Abstract
Candida auris readily colonizes skin and efficiently spreads among patients in healthcare settings worldwide. Given the capacity of this drug-resistant fungal pathogen to cause invasive disease with high mortality, hospitals frequently employ chlorhexidine bathing to reduce skin colonization. Using an ex vivo skin model, we show only a mild reduction in C. auris following chlorhexidine application. This finding helps explain why chlorhexidine bathing may have failures clinically, despite potent in vitro activity. We further show that isopropanol augments the activity of chlorhexidine against C. auris on skin. Additionally, we find both tea tree (Melaleuca alternifolia) oil and lemongrass (Cymbopogon flexuosus) oil to further enhance the activity of chlorhexidine/isopropanol for decolonization. We link this antifungal activity to individual oil components and show how some of these components act synergistically with chlorhexidine/isopropanol. Together, the studies provide strategies to improve C. auris skin decolonization through the incorporation of commonly used topical compounds.
Highlights
Over the past decade, Candida auris has appeared as a major cause of nosocomial invasive fungal infection [1]
C. auris Persists on Porcine Skin following the Application of Hospital Antiseptic Cleansers
We demonstrate that the common hospital disinfectant chlorhexidine only modestly reduces C. auris burden on porcine skin, despite its strong in vitro activity
Summary
Candida auris has appeared as a major cause of nosocomial invasive fungal infection [1]. In areas where it first emerged, C. auris accounts for up to nearly 20% of candidemias [2,3]. C. auris has been termed a global public health threat based on its ability to spread rapidly in healthcare settings and cause invasive disease with a mortality rate approaching 60% [1,4,5,6]. C. auris skin colonization places patients at risk for invasive disease. Invasive candidiasis often occurs in patients with indwelling medical devices, such as vascular catheters and
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