Medical Microbiology and Hygiene, University Hospital Ulm, 89081 Ulm, Germany;
| | - Armando Rodríguez
- Core Facility for Functional Peptidomics, Ulm Peptide Pharmaceuticals (U-PEP), Faculty of Medicine, Ulm University, 89081 Ulm, Germany; (A.R.); (L.S.)
- Core Unit of Mass Spectrometry and Proteomics, Faculty of Medicine, Ulm University, 89081 Ulm, Germany
| | - Ludger Ständker
- Core Facility for Functional Peptidomics, Ulm Peptide Pharmaceuticals (U-PEP), Faculty of Medicine, Ulm University, 89081 Ulm, Germany; (A.R.); (L.S.)
| | - Frank Rosenau
- Institute of Pharmaceutical Biotechnology, Ulm University, Albert-Einstein-Allee 11, 89081 Ulm, Germany; (M.H.); (V.A.)
- Max Planck Institute for Polymer Research Mainz, Ackermannweg 10, 55128 Mainz, Germany; (T.H.); (C.S.); (N.K.-P.); (T.W.)
- Correspondence: (A.-K.K.); (F.R.)
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Vaezi A, Moghadaszadeh M, Nasri E, Gharibi S, Diba K, Matkowski A, Fakhim H. In vitro activity of juglone (5-hydroxy-1,4-naphthoquinone) against both fluconazole-resistant and susceptible Candida isolates. Rev Iberoam Micol 2022; 39:50-53. [PMID: 35701335 DOI: 10.1016/j.riam.2022.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 11/23/2021] [Accepted: 01/12/2022] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND The rise in antifungal resistance and drug class limitations are causing higher morbidity and mortality rates all over the world. This issue highlights the urgent need for new and improved antifungal drugs with a novel target. AIMS In order to evaluate whether juglone can be served as an alternative antifungal to cure drug-resistant Candida infections, we studied the in vitro susceptibility of juglone against fluconazole-susceptible and -resistance Candida isolates, alone and in combination. METHODS Antifungal susceptibility testing was performed according to the CLSI (Clinical and Laboratory Standards Institute) guidelines. RESULTS Juglone exhibited the highest minimal inhibitory concentration (MIC) values, followed by fluconazole and nystatin. Voriconazole showed significantly better antifungal activity than juglone, fluconazole, and nystatin, with MIC50 and MIC90 of 0.031 and 0.5μg/mL. There were significant differences in MICs of fluconazole (p<0.001) and juglone (p<0.0003) between Candidaalbicans and the rest of the species. Combination of juglone with fluconazole revealed insignificant effects against fluconazole-susceptible and -resistant Candida isolates. Juglone increased the antifungal activity of fluconazole; however, no synergism effects were observed for any combination, and only an insignificant effect was found against all tested Candida species. CONCLUSIONS Although obtaining new antifungal drugs is a critical point, a completely novel approach should be implemented.
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Affiliation(s)
- Afsane Vaezi
- Department of Medical Laboratory Science, School of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Masoud Moghadaszadeh
- Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elahe Nasri
- Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shima Gharibi
- Core Research Facilities, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Kambiz Diba
- Department of Medical Parasitology and Mycology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Adam Matkowski
- Department of Pharmaceutical Biology and Botanical Garden of Medicinal Plants, Wroclaw Medical University, Wrocław, Poland
| | - Hamed Fakhim
- Department of Medical Parasitology and Mycology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran; Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
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35
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Simantirakis SC, MacCallum DM. Mouse Gastrointestinal Colonization Model for Candida auris. Methods Mol Biol 2022; 2517:329-340. [PMID: 35674966 DOI: 10.1007/978-1-0716-2417-3_26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Animal colonization and infection models are frequently used to investigate host-pathogen interactions and disease progression. Here, we describe an effective model to investigate the ability of the newly emerged fungal pathogen Candida auris to persistently colonize the gut of immunocompetent mice. In our model, mice are inoculated by gavage and are subsequently monitored for colonization by determining daily fungal stool burdens. At the end of the experiment, mice are culled, and their spleen, liver, kidneys, lungs, heart, and caecum harvested to determine the fungal burdens in order to investigate colonization and potentially dissemination of C. auris to other host organs.
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Affiliation(s)
- Stylianos C Simantirakis
- Aberdeen Fungal Group, Institute of Medical Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Donna M MacCallum
- Aberdeen Fungal Group, Institute of Medical Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK.
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Lara-Aguilar V, Rueda C, García-Barbazán I, Varona S, Monzón S, Jiménez P, Cuesta I, Zaballos Á, Zaragoza Ó. Adaptation of the emerging pathogenic yeast Candida auris to high caspofungin concentrations correlates with cell wall changes. Virulence 2021; 12:1400-1417. [PMID: 34180774 PMCID: PMC8244764 DOI: 10.1080/21505594.2021.1927609] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 04/15/2021] [Accepted: 04/30/2021] [Indexed: 11/13/2022] Open
Abstract
Candida auris has emerged as a fungal pathogen that causes nosocomial outbreaks worldwide. Diseases caused by this fungus are of concern, due to its reduced susceptibility to several antifungals. C. auris exhibits paradoxical growth (PG; defined as growth at high, but not intermediate antifungal concentrations) in the presence of caspofungin (CPF). We have characterized the cellular changes associated with adaptation to CPF. Using EUCAST AFST protocols, all C. auris isolates tested showed PG to CPF, although in some isolates it was more prominent. Most isolates also showed a trailing effect (TE) to micafungin and anidulafungin. We identified two FKS genes in C. auris that encode the echinocandins target, namely β-1,3-glucan synthase. FKS1 contained the consensus hot-spot (HS) 1 and HS2 sequences. FKS2 only contained the HS1 region which had a change (F635Y), that has been shown to confer resistance to echinocandins in C. glabrata. PG has been characterized in other species, mainly C. albicans, where high CPF concentrations induced an increase in chitin, cell volume and aggregation. In C. auris CPF only induced a slight accumulation of chitin, and none of the other phenomena. RNAseq experiments demonstrated that CPF induced the expression of genes encoding several GPI-anchored cell wall proteins, membrane proteins required for the stability of the cell wall, chitin synthase and mitogen-activated protein kinases (MAPKs) involved in cell integrity, such as BCK2, HOG1 and MKC1 (SLT2). Our work highlights some of the processes induced in C. auris to adapt to echinocandins.
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Affiliation(s)
- Violeta Lara-Aguilar
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto De Salud Carlos III, Madrid, Spain
| | - Cristina Rueda
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto De Salud Carlos III, Madrid, Spain
| | - Irene García-Barbazán
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto De Salud Carlos III, Madrid, Spain
| | - Sarai Varona
- Bioinformatics Unit, Core Scientific and Technical Units, Instituto De Salud Carlos III, Madrid, Spain
| | - Sara Monzón
- Bioinformatics Unit, Core Scientific and Technical Units, Instituto De Salud Carlos III, Madrid, Spain
| | - Pilar Jiménez
- Genomics Unit, Core Scientific and Technical Units, Instituto De Salud Carlos III, Madrid, Spain
| | - Isabel Cuesta
- Bioinformatics Unit, Core Scientific and Technical Units, Instituto De Salud Carlos III, Madrid, Spain
| | - Ángel Zaballos
- Genomics Unit, Core Scientific and Technical Units, Instituto De Salud Carlos III, Madrid, Spain
| | - Óscar Zaragoza
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto De Salud Carlos III, Madrid, Spain
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Flores-Maldonado O, González GM, Andrade A, Montoya A, Treviño-Rangel R, Silva-Sánchez A, Becerril-García MA. Dissemination of Candida auris to deep organs in neonatal murine invasive candidiasis. Microb Pathog 2021; 161:105285. [PMID: 34774701 DOI: 10.1016/j.micpath.2021.105285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/03/2021] [Accepted: 11/04/2021] [Indexed: 10/19/2022]
Abstract
Candida auris is an emerging multidrug resistant fungal pathogen, which represents a major challenge for newborns systemic infections worldwide. Management of C. auris infections is complicated due to its intrinsic antifungal resistance and the limited information available on its pathogenesis, particularly during neonatal period. In this study, we developed a murine model of C. auris neonatal invasive infection. C. auris dissemination was evaluated by fungal burden and histopathological analysis of lung, brain, liver, kidney, and spleen at different time intervals. We found fungal cells in all the analyzed tissues, neonatal liver and brain were the most susceptible tissues to fungal invasion. This model will help to better understand pathogenesis mechanisms and facilitate strategies for control and prevention of C. auris infections in newborns.
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Affiliation(s)
- Orlando Flores-Maldonado
- Departamento de Microbiología, Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Av. Francisco I. Madero, Mitras Centro, 64460, Monterrey, Mexico
| | - Gloria M González
- Departamento de Microbiología, Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Av. Francisco I. Madero, Mitras Centro, 64460, Monterrey, Mexico
| | - Angel Andrade
- Departamento de Microbiología, Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Av. Francisco I. Madero, Mitras Centro, 64460, Monterrey, Mexico
| | - Alexandra Montoya
- Departamento de Microbiología, Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Av. Francisco I. Madero, Mitras Centro, 64460, Monterrey, Mexico
| | - Rogelio Treviño-Rangel
- Departamento de Microbiología, Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Av. Francisco I. Madero, Mitras Centro, 64460, Monterrey, Mexico
| | - Aarón Silva-Sánchez
- Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Miguel A Becerril-García
- Departamento de Microbiología, Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Av. Francisco I. Madero, Mitras Centro, 64460, Monterrey, Mexico.
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Ahamefule CS, Ezeuduji BC, Ogbonna JC, Moneke AN, Ike AC, Jin C, Wang B, Fang W. Caenorhabditis elegans as an Infection Model for Pathogenic Mold and Dimorphic Fungi: Applications and Challenges. Front Cell Infect Microbiol 2021; 11:751947. [PMID: 34722339 PMCID: PMC8554291 DOI: 10.3389/fcimb.2021.751947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 09/28/2021] [Indexed: 11/13/2022] Open
Abstract
The threat burden from pathogenic fungi is universal and increasing with alarming high mortality and morbidity rates from invasive fungal infections. Understanding the virulence factors of these fungi, screening effective antifungal agents and exploring appropriate treatment approaches in in vivo modeling organisms are vital research projects for controlling mycoses. Caenorhabditis elegans has been proven to be a valuable tool in studies of most clinically relevant dimorphic fungi, helping to identify a number of virulence factors and immune-regulators and screen effective antifungal agents without cytotoxic effects. However, little has been achieved and reported with regard to pathogenic filamentous fungi (molds) in the nematode model. In this review, we have summarized the enormous breakthrough of applying a C. elegans infection model for dimorphic fungi studies and the very few reports for filamentous fungi. We have also identified and discussed the challenges in C. elegans-mold modeling applications as well as the possible approaches to conquer these challenges from our practical knowledge in C. elegans-Aspergillus fumigatus model.
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Affiliation(s)
- Chukwuemeka Samson Ahamefule
- National Engineering Research Center for Non-Food Biorefinery, Guangxi Academy of Sciences, Nanning, China.,College of Life Science and Technology, Guangxi University, Nanning, China.,Department of Microbiology, University of Nigeria, Nsukka, Nigeria
| | | | - James C Ogbonna
- Department of Microbiology, University of Nigeria, Nsukka, Nigeria
| | - Anene N Moneke
- Department of Microbiology, University of Nigeria, Nsukka, Nigeria
| | - Anthony C Ike
- Department of Microbiology, University of Nigeria, Nsukka, Nigeria
| | - Cheng Jin
- National Engineering Research Center for Non-Food Biorefinery, Guangxi Academy of Sciences, Nanning, China.,College of Life Science and Technology, Guangxi University, Nanning, China
| | - Bin Wang
- National Engineering Research Center for Non-Food Biorefinery, Guangxi Academy of Sciences, Nanning, China.,State Key Laboratory of Non-Food Biomass and Enzyme Technology, Guangxi Academy of Sciences, Nanning, China
| | - Wenxia Fang
- National Engineering Research Center for Non-Food Biorefinery, Guangxi Academy of Sciences, Nanning, China.,State Key Laboratory of Non-Food Biomass and Enzyme Technology, Guangxi Academy of Sciences, Nanning, China
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Wang T, Pan M, Xiao N, Wu J, Wang Q, Cheng T, Yan G, Wu D, Li N, Shao J. In vitro and in vivo analysis of monotherapy and dual therapy with ethyl caffeate and fluconazole on virulence factors of Candida albicans and systemic candidiasis. J Glob Antimicrob Resist 2021; 27:253-266. [PMID: 34700054 DOI: 10.1016/j.jgar.2021.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 10/01/2021] [Accepted: 10/12/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Candida albicans is the most clinically prevalent cause of systemic fungal infections in the immunocompromised population. The biofilm-forming ability of C. albicans confers resistance to conventional antifungal agents. The main aim of this study was to investigate the antifungal effects of ethyl caffeate (EC) alone and in combination with fluconazole (FLU) against C. albicans isolates. METHODS The single and combined antifungal activities of EC and FLU were evaluated against planktonic and biofilm cells of C. albicans by the checkerboard assay, time-kill test, crystal violet assay, live/dead staining, rhodamine 6G (R6G) efflux analysis and hydrolase activity. Monotherapy and dual therapy of EC and FLU against systemic candidiasis in a mouse model was also evaluated. RESULTS The results showed that EC+FLU displayed synergism in 14/26 planktonic C. albicans isolates and 11/26 C. albicans biofilms with fractional inhibitory concentration index (FICI) values ranging between 0.06-0.49 and 0.02-0.38, respectively. Compared with monotherapy, the combination of EC+FLU can markedly inhibit adhesion, yeast-to-hyphae transition, premature and mature biofilm metabolism, hydrolase secretion and drug efflux function of C. albicans Z1407 and Z4935. Moreover, EC can potentiate the antifungal activity of FLU to improve mouse survival, reduce fungal burden and alleviate pathological damage in both C. albicans isolates compared with EC or FLU used alone. CONCLUSION EC exhibits a moderate antifungal potential but can be a strong synergist with FLU against C. albicans, highlighting the potential of EC in clinical antifungal therapy as a sensitiser.
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Affiliation(s)
- Tianming Wang
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, School of Pharmacy, Anhui Medical University, 81 Meishan Road, 230032, Hefei, P.R. China; Laboratory of Infection and Immunity, College of Integrated Chinese and Western Medicine (College of Life Science), Anhui University of Chinese Medicine, 436 Room, Zhijing Building, 350 Longzihu Road, Xinzhan District, 230012, Hefei, P.R. China; Institute of Integrated Traditional Chinese and Western Medicine, Anhui Academy of Chinese Medicine, Zhijing Building, 350 Longzihu Road, Xinzhan District, Hefei, 230012, Anhui, P.R. China
| | - Min Pan
- Laboratory of Infection and Immunity, College of Integrated Chinese and Western Medicine (College of Life Science), Anhui University of Chinese Medicine, 436 Room, Zhijing Building, 350 Longzihu Road, Xinzhan District, 230012, Hefei, P.R. China
| | - Nan Xiao
- Laboratory of Infection and Immunity, College of Integrated Chinese and Western Medicine (College of Life Science), Anhui University of Chinese Medicine, 436 Room, Zhijing Building, 350 Longzihu Road, Xinzhan District, 230012, Hefei, P.R. China
| | - Jiadi Wu
- Department of Anatomy, School of Basic Medicine, Huazhong University of Science and Technology, 1037 Luoyu Road, Hongshan District, 430074, Wuhan, P.R. China
| | - Qirui Wang
- Laboratory of Infection and Immunity, College of Integrated Chinese and Western Medicine (College of Life Science), Anhui University of Chinese Medicine, 436 Room, Zhijing Building, 350 Longzihu Road, Xinzhan District, 230012, Hefei, P.R. China
| | - Ting Cheng
- Laboratory of Infection and Immunity, College of Integrated Chinese and Western Medicine (College of Life Science), Anhui University of Chinese Medicine, 436 Room, Zhijing Building, 350 Longzihu Road, Xinzhan District, 230012, Hefei, P.R. China
| | - Guiming Yan
- Laboratory of Infection and Immunity, College of Integrated Chinese and Western Medicine (College of Life Science), Anhui University of Chinese Medicine, 436 Room, Zhijing Building, 350 Longzihu Road, Xinzhan District, 230012, Hefei, P.R. China; Institute of Integrated Traditional Chinese and Western Medicine, Anhui Academy of Chinese Medicine, Zhijing Building, 350 Longzihu Road, Xinzhan District, Hefei, 230012, Anhui, P.R. China
| | - Daqiang Wu
- Laboratory of Infection and Immunity, College of Integrated Chinese and Western Medicine (College of Life Science), Anhui University of Chinese Medicine, 436 Room, Zhijing Building, 350 Longzihu Road, Xinzhan District, 230012, Hefei, P.R. China; Institute of Integrated Traditional Chinese and Western Medicine, Anhui Academy of Chinese Medicine, Zhijing Building, 350 Longzihu Road, Xinzhan District, Hefei, 230012, Anhui, P.R. China; CAS Center for Excellence in Molecular Cell Sciences, Ministry of Education Key Laboratory for Membrane-less Organelles & Cellular Dynamics, Hefei National Laboratory for Physical Sciences at the Microscale, School of Life Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, 230027, Hefei, P.R. China
| | - Ning Li
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, School of Pharmacy, Anhui Medical University, 81 Meishan Road, 230032, Hefei, P.R. China.
| | - Jing Shao
- Laboratory of Infection and Immunity, College of Integrated Chinese and Western Medicine (College of Life Science), Anhui University of Chinese Medicine, 436 Room, Zhijing Building, 350 Longzihu Road, Xinzhan District, 230012, Hefei, P.R. China; Institute of Integrated Traditional Chinese and Western Medicine, Anhui Academy of Chinese Medicine, Zhijing Building, 350 Longzihu Road, Xinzhan District, Hefei, 230012, Anhui, P.R. China.
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Pharkjaksu S, Boonmee N, Mitrpant C, Ngamskulrungroj P. Immunopathogenesis of Emerging Candida auris and Candida haemulonii Strains. J Fungi (Basel) 2021; 7:725. [PMID: 34575763 PMCID: PMC8469599 DOI: 10.3390/jof7090725] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/31/2021] [Accepted: 09/01/2021] [Indexed: 12/20/2022] Open
Abstract
The emergence of a multidrug-resistant Candida species, C. auris and C. haemulonii, has been reported worldwide. In Thailand, information on them is limited. We collected clinical isolates from Thai patients with invasive candidiasis. Both species were compared with a laboratory C. albicans strain. In vitro antifungal susceptibility and thermotolerance, and pathogenesis in the zebrafish model of infection were investigated. Both species demonstrated high minimal inhibitory concentrations to fluconazole and amphotericin B. Only C. auris tolerated high temperatures, like C. albicans. In a zebrafish swim-bladder-inoculation model, the C. auris-infected group had the highest mortality rate and infectivity, suggesting the highest virulence. The case fatality rates of C. auris, C. haemulonii, and C. albicans were 100%, 83.33%, and 51.52%, respectively. Further immunological studies revealed that both emerging Candida species stimulated genes involved in the proinflammatory cytokine group. Interestingly, the genes relating to leukocyte recruitment were downregulated only for C. auris infections. Almost all immune response genes to C. auris had a peak response at an early infection time, which contrasted with C. haemulonii. In conclusion, both emerging species were virulent in a zebrafish model of infection and could activate the inflammatory pathway. This study serves as a stepping stone for further pathogenesis studies of these important emerging species.
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Affiliation(s)
- Sujiraphong Pharkjaksu
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 10700 Bangkok, Thailand;
| | - Nawarat Boonmee
- Department of Biochemistry, Faculty of Medicine Siriraj Hospital, Mahidol University, 10700 Bangkok, Thailand; (N.B.); (C.M.)
| | - Chalermchai Mitrpant
- Department of Biochemistry, Faculty of Medicine Siriraj Hospital, Mahidol University, 10700 Bangkok, Thailand; (N.B.); (C.M.)
| | - Popchai Ngamskulrungroj
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 10700 Bangkok, Thailand;
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Zatorska B, Moser D, Diab-Elschahawi M, Ebner J, Lusignani LS, Presterl E. The effectiveness of surface disinfectants and a micellic H 2O 2 based water disinfectant on Candida auris. J Mycol Med 2021; 31:101178. [PMID: 34388399 DOI: 10.1016/j.mycmed.2021.101178] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 06/14/2021] [Accepted: 07/30/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND As infection control faces new challenges from emerging, multidrug resistant strains of the yeast Candida auris, this study was conducted in order to examine the efficacy of hospital surface disinfectants and a new water disinfectant against C. auris biofilm forms. METHODS We tested four reference strains of C. auris (NCPF8971, NCPF8977, NCPF8984, DSM21092) and one C. albicans strain (ATCC10231) against disinfectants based on ethanol (ETH), quaternary ammonium (QAC), a combination of glutaraldehyde, quaternary ammonium and surfactant (ALD) and potassium peroxymonosulfate (PP) as well as 3.4% H2O2 and 4.25% H2O2 alone. In addition, a micellic-based formulation containing 17% v/v hydrogene peroxide disinfectant (mH2O2) was tested. The efficacy of the disinfectants was measured in a 96-well plate using tetrazolium salt reduction (XTT) and the log10 reduction assay. RESULTS ETH and QAC displayed in clinically recommended concentrations more than 5log10 reduction and more than 80% XTT activity reduction for all of the Candida biofilms and planktonic cells. Only biofilms of C. auris NCPF8984 were additionally sensitive to all remaining disinfectants. All tested C. auris biofilms were sensitive to PP disinfectant and showed more than 5log10 reduction. However, the XTT assay showed a reduction of less than 80% for the PP disinfectant, indicating the presence of active but non-culturable cells. The 25% mH2O2 (corresponding to 4.25% H2O2) killed Candida biofilms after 1 minute.
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Affiliation(s)
- Beata Zatorska
- Department of Hospital Hygiene and Infection Control, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Doris Moser
- Department of Cranio-Maxillofacial and Oral Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Magda Diab-Elschahawi
- Department of Hospital Hygiene and Infection Control, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Julia Ebner
- Department of Hospital Hygiene and Infection Control, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Luigi Segagni Lusignani
- Department of Hospital Hygiene and Infection Control, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Elisabeth Presterl
- Department of Hospital Hygiene and Infection Control, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
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Faudoa-Arzate A, Camarillo-Cisneros J, Castillo-González AR, Favila-Pérez MA, Sáenz-Hernández RJ, Realyvazquez-Guevara PR, Arzate-Quintana C. Disinfection mechanism of the photocatalytic activity of SnO 2 thin films against Candida albicans, proposed from experimental and simulated perspectives. Can J Microbiol 2021; 67:667-676. [PMID: 34081871 DOI: 10.1139/cjm-2020-0559] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Nosocomial infections are an important health problem and cause of complications and death in hospitalized patients. This problem should be solved from the preventive angle, avoiding the spread of infections by designing disinfection methods based on the photocatalytic activity of semiconductor materials such as tin oxide (SnO2). The antimicrobial activity of UV light was tested by using inoculation with Candida albicans ATCC10231 on SnO2 thin films and counting colony forming units (CFU). The interaction of UV light with SnO2 was analyzed by density functional theory (DFT) and the extension to the Hubbard model (DFT+U) schemes to predict the electron behavior at the subatomic level. After exposure to UV light, C. albicans showed a reduction of 36.5% in viable cells, and when SnO2 was included, cell viability was reduced by 60.2%. Measurements of the electronic structure obtained by the first-principle calculations under the DFT and DFT+U schemes showed that the O-p orbitals mediate the oxidation process in the bulk semiconductor. By including the surface effects when cleaving the (1 0 0) plane, the three orbitals O-p, Sn-p, and Sn-s are the mediators. SnO2 films are promising antimicrobial coatings because UV light has a synergic activity with thin films, resulting in faster disinfection.
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Affiliation(s)
| | - Javier Camarillo-Cisneros
- Facultad de Medicina y Ciencias Biomédicas, Universidad Autónoma de Chihuahua, 31125 Chihuahua, Chih., Mexico
| | | | | | | | | | - Carlos Arzate-Quintana
- Facultad de Medicina y Ciencias Biomédicas, Universidad Autónoma de Chihuahua, 31125 Chihuahua, Chih., Mexico
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LncRNA DINOR is a virulence factor and global regulator of stress responses in Candida auris. Nat Microbiol 2021; 6:842-851. [PMID: 34083769 DOI: 10.1038/s41564-021-00915-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 04/29/2021] [Indexed: 11/08/2022]
Abstract
The emergent fungal pathogen Candida auris exhibits high resistance to antifungal drugs and environmental stresses, impeding treatment and decontamination1-3. The fungal factors mediating this stress tolerance are largely unknown. In the present study, we performed piggyBac, transposon-mediated, genome-wide mutagenesis and genetic screening in C. auris, and identified a mutant that grew constitutively in the filamentous form. Mapping the transposon insertion site revealed the disruption of a long non-coding RNA, named DINOR for DNA damage-inducible non-coding RNA. Deletion of DINOR caused DNA damage and an upregulation of genes involved in morphogenesis, DNA damage and DNA replication. The DNA checkpoint kinase Rad53 was hyperphosphorylated in dinorΔ mutants, and deletion of RAD53 abolished DNA damage-induced filamentation. DNA-alkylating agents, which cause similar filamentous growth, induced DINOR expression, suggesting a role for DINOR in maintaining genome integrity. Upregulation of DINOR also occurred during exposure to the antifungal drugs caspofungin and amphotericin B, macrophages, H2O2 and sodium dodecylsulfate, indicating that DINOR orchestrates multiple stress responses. Consistently, dinorΔ mutants displayed increased sensitivity to these stresses and were attenuated for virulence in mice. Moreover, genome-wide genetic interaction studies revealed links between the function of DINOR and TOR signalling, an evolutionarily conserved pathway that regulates the stress response. Identification of the mechanism(s) by which DINOR regulates stress responses in C. auris may provide future opportunities for the development of therapeutics.
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Jafarian H, Gharaghani M, Seyedian SS, Mahmoudabadi AZ. Genotyping, antifungal susceptibility, enzymatic activity, and phenotypic variation in Candida albicans from esophageal candidiasis. J Clin Lab Anal 2021; 35:e23826. [PMID: 33988259 PMCID: PMC8274993 DOI: 10.1002/jcla.23826] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 04/23/2021] [Accepted: 04/28/2021] [Indexed: 12/17/2022] Open
Abstract
Background Esophageal candidiasis is the most frequent form of esophagitis. The pathogenicity of Candida spp. is related to a combination of microbial factors, hydrolytic enzyme secretion and phenotypic switching. This study was designed to investigate esophageal candidiasis, antifungal activity, enzymatic activity patterns, phenotyping, and genotyping profiles of Candida albicans species. Methods Nine hundred thirty‐three visited patients were evaluated, and esophageal biopsies from patients were included in this study during 2019–2020. Direct smear, Gram staining, and culture on CHROMagar were performed for each sample. Isolated species were identified with conventional procedures and PCR‐RFLP. Susceptibility to antifungals was determined according to CLSI guidelines. ABC typing, phenotype switching, hemolysin, proteinase, phospholipase, and esterase activity were also determined with the appropriate protocols. Results Twenty‐three (2.5%) patients (mean age 55.2 years) were diagnosed with esophageal candidiasis. The species isolated were 19(82.6%) C. albicans, 3(13.1%) C. glabrata, and 1(4.3%) C. tropicalis. Genotype A (57.9%) was the predominant type in C. albicans isolates. 50% of C. albicans isolates exhibited a white phenotype. A high level of phospholipase (47.4%), hemolysin (68.4%), and proteinase activity (36.8%) was observed in the C. albicans isolates. Only three C. glabrata isolates displayed non‐wild type susceptibility to voriconazole and itraconazole. Conclusion This study shows that C. albicans are still the most frequent isolates from patients with esophageal candidiasis. The predominance of genotype A, the white phenotype, and strong hemolysin activity may indicate a high prevalence of pathogenicity in these isolates. Sensitivity to antifungal drugs was greatest for amphotericin and fluconazole.
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Affiliation(s)
- Hadis Jafarian
- Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maral Gharaghani
- Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Saeed Seyedian
- Department of Gastroenterology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ali Zarei Mahmoudabadi
- Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Hernando-Ortiz A, Mateo E, Perez-Rodriguez A, de Groot PWJ, Quindós G, Eraso E. Virulence of Candida auris from different clinical origins in Caenorhabditis elegans and Galleria mellonella host models. Virulence 2021; 12:1063-1075. [PMID: 33843456 PMCID: PMC8043173 DOI: 10.1080/21505594.2021.1908765] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Candida auris is an emerging multidrug-resistant fungal pathogen responsible for nosocomial outbreaks of invasive candidiasis. Although several studies on the pathogenicity of this species have been reported, the knowledge on C. auris virulence is still limited. This study aims to analyze the pathogenicity of C. auris, using one aggregating isolate and eleven non-aggregating isolates from different clinical origins (blood, urine and oropharyngeal specimens) in two alternative host models of candidiasis: Caenorhabditis elegans and Galleria mellonella. Furthermore, possible associations between virulence, aggregation, biofilm-forming capacity, and clinical origin were assessed. The aggregating phenotype isolate was less virulent in both in vivo invertebrate infection models than non-aggregating isolates but showed higher capacity to form biofilms. Blood isolates were significantly more virulent than those isolated from urine and respiratory specimens in the G. mellonella model of candidiasis. We conclude that both models of candidiasis present pros and cons but prove useful to evaluate the virulence of C. auris in vivo. Both models also evidence the heterogeneity in virulence that this species can develop, which may be influenced by the aggregative phenotype and clinical origin.
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Affiliation(s)
- Ainara Hernando-Ortiz
- Department of Immunology, Microbiology and Parasitology, Faculty of Medicine and Nursery, University of the Basque Country (UPV/EHU), Bilbao, Spain
| | - Estibaliz Mateo
- Department of Immunology, Microbiology and Parasitology, Faculty of Medicine and Nursery, University of the Basque Country (UPV/EHU), Bilbao, Spain
| | - Aitzol Perez-Rodriguez
- Department of Immunology, Microbiology and Parasitology, Faculty of Medicine and Nursery, University of the Basque Country (UPV/EHU), Bilbao, Spain
| | - Piet W J de Groot
- Regional Center for Biomedical Research, Castilla-La Mancha Science & Technology Park, University of Castilla-La Mancha, Albacete, Spain
| | - Guillermo Quindós
- Department of Immunology, Microbiology and Parasitology, Faculty of Medicine and Nursery, University of the Basque Country (UPV/EHU), Bilbao, Spain
| | - Elena Eraso
- Department of Immunology, Microbiology and Parasitology, Faculty of Medicine and Nursery, University of the Basque Country (UPV/EHU), Bilbao, Spain
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Kaan Ö, Koç AN, Atalay MA, Mutlu Sarigüzel F. Molecular epidemiology, antifungal susceptibility and virulence factors of Candida glabrata complex strains in Kayseri/Turkey. Microb Pathog 2021; 154:104870. [PMID: 33774107 DOI: 10.1016/j.micpath.2021.104870] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/17/2021] [Accepted: 03/18/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Candida nivariensis and Candida bracarensis are included in Candida glabrata complex, which are usually misidentified as C. glabrata based on phenotypic identification methods. It was aimed to identify C. glabrata complex isolated from various clinical samples in Kayseri/Turkey to the species level and to determine antifungal susceptibilities, virulence factors, and molecular epidemiology. METHODS Eighty three C. glabrata complex strains were studied in this study. Strains were phenotypically and molecularly identified. Phylogenetic analysis was done by the neighbor-joining method. Proteinase, phospholipase, esterase enzyme activity, and biofilm formation of strains were determined phenotypically. Antifungal susceptibility of strains were determined according to M60-Ed2 recommendations. RESULTS All the 83 strains identified as C. glabrata complex by phenotypic tests were confirmed as C. glabrata sensu stricto (C. glabrata) by PCR amplification and sequence analysis, but other complex members C. nivariensis and C. bracarensis were not detected. Phylogenetic analysis results revealed 19 different genotypes. No clonal relationship was detected among the strains. Biofilm formation in 75.9% of strains and esterase activity in 7.2% were found positive. Antifungal resistance rates of strains were determined as 9.2% for fluconazole and 45.8% for itraconazole; 43.4% of the strains for voriconazole were determined as non-wild type. CONCLUSION It was determined that biofilm and esterase activity might play an active role in the virulence of C. glabrata. In addition, high resistance rates to azoles in C. glabrata strains isolated in our hospital at Kayseri/Turkey emphasized the significance of epidemiological studies.
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Affiliation(s)
- Özge Kaan
- Department of Medical Microbiology, School of Medicine, Erciyes University, Kayseri, Turkey
| | - A Nedret Koç
- Department of Medical Microbiology, School of Medicine, Erciyes University, Kayseri, Turkey.
| | - Mustafa Altay Atalay
- Department of Medical Microbiology, School of Medicine, Erciyes University, Kayseri, Turkey
| | - Fatma Mutlu Sarigüzel
- Department of Medical Microbiology, School of Medicine, Erciyes University, Kayseri, Turkey
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Wu X, Xia Y, He F, Zhu C, Ren W. Intestinal mycobiota in health and diseases: from a disrupted equilibrium to clinical opportunities. MICROBIOME 2021; 9:60. [PMID: 33715629 PMCID: PMC7958491 DOI: 10.1186/s40168-021-01024-x] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 02/04/2021] [Indexed: 05/08/2023]
Abstract
Bacteria, viruses, protozoa, and fungi establish a complex ecosystem in the gut. Like other microbiota, gut mycobiota plays an indispensable role in modulating intestinal physiology. Notably, the most striking characteristics of intestinal fungi are their extraintestinal functions. Here, we provide a comprehensive review of the importance of gut fungi in the regulation of intestinal, pulmonary, hepatic, renal, pancreatic, and brain functions, and we present possible opportunities for the application of gut mycobiota to alleviate/treat human diseases. Video Abstract.
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Affiliation(s)
- Xiaoyan Wu
- State Key Laboratory for Conservation and Utilization of Subtropical Agro-Bioresources, Guangdong Laboratory of Lingnan Modern Agriculture, National Engineering Research Center for Breeding Swine Industry, Guangdong Provincial Key Laboratory of Animal Nutrition Control, College of Animal Science, South China Agricultural University, Guangzhou, 510642 China
| | - Yaoyao Xia
- State Key Laboratory for Conservation and Utilization of Subtropical Agro-Bioresources, Guangdong Laboratory of Lingnan Modern Agriculture, National Engineering Research Center for Breeding Swine Industry, Guangdong Provincial Key Laboratory of Animal Nutrition Control, College of Animal Science, South China Agricultural University, Guangzhou, 510642 China
| | - Fang He
- College of Animal Science and Technology, Southwest University, Chongqing, 400716 China
| | - Congrui Zhu
- College of Veterinary Medicine, Kansas State University, Manhattan, KS USA
| | - Wenkai Ren
- State Key Laboratory for Conservation and Utilization of Subtropical Agro-Bioresources, Guangdong Laboratory of Lingnan Modern Agriculture, National Engineering Research Center for Breeding Swine Industry, Guangdong Provincial Key Laboratory of Animal Nutrition Control, College of Animal Science, South China Agricultural University, Guangzhou, 510642 China
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Huang X, Hurabielle C, Drummond RA, Bouladoux N, Desai JV, Sim CK, Belkaid Y, Lionakis MS, Segre JA. Murine model of colonization with fungal pathogen Candida auris to explore skin tropism, host risk factors and therapeutic strategies. Cell Host Microbe 2021; 29:210-221.e6. [PMID: 33385336 PMCID: PMC7878403 DOI: 10.1016/j.chom.2020.12.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 09/28/2020] [Accepted: 12/03/2020] [Indexed: 12/15/2022]
Abstract
Candida auris is an emerging multi-drug-resistant human fungal pathogen. C. auris skin colonization results in environmental shedding, which underlies hospital transmissions, and predisposes patients to subsequent infections. We developed a murine skin topical exposure model for C. auris to dissect risk factors for colonization and to test interventions that might protect patients. We demonstrate that C. auris establishes long-term residence within the skin tissue compartment, which would elude clinical surveillance. The four clades of C. auris, with geographically distinct origins, differ in their abilities to colonize murine skin, mirroring epidemiologic findings. The IL-17 receptor signaling and specific arms of immunity protect mice from long-term C. auris skin colonization. We further determine that commonly used chlorhexidine antiseptic serves as a protective and decolonizing agent against C. auris. This translational model facilitates an integrated approach to develop strategies to combat the unfolding global outbreaks of C. auris and other skin-associated microbial pathogens.
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Affiliation(s)
- Xin Huang
- Microbial Genomics Section, National Human Genome Research Institute, NIH, Bethesda, MD 20892, USA
| | - Charlotte Hurabielle
- Metaorganism Immunity Section, Laboratory of Immune System Biology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD 20892, USA
| | - Rebecca A Drummond
- Fungal Pathogenesis Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD 20892, USA
| | - Nicolas Bouladoux
- Metaorganism Immunity Section, Laboratory of Immune System Biology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD 20892, USA; NIAID Microbiome Program, National Institute of Allergy and Infectious Diseases, Bethesda, MD 20892, USA
| | - Jigar V Desai
- Fungal Pathogenesis Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD 20892, USA
| | - Choon K Sim
- Microbial Genomics Section, National Human Genome Research Institute, NIH, Bethesda, MD 20892, USA
| | - Yasmine Belkaid
- Metaorganism Immunity Section, Laboratory of Immune System Biology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD 20892, USA; NIAID Microbiome Program, National Institute of Allergy and Infectious Diseases, Bethesda, MD 20892, USA
| | - Michail S Lionakis
- Fungal Pathogenesis Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD 20892, USA.
| | - Julia A Segre
- Microbial Genomics Section, National Human Genome Research Institute, NIH, Bethesda, MD 20892, USA.
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Forgács L, Borman AM, Prépost E, Tóth Z, Kardos G, Kovács R, Szekely A, Nagy F, Kovacs I, Majoros L. Comparison of in vivo pathogenicity of four Candida auris clades in a neutropenic bloodstream infection murine model. Emerg Microbes Infect 2021; 9:1160-1169. [PMID: 32486923 PMCID: PMC7448943 DOI: 10.1080/22221751.2020.1771218] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Candida auris is an emerging worldwide concern, but comparative data about the virulence of different C. auris lineages in mammalian hosts is lacking. Different isolates of the four prevalent C. auris clades (South Asian n = 5, East Asian n = 4, South African n = 5, and South American n = 5) were compared to assess their virulence in a neutropenic murine bloodstream infection model with C. albicans as reference. C. auris, regardless of clade, proved to be less virulent than C. albicans. Highest overall mortality at day 21 was observed for the South American clade (96%), followed by the South Asian (80%), South African (45%) and East Asian (44%) clades. Fungal burden results showed close correlation with lethality. Histopathological examination revealed large aggregates of blastoconidia and budding yeast cells in the hearts, kidneys and livers but not in the spleens. The myocardium of apparently healthy sacrificed mice as well as of mice found moribund showed contraction band necrosis in case of all lineages. Regardless of clade, the heart and kidneys were the most heavily affected organs. Isolates of the same clade showed differences in virulence in mice, but a markedly higher virulence of the South American clade was clearly demonstrated.
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Affiliation(s)
- Lajos Forgács
- Department of Medical Microbiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Doctoral School of Pharmaceutical Sciences, University of Debrecen, Debrecen, Hungary
| | - Andrew M Borman
- UK National Mycology Reference Laboratory (MRL), Public Health England South-West, Bristol, UK
| | - Eszter Prépost
- Department of Medical Microbiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Doctoral School of Pharmaceutical Sciences, University of Debrecen, Debrecen, Hungary
| | - Zoltán Tóth
- Department of Medical Microbiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Doctoral School of Pharmaceutical Sciences, University of Debrecen, Debrecen, Hungary
| | - Gábor Kardos
- Department of Medical Microbiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Renátó Kovács
- Department of Medical Microbiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Faculty of Pharmacy, University of Debrecen, Debrecen, Hungary
| | - Adrien Szekely
- UK National Mycology Reference Laboratory (MRL), Public Health England South-West, Bristol, UK
| | - Fruzsina Nagy
- Department of Medical Microbiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Doctoral School of Pharmaceutical Sciences, University of Debrecen, Debrecen, Hungary
| | - Ilona Kovacs
- Department of Pathology, Kenézy Gyula Hospital, University of Debrecen, Debrecen, Hungary
| | - László Majoros
- Department of Medical Microbiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Abe M, Katano H, Nagi M, Higashi Y, Sato Y, Kikuchi K, Hasegawa H, Miyazaki Y. Potency of gastrointestinal colonization and virulence of Candida auris in a murine endogenous candidiasis. PLoS One 2020; 15:e0243223. [PMID: 33264362 PMCID: PMC7710084 DOI: 10.1371/journal.pone.0243223] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 11/17/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Candida auris infections have recently emerged worldwide, and this species is highly capable of colonization and is associated with high levels of mortality. However, strain-dependent differences in colonization capabilities and virulence have not yet been reported. OBJECTIVES In the present study, we aimed to clarify the differences between clinically isolated invasive and non-invasive strains of C. auris. METHODS We evaluated colonization, dissemination, and survival rates in wild C57BL/6J mice inoculated with invasive or non-invasive strains of C. auris under cortisone acetate immunosuppression, comparing with those of Candida albicans and Candida glabrata infections. We also evaluated the potency of biofilm formation. RESULTS Stool fungal burdens were significantly higher in mice inoculated with the invasive strains than in those infected with the non-invasive strain. Along with intestinal colonization, liver and kidney fungal burdens were also significantly higher in mice inoculated with the invasive strains. In addition, histopathological findings revealed greater dissemination and colonization of the invasive strains. Regarding biofilm-forming capability, the invasive strain of C. auris exhibited a significantly higher capacity of producing biofilms. Moreover, inoculation with the invasive strains resulted in significantly greater loss of body weight than that noted following infection with the non-invasive strain. CONCLUSIONS Invasive strains showed higher colonization capability and rates of dissemination from gastrointestinal tracts under cortisone acetate immunosuppression than non-invasive strains, although the mortality rates caused by C. auris were lower than those caused by C. albicans.
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Affiliation(s)
- Masahiro Abe
- Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Tokyo, Japan
| | - Harutaka Katano
- Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Minoru Nagi
- Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yoshitsugu Higashi
- Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yuko Sato
- Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Ken Kikuchi
- Department of Infectious Diseases, Tokyo Women's Medical University, Tokyo, Japan
| | - Hideki Hasegawa
- Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan.,Influenza Virus Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yoshitsugu Miyazaki
- Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Tokyo, Japan
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