Abstract
Candida auris has emerged globally as a multidrug-resistant fungal pathogen. Isolates of C. auris are reported to be misidentified as Candida haemulonii. The aim of the study was to compare the heat production profiles of C. auris strains and other Candida spp. and evaluate their antifungal susceptibility using isothermal microcalorimetry. The minimum heat inhibitory concentrations (MHIC) and the minimum biofilm fungicidal concentration (MBFC) were defined as the lowest antimicrobial concentration leading to the lack of heat flow production after 24 h for planktonic cells and 48 h for biofilm-embedded cells. C. auris exhibited a peculiar heat production profile. Thermogenic parameters of C. auris suggested a slower growth rate compared to Candida lusitaniae and a different distinct heat profile compared to that of C. haemulonii species complex strains, although they all belong to the Metschnikowiaceae clade. Amphotericin B MHIC and MBFC were 0.5 µg/mL and ≥8 µg/mL, respectively. C. auris strains were non-susceptible to fluconazole at tested concentrations (MHIC > 128 µg/mL, MBFC > 256 µg/mL). The heat curve represents a fingerprint of C. auris, which distinguished it from other species. Treatment based on amphotericin B represents a potential therapeutic option for C. auris infection.
Highlights
Since its initial description in 2009, Candida auris has emerged as a new nosocomial pathogen, characterized by traits of drug resistance, that may cause fungemia and other deep-seated infections in at-risk populations, posing a global threat for public health [1,2]
Resistance to azole is rather common among circulating strains of C. auris, at least in South Asia, and clones resistant to amphotericin B and echinocandins have been described [1,3,4]
To other Candida spp., C. auris has been shown to attach on abiotic surfaces and form biofilms in vitro [8]
Summary
Since its initial description in 2009, Candida auris has emerged as a new nosocomial pathogen, characterized by traits of drug resistance, that may cause fungemia and other deep-seated infections in at-risk populations, posing a global threat for public health [1,2]. Unlike most other Candida spp., C. auris is associated with skin rather than with gastrointestinal tract colonization and presents an intrinsic resistance to conventional front-line antifungal agents, J. J. Fungi 2019, 5, 103 antiseptics, and disinfectants [1]. C. auris is able to survive and persist in different environments and conditions with a high grade of resilience and adaptivity [5]. Such a persistent colonizing phenotype of C. auris may be linked to its ability to form a biofilm [6,7,8]. To other Candida spp., C. auris has been shown to attach on abiotic surfaces and form biofilms in vitro [8]. In vitro biofilms of C. auris appeared less thick than those of Candida albicans, mostly due to the lack of hyphae production [9]
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