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Wu WG, Luk KS, Hung MF, Tsang WY, Lee KP, Lam BHS, Cheng KL, Cheung WS, Tang HL, To WK. Antifungal efficacy of natural antiseptic products against Candida auris. Med Mycol 2024; 62:myae060. [PMID: 38936838 DOI: 10.1093/mmy/myae060] [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: 12/21/2023] [Revised: 05/29/2024] [Accepted: 06/03/2024] [Indexed: 06/29/2024] Open
Abstract
Candida auris is an emerging fungal pathogen responsible for healthcare-associated infections and outbreaks with high mortality around the world. It readily colonizes the skin, nares, respiratory and urinary tract of hospitalized patients, and such colonization may lead to invasive Candida infection in susceptible patients. However, there is no recommended decolonization protocol for C. auris by international health authorities. The aim of this study is to evaluate the susceptibility of C. auris to commonly used synthetic and natural antiseptic products using an in vitro, broth microdilution assay. Synthetic antiseptics including chlorhexidine, povidone-iodine, and nystatin were shown to be fungicidal against C. auris. Among the natural antiseptics tested, tea tree oil and manuka oil were both fungicidal against C. auris at concentrations less than or equal to 1.25% (v/v). Manuka honey inhibited C. auris at 25% (v/v) concentrations. Among the commercial products tested, manuka body wash and mouthwash were fungicidal against C. auris at concentrations less than or equal to 0.39% (w/v) and 6.25% (v/v) of products as supplied for use, respectively, while tea tree body wash and MedihoneyTM wound gel demonstrated fungistatic properties. In conclusion, this study demonstrated good in vitro antifungal efficacy of tea tree oil, manuka oil, manuka honey, and commercially available antiseptic products containing these active ingredients. Future studies are warranted to evaluate the effectiveness of these antiseptic products in clinical settings.
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Affiliation(s)
- Wing-Gi Wu
- Department of Pathology, Princess Margaret Hospital, Hong Kong, Special Administrative Region, China
| | - Kristine Shik Luk
- Department of Pathology, Princess Margaret Hospital, Hong Kong, Special Administrative Region, China
- Infection Control Team, Princess Margaret Hospital, Hong Kong, Special Administrative Region, China
- Infection Control Team, Caritas Medical Centre, Hong Kong, Special Administrative Region, China
- Infection Control Team, Yan Chai Hospital, Hong Kong, Special Administrative Region, China
| | - Mei-Fan Hung
- Department of Pathology, Princess Margaret Hospital, Hong Kong, Special Administrative Region, China
| | - Wing-Yi Tsang
- Department of Pathology, Princess Margaret Hospital, Hong Kong, Special Administrative Region, China
| | - Kin-Ping Lee
- Department of Pathology, Princess Margaret Hospital, Hong Kong, Special Administrative Region, China
- Infection Control Team, Caritas Medical Centre, Hong Kong, Special Administrative Region, China
| | - Bosco Hoi-Shiu Lam
- Department of Pathology, Princess Margaret Hospital, Hong Kong, Special Administrative Region, China
| | - Ka-Lam Cheng
- Infection Control Team, Caritas Medical Centre, Hong Kong, Special Administrative Region, China
| | - Wing-Sze Cheung
- Infection Control Team, Princess Margaret Hospital, Hong Kong, Special Administrative Region, China
| | - Hau-Ling Tang
- Infection Control Team, Yan Chai Hospital, Hong Kong, Special Administrative Region, China
| | - Wing-Kin To
- Department of Pathology, Princess Margaret Hospital, Hong Kong, Special Administrative Region, China
- Infection Control Team, Princess Margaret Hospital, Hong Kong, Special Administrative Region, China
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Rosa R, Abbo LM, Jimenez A, Carter C, Ruiz M, Gerald W, Jimenez Hamann M. Effectiveness of a sodium hypochlorite isotonic solution in decolonization of patients with Candida auris: Learnings from a county health care system. Am J Infect Control 2024; 52:595-598. [PMID: 38007101 DOI: 10.1016/j.ajic.2023.11.008] [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: 05/31/2023] [Revised: 11/10/2023] [Accepted: 11/11/2023] [Indexed: 11/27/2023]
Abstract
BACKGROUND Candida auris (CA) is an organism that has spread globally over the last decade. We conducted a quality improvement project with the aim of decreasing or eliminating skin colonization of patients with CA through a modified bathing protocol. METHODS An isotonic hypochlorite solution was added to routine bathing protocols for hospitalized patients colonized with CA. Weekly skin swabs from axillary and inguinal areas were tested for the presence of CA using polymerase chain reaction and culture. Multidisciplinary efforts, such as environmental terminal cleaning, dedicated equipment, education, and signage were reinforced among staff to improve patient outcomes. RESULTS A total of 24 patients were included. After 4 weeks of a modified bathing protocol, 81.2% of the patients remained colonized with CA. Three patients were discharged safely to their homes and 3 were transferred to long-term care acute hospitals. Nine patients remained hospitalized after 60 days. Localized rash was reported in 3 patients, which resolved after discontinuation of the product. CONCLUSIONS Modification of our bathing protocols by including an isotonic hypochlorite solution did not lead to skin decolonization of CA. Further studies are needed to identify effective measures to eradicate, eliminate or reduce colonization.
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Affiliation(s)
- Rossana Rosa
- Infection Prevention and Control Department, Jackson Health System, Miami, FL
| | - Lilian M Abbo
- Infection Prevention and Control Department, Jackson Health System, Miami, FL; Deparment of Medicine, University of Miami Miller School of Medicine, Miami, FL
| | - Adriana Jimenez
- Infection Prevention and Control Department, Jackson Health System, Miami, FL; Epidemiology Department, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL
| | - Carolyn Carter
- Nursing Administration, Jackson Health System, Miami, FL
| | - Maribel Ruiz
- Infection Prevention and Control Department, Jackson Health System, Miami, FL
| | - Wilson Gerald
- Infection Prevention and Control Department, Jackson Health System, Miami, FL
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3
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Omardien S, Teska P. Skin and hard surface disinfection against Candida auris - What we know today. Front Med (Lausanne) 2024; 11:1312929. [PMID: 38384416 PMCID: PMC10879571 DOI: 10.3389/fmed.2024.1312929] [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: 10/12/2023] [Accepted: 01/05/2024] [Indexed: 02/23/2024] Open
Abstract
Candida auris has emerged as a global healthcare threat, displaying resistance to important healthcare antifungal therapies. Infection prevention and control protocols have become paramount in reducing transmission of C. auris in healthcare, of which cleaning and disinfection plays an important role. Candida albicans is used as a surrogate yeast for yeasticidal claims of disinfection products, but reports have been made that sensitivity to disinfectants by C. auris differs from its surrogate. In this review, we aimed to compile the information reported for products used for skin and hard surface disinfection against C. auris in its planktonic or biofilm form. A comparison was made with other Candida species, and information were gathered from laboratory studies and observations made in healthcare settings.
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Affiliation(s)
| | - Peter Teska
- Diversey Holdings Ltd., Fort Mill, SC, United States
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Elbahr U, Khairy A, Dayyab F, Delos Reyes CS, Pastrana J, Vineeth C, Hejres S, Sudha SP, Keskin O, Rana SS, Fadel E, Erdem H, Sipahi OR. Can daily bathing with 4% chlorhexidine + daily chlorhexidine wipe for 1 week be effective in decolonizing Candida auris colonization? Eur J Clin Microbiol Infect Dis 2024; 43:243-247. [PMID: 38012351 DOI: 10.1007/s10096-023-04723-5] [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: 05/08/2023] [Accepted: 11/20/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Herein, it is aimed to present the decolonizing rates of Candida auris colonized cases after daily bathing with 4% chlorhexidine plus daily cleaning with 4% chlorhexidine wipe for 1 week (will be mentioned as DCHX). METHODS The study period was from October, 2021, to November, 2022. Inclusion criteria were (i) age > 18, (ii) receiving DCHX, (iii) proven C. auris carrier on auricular, or axillar or inguinal swab surveillance cultures up to 5-day period before DCHX. Cases with three consecutive negative surveillance cultures 3 days apart were considered to be decolonized. RESULTS A total of 38 cases [14 female, aged 61.8 ± 15.5 years] fulfilled the inclusion criteria. Six (15.8%), 23 (60.1%), and 22 cases (57.8%) were postauricular, inguinal, and axillary culture positive, respectively. Only three cases (7.9%) were triple culture positive. Nine cases (23.7%) had three consequent negative surveillance cultures after DCHX and were considered to be decolonized. There was no significant difference in decolonization rates of concomitant only antibiotic receiving cohort vs. concomitant antifungal + antibiotic receiving cohort (5/16 vs. 2/8, p = 1) were decolonized similarly. Of the nine C. auris decolonized cases, two developed C. auris infection in 30 days follow-up after decolonization. However, 10 (34.5%) of 29 non-decolonized cases developed C. auris infection (p: 0.450) within 30 days after surveillance culture positivity. Over all cohorts, day 30 mortality was 23.7% (9/38). CONCLUSION In conclusion, based on our observational and relatively small uncontrolled series, it appears that DCHX is not very effective in decolonizing C. auris carriers (especially in cases who are C. auris colonized in > 1 areas), although it is not completely ineffective.
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Affiliation(s)
- Umran Elbahr
- Infectious Diseases Department, Bahrain Oncology Center, King Hamad University Hospital, AlMuharraq, Bahrain.
| | - Amira Khairy
- Microbiology Department, King Hamad University Hospital, AlMuharraq, Bahrain
| | - Farouq Dayyab
- Infectious Diseases, Mohammed Bin Khalifa Bin Salman Al Khalifa Specialist Cardiac Centre, Awali, Bahrain
| | - Clark Steven Delos Reyes
- Infectious Diseases Department, Bahrain Oncology Center, King Hamad University Hospital, AlMuharraq, Bahrain
| | - Jennie Pastrana
- Infectious Diseases Department, Bahrain Oncology Center, King Hamad University Hospital, AlMuharraq, Bahrain
| | - Chithra Vineeth
- Infectious Diseases Department, Bahrain Oncology Center, King Hamad University Hospital, AlMuharraq, Bahrain
| | - Suha Hejres
- Department of Pathology, Blood Bank and Laboratory Medicine, Bahrain Oncology Center, King Hamad University Hospital, AlMuharraq, Bahrain
| | - Shruti Prem Sudha
- Hematology Department, Bahrain Oncology Center, King Hamad University Hospital, AlMuharraq, Bahrain
| | - Ozge Keskin
- Oncology Department, Bahrain Oncology Center, King Hamad University Hospital, AlMuharraq, Bahrain
| | - Shiv Singh Rana
- Department of Palliative Care and Pain Management, Bahrain Oncology Centre, King Hamad University Hospital, AlMuharraq, Bahrain
| | - Elias Fadel
- Oncology Department, Bahrain Oncology Center, King Hamad University Hospital, AlMuharraq, Bahrain
| | - Hakan Erdem
- Infectious Diseases, Mohammed Bin Khalifa Bin Salman Al Khalifa Specialist Cardiac Centre, Awali, Bahrain
- Department of Infectious Diseases and Clinical Microbiology, Gulhane School of Medicine, Turkish Health Sciences University, Ankara, Turkey
| | - Oguz Resat Sipahi
- Infectious Diseases Department, Bahrain Oncology Center, King Hamad University Hospital, AlMuharraq, Bahrain
- Department of Infectious Diseases and Clinical Microbiology, Ege University, Faculty of Medicine, Bornova, Izmir, Turkey
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5
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Jaromin A, Zarnowski R, Markowski A, Zagórska A, Johnson CJ, Etezadi H, Kihara S, Mota-Santiago P, Nett JE, Boyd BJ, Andes DR. Liposomal formulation of a new antifungal hybrid compound provides protection against Candida auris in the ex vivo skin colonization model. Antimicrob Agents Chemother 2024; 68:e0095523. [PMID: 38092678 PMCID: PMC10777852 DOI: 10.1128/aac.00955-23] [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: 07/30/2023] [Accepted: 10/28/2023] [Indexed: 01/11/2024] Open
Abstract
The newly emerged pathogen, Candida auris, presents a serious threat to public health worldwide. This multidrug-resistant yeast often colonizes and persists on the skin of patients, can easily spread from person to person, and can cause life-threatening systemic infections. New antifungal therapies are therefore urgently needed to limit and control both superficial and systemic C. auris infections. In this study, we designed a novel antifungal agent, PQA-Az-13, that contains a combination of indazole, pyrrolidine, and arylpiperazine scaffolds substituted with a trifluoromethyl moiety. PQA-Az-13 demonstrated antifungal activity against biofilms of a set of 10 different C. auris clinical isolates, representing all four geographical clades distinguished within this species. This compound showed strong activity, with MIC values between 0.67 and 1.25 µg/mL. Cellular proteomics indicated that PQA-Az-13 partially or completely inhibited numerous enzymatic proteins in C. auris biofilms, particularly those involved in both amino acid biosynthesis and metabolism processes, as well as in general energy-producing processes. Due to its hydrophobic nature and limited aqueous solubility, PQA-Az-13 was encapsulated in cationic liposomes composed of soybean phosphatidylcholine (SPC), 1,2-dioleoyloxy-3-trimethylammonium-propane chloride (DOTAP), and N-(carbonyl-methoxypolyethylene glycol-2000)-1,2-distearoyl-sn-glycero-3-phosphoethanolamine, sodium salt (DSPE-PEG 2000), and characterized by biophysical and spectral techniques. These PQA-Az-13-loaded liposomes displayed a mean size of 76.4 nm, a positive charge of +45.0 mV, a high encapsulation efficiency of 97.2%, excellent stability, and no toxicity to normal human dermal fibroblasts. PQA-Az-13 liposomes demonstrated enhanced antifungal activity levels against both C. auris in in vitro biofilms and ex vivo skin colonization models. These initial results suggest that molecules like PQA-Az-13 warrant further study and development.
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Affiliation(s)
- Anna Jaromin
- Department of Lipids and Liposomes, Faculty of Biotechnology, University of Wrocław, Wrocław, Poland
| | - Robert Zarnowski
- Department of Medicine, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Medical Microbiology, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Adam Markowski
- Department of Lipids and Liposomes, Faculty of Biotechnology, University of Wrocław, Wrocław, Poland
| | - Agnieszka Zagórska
- Department of Medicinal Chemistry, Jagiellonian University Medical College, Cracow, Poland
| | - Chad J. Johnson
- Department of Medicine, University of Wisconsin, Madison, Wisconsin, USA
| | - Haniyeh Etezadi
- Department of Pharmacy, University of Copenhagen, Copenhagen, Denmark
| | - Shinji Kihara
- Department of Pharmacy, University of Copenhagen, Copenhagen, Denmark
| | | | - Jeniel E. Nett
- Department of Medicine, University of Wisconsin, Madison, Wisconsin, USA
- Department of Medical Microbiology and Immunology, University of Wisconsin, Madison, Wisconsin, USA
| | - Ben J. Boyd
- Department of Pharmacy, University of Copenhagen, Copenhagen, Denmark
- Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University (Parkville Campus), Victoria, Australia
| | - David R. Andes
- Department of Medicine, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Medical Microbiology, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Tuor M, LeibundGut-Landmann S. The skin mycobiome and intermicrobial interactions in the cutaneous niche. Curr Opin Microbiol 2023; 76:102381. [PMID: 37703811 DOI: 10.1016/j.mib.2023.102381] [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: 06/15/2023] [Revised: 08/18/2023] [Accepted: 08/18/2023] [Indexed: 09/15/2023]
Abstract
Mammalian microbiomes have coevolved with their host to establish a stable homeostatic relationship. Multifaceted commensal-host and commensal-commensal interactions contribute to the maintenance of the equilibrium with an impact on diverse host physiological processes. Despite constant exposure to physical and chemical insults from the environment, the skin harbors a surprisingly stable microbiome. The fungal compartment of the skin microbiome, the skin mycobiome, is unique in that it is dominated by a single fungus, Malassezia. The lack in diversity suggests that the skin may provide a unique niche for this fungal genus and that Malassezia may efficiently outcompete other fungi from the skin. This opinion article examines aspects in support of this hypothesis, discusses how changes in niche conditions associate with skin mycobiome dysregulation, and highlights an emerging example of Malassezia being displaced from the skin by the emerging fungal pathogen C. auris, thereby generating a predisposing situation for fatal-invasive infection.
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Affiliation(s)
- Meret Tuor
- Section of Immunology, Vetsuisse Faculty and Institute of Experimental Immunology, University of Zurich, Switzerland
| | - Salomé LeibundGut-Landmann
- Section of Immunology, Vetsuisse Faculty and Institute of Experimental Immunology, University of Zurich, Switzerland.
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7
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Beattie SR, Esan T, Zarnowski R, Eix E, Nett JE, Andes DR, Hagen T, Krysan DJ. Novel Keto-Alkyl-Pyridinium Antifungal Molecules Active in Models of In Vivo Candida albicans Vascular Catheter Infection and Ex Vivo Candida auris Skin Colonization. Antimicrob Agents Chemother 2023; 67:e0008123. [PMID: 37097144 PMCID: PMC10190616 DOI: 10.1128/aac.00081-23] [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: 01/17/2023] [Accepted: 03/10/2023] [Indexed: 04/26/2023] Open
Abstract
New antifungal therapies are needed for both systemic, invasive infections in addition to superficial infections of mucosal and skin surfaces as well as biofilms associated with medical devices. The resistance of biofilm and biofilm-like growth phases of fungi contributes to the poor efficacy of systemic therapies to nonsystemic infections. Here, we describe the identification and characterization of a novel keto-alkyl-pyridinium scaffold with broad spectrum activity (2 to 16 μg/mL) against medically important yeasts and molds, including clinical isolates resistant to azoles and/or echinocandins. Furthermore, these keto-alkyl-pyridinium agents retain substantial activity against biofilm phase yeast and have direct activity against hyphal A. fumigatus. Although their toxicity precludes use in systemic infections, we found that the keto-alkyl-pyridinium molecules reduce Candida albicans fungal burden in a rat model of vascular catheter infection and reduce Candida auris colonization in a porcine ex vivo model. These initial preclinical data suggest that molecules of this class may warrant further study and development for nonsystemic applications.
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Affiliation(s)
- Sarah R. Beattie
- Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Taiwo Esan
- Department of Chemistry and Biochemistry, Northern Illinois University, DeKalb, Illinois, USA
| | - Robert Zarnowski
- Department of Medicine, Section of Infectious Disease, University of Wisconsin, Madison, Wisconsin, USA
- Department of Medical Microbiology and Immunology, University of Wisconsin, Madison Wisconsin, USA
| | - Emily Eix
- Department of Medicine, Section of Infectious Disease, University of Wisconsin, Madison, Wisconsin, USA
- Department of Medical Microbiology and Immunology, University of Wisconsin, Madison Wisconsin, USA
| | - Jeniel E. Nett
- Department of Medicine, Section of Infectious Disease, University of Wisconsin, Madison, Wisconsin, USA
- Department of Medical Microbiology and Immunology, University of Wisconsin, Madison Wisconsin, USA
| | - David R. Andes
- Department of Medicine, Section of Infectious Disease, University of Wisconsin, Madison, Wisconsin, USA
- Department of Medical Microbiology and Immunology, University of Wisconsin, Madison Wisconsin, USA
| | - Timothy Hagen
- Department of Chemistry and Biochemistry, Northern Illinois University, DeKalb, Illinois, USA
| | - Damian J. Krysan
- Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
- Department of Microbiology/Immunology, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
- Department of Molecular Physiology and Biophysics, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
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8
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Novel keto-alkyl-pyridinium antifungal molecules active in models of in vivo Candida albicans vascular catheter infection and ex vivo Candida auris skin colonization. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.01.19.524835. [PMID: 36711909 PMCID: PMC9882332 DOI: 10.1101/2023.01.19.524835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
New antifungal therapies are needed for both systemic, invasive infections as well as superficial infections of mucosal and skin surfaces as well as biofilms associated with medical devices. The resistance of biofilm and biofilm-like growth phases of fungi contributes to the poor efficacy of systemic therapies to non-systemic infections. Here, we describe the identification and characterization of a novel keto-alkyl-pyridinium scaffold with broad spectrum activity (2-16 µg/mL) against medically important yeasts and moulds, including clinical isolates resistant to azoles and/or echinocandins. Furthermore, these keto-alkyl-pyridinium agents retain substantial activity against biofilm phase yeast and have direct activity against hyphal A. fumigatus . Although their toxicity precludes use in systemic infections, we found that the keto-alkyl-pyridinium molecules reduce C. albicans fungal burden in a rat model of vascular catheter infection and reduce Candida auris colonization in a porcine ex vivo model. These initial pre-clinical data suggest that molecules of this class may warrant further study and development.
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9
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Rosato R, Napoli E, Granata G, Di Vito M, Garzoli S, Geraci C, Rizzo S, Torelli R, Sanguinetti M, Bugli F. Study of the Chemical Profile and Anti-Fungal Activity against Candida auris of Cinnamomum cassia Essential Oil and of Its Nano-Formulations Based on Polycaprolactone. PLANTS (BASEL, SWITZERLAND) 2023; 12:358. [PMID: 36679069 PMCID: PMC9860731 DOI: 10.3390/plants12020358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Candida auris represents an emerging pathogen that results in nosocomial infections and is considered a serious global health problem. The aim of this work was to evaluate the in vitro antifungal efficacy of Cinnamomum cassia essential oil (CC-EO) pure or formulated in polycaprolactone (PCL) nanoparticles against ten clinical strains of C. auris. METHODS nanoparticles of PCL were produced using CC-EO (nano-CC-EO) and cinnamaldehyde (CIN) through the nanoprecipitation method. The chemical profile of both CC-EO and nano-CC-EO was evaluated using SPME sampling followed by GC-MS analysis. Micro-broth dilution tests were performed to evaluate both fungistatic and fungicidal effectiveness of CC-EO and CIN, pure and nano-formulated. Furthermore, checkerboard tests to evaluate the synergistic action of CC-EO or nano-CC-EO with micafungin or fluconazole were conducted. Finally, the biofilm disrupting activity of both formulations was evaluated. RESULTS GC-MS analysis shows a different composition between CC-EO and nano-CC-EO. Moreover, the microbiological analyses do not show any variation in antifungal effectiveness either towards the planktonic form (MICCC-EO = 0.01 ± 0.01 and MICnano-CC-EO = 0.02 ± 0.01) or the biofilm form. No synergistic activity with the antifungal drugs tested was found. CONCLUSIONS both CC-EO and nano-CC-EO show the same antimicrobial effectiveness and are potential assets in the fight against C. auris.
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Affiliation(s)
- Roberto Rosato
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, 00167 Rome, Italy
| | - Edoardo Napoli
- Istituto di Chimica Biomolecolare—Consiglio Nazionale delle Ricerche, 95126 Catania, Italy
| | - Giuseppe Granata
- Istituto di Chimica Biomolecolare—Consiglio Nazionale delle Ricerche, 95126 Catania, Italy
| | - Maura Di Vito
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, 00167 Rome, Italy
| | - Stefania Garzoli
- Dipartimento di Chimica e Tecnologie del Farmaco, Università di Roma Sapienza, Piazzale Aldo Moro 5, 00100 Rome, Italy
| | - Corrada Geraci
- Istituto di Chimica Biomolecolare—Consiglio Nazionale delle Ricerche, 95126 Catania, Italy
| | - Silvia Rizzo
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, 00167 Rome, Italy
| | - Riccardo Torelli
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Maurizio Sanguinetti
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, 00167 Rome, Italy
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Francesca Bugli
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, 00167 Rome, Italy
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
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Ahmad S, Asadzadeh M. Strategies to Prevent Transmission of Candida auris in Healthcare Settings. CURRENT FUNGAL INFECTION REPORTS 2023; 17:36-48. [PMID: 36718372 PMCID: PMC9878498 DOI: 10.1007/s12281-023-00451-7] [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] [Accepted: 11/18/2022] [Indexed: 01/27/2023]
Abstract
Purpose of Review Candida auris, a recently recognized yeast pathogen, has become a major public health threat due to the problems associated with its accurate identification, intrinsic and acquired resistance to antifungal drugs, and its potential to easily contaminate the environment causing clonal outbreaks in healthcare facilities. These outbreaks are associated with high mortality rates particularly among older patients with multiple comorbidities under intensive care settings. The purpose of this review is to highlight strategies that are being adapted to prevent transmission of C. auris in healthcare settings. Recent Findings Colonized patients shed C. auris into their environment which contaminates surrounding equipment. It resists elimination even by robust decontamination procedures and is easily transmitted to new patients during close contact resulting in outbreaks. Efforts are being made to rapidly identify C. auris-infected/C. auris-colonized patients, to determine its susceptibility to antifungals, and to perform effective cleaning and decontamination of the environment and isolation of colonized patients to prevent further transmission. Summary Rapid and accurate identification of hospitalized patients infected/colonized with C. auris, rapid detection of its susceptibility patterns, and appropriate use of infection control measures can help to contain the spread of this highly pathogenic yeast in healthcare settings and prevent/control outbreaks.
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Affiliation(s)
- Suhail Ahmad
- Faculty of Medicine, Department of Microbiology, Kuwait University, PO Box: 24923, 13110 Safat, Kuwait
| | - Mohammad Asadzadeh
- Faculty of Medicine, Department of Microbiology, Kuwait University, PO Box: 24923, 13110 Safat, Kuwait
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11
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Maione A, La Pietra A, de Alteriis E, Mileo A, De Falco M, Guida M, Galdiero E. Effect of Myrtenol and Its Synergistic Interactions with Antimicrobial Drugs in the Inhibition of Single and Mixed Biofilms of Candida auris and Klebsiella pneumoniae. Microorganisms 2022; 10:microorganisms10091773. [PMID: 36144375 PMCID: PMC9501169 DOI: 10.3390/microorganisms10091773] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/24/2022] [Accepted: 08/30/2022] [Indexed: 11/16/2022] Open
Abstract
The increased incidence of mixed infections requires that the scientific community develop novel antimicrobial molecules. Essential oils and their bioactive pure compounds have been found to exhibit a wide range of remarkable biological activities and are attracting more and more attention. Therefore, the aim of this study was to evaluate myrtenol (MYR), one of the constituents commonly found in some essential oils, for its potential to inhibit biofilms alone and in combination with antimicrobial drugs against Candida auris/Klebsiella pneumoniae single and mixed biofilms. The antimicrobial activity of MYR was evaluated by determining bactericidal/fungicidal concentrations (MIC), and biofilm formation at sub-MICs was analyzed in a 96-well microtiter plate by crystal violet, XTT reduction assay, and CFU counts. The synergistic interaction between MYR and antimicrobial drugs was evaluated by the checkerboard method. The study found that MYR exhibited antimicrobial activity at high concentrations while showing efficient antibiofilm activity against single and dual biofilms. To understand the underlying mechanism by which MYR promotes single/mixed-species biofilm inhibition, we observed a significant downregulation in the expression of mrkA, FKS1, ERG11, and ALS5 genes, which are associated with bacterial motility, adhesion, and biofilm formation as well as increased ROS production, which can play an important role in the inhibition of biofilm formation. In addition, the checkerboard microdilution assay showed that MYR was strongly synergistic with both caspofungin (CAS) and meropenem (MEM) in inhibiting the growth of Candida auris/Klebsiella pneumoniae-mixed biofilms. Furthermore, the tested concentrations showed an absence of toxicity for both mammalian cells in the in vitro and in vivo Galleria mellonella models. Thus, MYR could be considered as a potential agent for the management of polymicrobial biofilms.
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Affiliation(s)
- Angela Maione
- Department of Biology, University of Naples ‘Federico II’, Via Cinthia, 80126 Naples, Italy
| | - Alessandra La Pietra
- Department of Biology, University of Naples ‘Federico II’, Via Cinthia, 80126 Naples, Italy
| | - Elisabetta de Alteriis
- Department of Biology, University of Naples ‘Federico II’, Via Cinthia, 80126 Naples, Italy
| | - Aldo Mileo
- Department of Biology, University of Naples ‘Federico II’, Via Cinthia, 80126 Naples, Italy
| | - Maria De Falco
- Department of Biology, University of Naples ‘Federico II’, Via Cinthia, 80126 Naples, Italy
- National Institute of Biostructures and Biosystems (INBB), 00136 Rome, Italy
- Center for Studies on Bioinspired Agro-Environmental Technology (BAT Center), 80055 Portici, Italy
| | - Marco Guida
- Department of Biology, University of Naples ‘Federico II’, Via Cinthia, 80126 Naples, Italy
- Correspondence: (M.G.); (E.G.)
| | - Emilia Galdiero
- Department of Biology, University of Naples ‘Federico II’, Via Cinthia, 80126 Naples, Italy
- Correspondence: (M.G.); (E.G.)
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