dCandida albicans, an opportunistic fungus, and Staphylococcus aureus, a bacterial pathogen, are two clinically relevant biofilmforming microbes responsible for a majority of catheter-related infections, with such infections often resulting in catheter loss and removal. Not only do these pathogens cause a substantial number of nosocomial infections independently, but also they are frequently found coexisting as polymicrobial biofilms on host and environmental surfaces. Antimicrobial lock therapy is a current strategy to sterilize infected catheters. However, the robustness of this technique against polymicrobial biofilms has remained largely untested. Due to its antimicrobial activity, safety, stability, and affordability, we tested the hypothesis that ethanol (EtOH) could serve as a potentially efficacious catheter lock solution against C. albicans and S. aureus biofilms. Therefore, we optimized the dose and time necessary to achieve killing of both monomicrobial and polymicrobial biofilms formed on polystyrene and silicone surfaces in a static microplate lock therapy model. Treatment with 30% EtOH for a minimum of 4 h was inhibitory for monomicrobial and polymicrobial biofilms, as evidenced by XTT {sodium 2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-5-[(phenylamino)carbonyl]-2H-tetrazolium hydroxide inner salt} metabolic activity assays and confocal microscopy. Experiments to determine the regrowth of microorganisms on silicone after EtOH treatment were also performed. Importantly, incubation with 30% EtOH for 4 h was sufficient to kill and inhibit the growth of C. albicans, while 50% EtOH was needed to completely inhibit the regrowth of S. aureus. In summary, we have systematically defined the dose and duration of EtOH treatment that are effective against and prevent regrowth of C. albicans and S. aureus monomicrobial and polymicrobial biofilms in an in vitro lock therapy model.

The vacuolar membrane ATPase (V-ATPase) is a protein complex that utilizes ATP hydrolysis to drive protons from the cytosol into the vacuolar lumen, acidifying the vacuole and modulating several key cellular response systems in Saccharomyces cerevisiae. To study the contribution of V-ATPase to the biology and virulence attributes of the opportunistic fungal pathogen Candida albicans, we created a conditional mutant in which VMA3 was placed under the control of a tetracycline-regulated promoter (tetR-VMA3 strain). Repression of VMA3 in the tetR-VMA3 strain prevents V-ATPase assembly at the vacuolar membrane and reduces concanamycin A-sensitive ATPase-specific activity and proton transport by more than 90%. Loss of C. albicans VATPase activity alkalinizes the vacuolar lumen and has pleiotropic effects, including pH-dependent growth, calcium sensitivity, and cold sensitivity. Candida albicans is a major opportunistic human fungal pathogen and is responsible for 6.8% of hospital-acquired infections in the United States (1). Despite the availability of several classes of antifungal drugs, attributable mortality, cost of care, and length of stay due to invasive candidiasis remain unacceptably high (2, 3). In addition, resistance to currently available antifungal drugs is emerging (see reference 4 for a review). Therefore, development of new antifungal drug targets remains a critical need. A diverse set of factors contributing to C. albicans virulence have been identified, including the secretion of aspartyl proteases and lipases, filamentation, and biofilm formation (5-8). Understanding the biology and regulation of these processes and pathways may illuminate new candidates for antifungal therapy.The vacuole is a dynamic acidic organelle found in yeast and plants that is analogous to the mammalian lysosome. It functions in an array of cellular homeostasis processes and thereby plays an important role in stress response, adaptation to novel environments, and cell differentiation (9-13). Furthermore, in C. albicans, intact vacuolar function is important for filamentation and virulence (12)(13)(14)(15). Vacuolar function depends on the maintenance of acidic pH by the vacuolar H-ATPase (V-ATPase), an enzyme complex that functions in organelle acidification across eukaryotes (16,17). The V-ATPase utilizes hydrolysis of ATP to transport protons from the cytosol into a variety of organelles. V-ATPase-mediated acidification and membrane energization are necessary for important vacuolar functions, including calcium and metal homeostasis (18), cargo sorting and membrane trafficking in endocytic and secretory pathways (19), and drug resistance (20). In Saccharomyces cerevisiae, the V-ATPase is expressed at the vacuolar membrane and the membrane of prevacuolar compartments and the Golgi compartment.The V-ATPase complex consists of the V 1 and V o subcomplexes (16). The V 1 subcomplex is composed of peripherally associated subunits that form the sites of ATP binding and hydrolysis on the cytosolic side of the membrane. The V o su...

Background: V-ATPase regulates pH, and Candida albicans virulence is pH-dependent. Results: Deletion of V-ATPase V o a subunit Vph1p, but not Stv1p, alkalinizes vacuoles; several virulence-related traits remain unaffected. Conclusion: Vacuolar acidification is not essential for in vitro filamentation, biofilm formation, and macrophage killing in C. albicans. Significance: Stv1p in non-vacuolar organelles may play important roles in C. albicans infectivity, particularly if Vph1p is not functional.

These findings indicate that cranberry PACs have excellent in vitro activity against C. albicans biofilm formation in artificial urine. We present preliminary evidence that cranberry PAC activity against C. albicans biofilm formation is due to anti-adherence properties and/or iron chelation.