Abstract
Emerging pathogen Candida auris causes nosocomial outbreaks of life-threatening invasive candidiasis. It is unclear how this species colonizes skin and spreads in health care facilities. Here, we analyzed C. auris growth in synthetic sweat medium designed to mimic axillary skin conditions. We show that C. auris demonstrates a high capacity for biofilm formation in this milieu, well beyond that observed for the most commonly isolated Candida sp., Candida albicans The C. auris biofilms persist in environmental conditions expected in the hospital setting. To model C. auris skin colonization, we designed an ex vivo porcine skin model. We show that C. auris proliferates on porcine skin in multilayer biofilms. This capacity to thrive in skin niche conditions helps explain the propensity of C. auris to colonize skin, persist on medical devices, and rapidly spread in hospitals. These studies provide clinically relevant tools to further characterize this important growth modality.IMPORTANCE The emerging fungal pathogen Candida auris causes invasive infections and is spreading in hospitals worldwide. Why this species exhibits the capacity to transfer efficiently among patients is unknown. Our findings reveal that C. auris forms high-burden biofilms in conditions mimicking sweat on the skin surface. These adherent biofilm communities persist in environmental conditions expected in the hospital setting. Using a pig skin model, we show that C. auris also forms high-burden biofilm structures on the skin surface. Identification of this mode of growth sheds light on how this recently described pathogen persists in hospital settings and spreads among patients.
Highlights
Emerging pathogen Candida auris causes nosocomial outbreaks of lifethreatening invasive candidiasis
Auris to proliferate in skin niche conditions, we produced synthetic sweat medium, designed to mimic human axillary sweat, and examined biofilm formation
This is quite striking, as under typical laboratory conditions, C. albicans exhibits a capacity for biofilm formation well beyond that observed for most other Candida spp
Summary
Emerging pathogen Candida auris causes nosocomial outbreaks of lifethreatening invasive candidiasis It is unclear how this species colonizes skin and spreads in health care facilities. IMPORTANCE The emerging fungal pathogen Candida auris causes invasive infections and is spreading in hospitals worldwide Why this species exhibits the capacity to transfer efficiently among patients is unknown. Our findings reveal that C. auris forms high-burden biofilms in conditions mimicking sweat on the skin surface These adherent biofilm communities persist in environmental conditions expected in the hospital setting. Using a pig skin model, we show that C. auris forms high-burden biofilm structures on the skin surface Identification of this mode of growth sheds light on how this recently described pathogen persists in hospital settings and spreads among patients. We describe the remarkable ability of C. auris to form biofilms in conditions of the skin environment, mimicked experimentally using synthetic human sweat medium and an ex vivo porcine skin model
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