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Horton MV, Eix EF, Johnson CJ, Dean MEB, Andes BD, Wartman KM, Nett JE. Impact of micafungin on Candida auris β-glucan masking and neutrophil interactions. J Infect Dis 2024:jiae043. [PMID: 38330449 DOI: 10.1093/infdis/jiae043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 01/16/2024] [Accepted: 01/21/2024] [Indexed: 02/10/2024] Open
Abstract
Invasive fungal pathogen Candida auris has become a public health threat causing outbreaks of high mortality infections. Drug resistance often limits treatment options. For Candida albicans, subinhibitory concentrations of echinocandins unmask immunostimulatory β-glucan, augmenting immunity. Here we analyze the impact of echinocandin treatment of C. auris on β-glucan exposure and human neutrophil interactions. We show subinhibitory concentrations lead to minimal glucan unmasking and only subtle influences on neutrophil functions for the isolates belonging to circulating clades. The data suggest that echinocandin treatment will not largely alter phagocytic responses. Glucan masking pathways appear to differ between C. auris and C. albicans.
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Affiliation(s)
- Mark V Horton
- Department of Medicine, University of Wisconsin-Madison, WI, USA
- Department of Medical Microbiology and Immunology, University of Wisconsin-Madison, WI, USA
| | - Emily F Eix
- Department of Medicine, University of Wisconsin-Madison, WI, USA
- Department of Medical Microbiology and Immunology, University of Wisconsin-Madison, WI, USA
| | - Chad J Johnson
- Department of Medicine, University of Wisconsin-Madison, WI, USA
| | - Megan E B Dean
- Department of Medicine, University of Wisconsin-Madison, WI, USA
| | - Brody D Andes
- Department of Medicine, University of Wisconsin-Madison, WI, USA
| | - Kayla M Wartman
- Department of Medicine, University of Wisconsin-Madison, WI, USA
| | - Jeniel E Nett
- Department of Medicine, University of Wisconsin-Madison, WI, USA
- Department of Medical Microbiology and Immunology, University of Wisconsin-Madison, WI, USA
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Eix EF, Johnson CJ, Wartman KM, Kernien JF, Meudt JJ, Shanmuganayagam D, Gibson ALF, Nett JE. Ex Vivo Human and Porcine Skin Effectively Model Candida auris Colonization, Differentiating Robust and Poor Fungal Colonizers. J Infect Dis 2022; 225:1791-1795. [PMID: 35267041 PMCID: PMC9113498 DOI: 10.1093/infdis/jiac094] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 03/08/2022] [Indexed: 11/12/2022] Open
Abstract
Candida auris proliferates and persists on the skin of patients, often leading to health care-associated infections with high mortality. Here, we describe 2 clinically relevant skin models and show that C. auris grows similarly on human and porcine skin. Additionally, we demonstrate that other Candida spp., including those with phylogenetic similarity to C. auris, do not display high growth in the skin microenvironment. These studies highlight the utility of 2 ex vivo models of C. auris colonization that allow reproducible differentiation among Candida spp., which should be a useful tool for comparison of C. auris clinical isolates and genetically mutated strains.
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Affiliation(s)
- Emily F Eix
- Department of Medicine, University of Wisconsin, Madison, Wisconsin, USA
- Department of Medical Microbiology and Immunology, University of Wisconsin, Madison, Wisconsin, USA
| | - Chad J Johnson
- Department of Medicine, University of Wisconsin, Madison, Wisconsin, USA
| | - Kayla M Wartman
- Department of Medicine, University of Wisconsin, Madison, Wisconsin, USA
| | - John F Kernien
- Department of Medicine, University of Wisconsin, Madison, Wisconsin, USA
| | - Jennifer J Meudt
- Department of Animal and Dairy Sciences, University of Wisconsin, Madison, Wisconsin, USA
| | - Dhanansayan Shanmuganayagam
- Department of Animal and Dairy Sciences, University of Wisconsin, Madison, Wisconsin, USA
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
- Center for Biomedical Swine Research and Innovation, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Angela L F Gibson
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Jeniel E Nett
- Department of Medicine, University of Wisconsin, Madison, Wisconsin, USA
- Department of Medical Microbiology and Immunology, University of Wisconsin, Madison, Wisconsin, USA
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Johnson CJ, Eix EF, Lam BC, Wartman KM, Meudt JJ, Shanmuganayagam D, Nett JE. Augmenting the Activity of Chlorhexidine for Decolonization of Candida auris from Porcine skin. J Fungi (Basel) 2021; 7:jof7100804. [PMID: 34682225 PMCID: PMC8537331 DOI: 10.3390/jof7100804] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/08/2021] [Accepted: 09/15/2021] [Indexed: 01/15/2023] Open
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.
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Affiliation(s)
- Chad J. Johnson
- Department of Medicine, University of Wisconsin, Madison, WI 53706, USA; (C.J.J.); (E.F.E.); (B.C.L.); (K.M.W.)
| | - Emily F. Eix
- Department of Medicine, University of Wisconsin, Madison, WI 53706, USA; (C.J.J.); (E.F.E.); (B.C.L.); (K.M.W.)
- Department of Medical Microbiology and Immunology, University of Wisconsin, Madison, WI 53706, USA
| | - Brandon C. Lam
- Department of Medicine, University of Wisconsin, Madison, WI 53706, USA; (C.J.J.); (E.F.E.); (B.C.L.); (K.M.W.)
| | - Kayla M. Wartman
- Department of Medicine, University of Wisconsin, Madison, WI 53706, USA; (C.J.J.); (E.F.E.); (B.C.L.); (K.M.W.)
| | - Jennifer J. Meudt
- Department of Animal and Dairy Sciences, University of Wisconsin, Madison, WI 53706, USA; (J.J.M.); (D.S.)
| | - Dhanansayan Shanmuganayagam
- Department of Animal and Dairy Sciences, University of Wisconsin, Madison, WI 53706, USA; (J.J.M.); (D.S.)
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726, USA
- Center for Biomedical Swine Research and Innovation, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726, USA
| | - Jeniel E. Nett
- Department of Medicine, University of Wisconsin, Madison, WI 53706, USA; (C.J.J.); (E.F.E.); (B.C.L.); (K.M.W.)
- Department of Medical Microbiology and Immunology, University of Wisconsin, Madison, WI 53706, USA
- Correspondence: ; Tel.: +1-608-263-1545
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