Successful treatment of a
            <i>Candida auris</i>
            intra-articular infection

Zembower, Teresa; Bolon, Maureen K.; Kadakia, Anish R.; Gilley, Jasen; Ko, Jason H.; Clark, Jessica M.; Ward-Fore, Sharon; Taiwo, Babafemi

doi:10.1080/22221751.2019.1625287

Cited by 9 publications

(10 citation statements)

References 18 publications

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“…Like other Candida spp., C. auris forms biofilms on artificial surfaces and this mode of growth is presumably involved in catheter colonization by C. auris [2, 7••, 8•, 9•, 10, 11••, 12, 20, 21]. In addition, C. auris has been implicated in other device-associated infections, including central nervous system infection in the setting of neurosurgical device placement and prosthetic joint infection [22,23]. Biofilm formation is similarly anticipated to be involved in C. auris infection involving these and other medical devices [21,24].…”

Section: What Is the Clinical Presentation Of C Auris Infection?mentioning

confidence: 99%

Candida auris Infection and Biofilm Formation: Going Beyond the Surface

Horton

Nett

2020

Curr Clin Micro Rpt

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Purpose of Review Emergent fungal pathogen C. auris is spreading in hospitals throughout the world and mortality rates for patients with invasive disease approach 60%. This species exhibits a heightened capacity to colonize skin, persist on hospital surfaces, rapidly disseminate in healthcare settings, and resist antifungal therapy. Recent Findings Current investigations show that C. auris produces biofilms, surface-adherent communities that resist antifungals and withstand desiccation. These biofilms form when C. auris is growing on skin or in conditions expected in the hospital environment and on implanted medical devices. Summary Here, we will highlight the topic of biofilm formation by C. auris. We illustrate how this process influences resistance to antimicrobials and promotes nosocomial transmission.

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Section: What Is the Clinical Presentation Of C Auris Infection?mentioning

confidence: 99%

Candida auris Infection and Biofilm Formation: Going Beyond the Surface

Horton

Nett

2020

Curr Clin Micro Rpt

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“…Another report from Japan described the eradication of Candida guillermondii infection in an oncology patient using the same combination [ 37 ]. Roberts et al reported a case of a patient suffering from C. auris intra-articular infection successfully treated with amphotericin-impregnated spacer in addition to systemic fluconazole or micafungin [ 38 ]. Apart from these case reports, there is limited evidence on this issue, and the combined therapy of echinocandins with amphotericin B has been used mostly in the treatment of invasive aspergillosis.…”

Section: Discussionmentioning

confidence: 99%

In Vitro Interaction and Killing-Kinetics of Amphotericin B Combined with Anidulafungin or Caspofungin against Candida auris

et al. 2021

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Treatment of invasive infections caused by Candida auris is challenging due to the limited therapeutic options. The combination of antifungal drugs may be an interesting and feasible approach to be investigated. The aim of this study was to examine the in vitro activity of amphotericin B in combination with anidulafungin or caspofungin against C. auris. In vitro static time–kill curve experiments were conducted for 48 h with different combinations of amphotericin B with anidulafungin or caspofungin against six blood isolates of C. auris. The antifungal activity of 0.5 mg/L of amphotericin B was limited against the six isolates of C. auris. Similarly, echinocandins alone had a negligible effect, even at the highest tested concentrations. By contrast, 1 mg/L of amphotericin B showed fungistatic activity. Synergy was rapidly achieved (8 h) with 0.5 mg/L of amphotericin B plus 2 mg/L of anidulafungin or caspofungin. These combinations lead to a sustained fungistatic effect, and the fungicidal endpoint was reached against some C. auris isolates. Additionally, ≥0.5 mg/L of either of the two echinocandins with 1 mg/L of amphotericin B resulted in fungicidal effect against all C. auris isolates. In conclusion, combinations of amphotericin B with anidulafungin or caspofungin provided greater killing with a lower dose requirement for amphotericin B compared to monotherapy, with synergistic and/or fungicidal outcomes.

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“…Up to date, it has been detected in 32 countries over six continents ( 2 ). C. auris infects various tissues and organs, including central nervous system ( 3 ), cardiovascular system ( 4 ), respiratory tract ( 5 ), bones and joints ( 6 ), and possesses the potential to cause nosocomial infections ( 7 ). The diagnosis of C. auris is difficult due to non-availability of specific laboratory techniques which could rapidly and accurately detect it in clinical samples.…”

Section: Introductionmentioning

confidence: 99%

Genome-wide scan for potential CD4+ T-cell vaccine candidates in Candida auris by exploiting reverse vaccinology and evolutionary information

et al. 2022

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Candida auris is a globally emerging fungal pathogen responsible for causing nosocomial outbreaks in healthcare associated settings. It is known to cause infection in all age groups and exhibits multi-drug resistance with high potential for horizontal transmission. Because of this reason combined with limited therapeutic choices available, C. auris infection has been acknowledged as a potential risk for causing a future pandemic, and thus seeking a promising strategy for its treatment is imperative. Here, we combined evolutionary information with reverse vaccinology approach to identify novel epitopes for vaccine design that could elicit CD4+ T-cell responses against C. auris. To this end, we extensively scanned the family of proteins encoded by C. auris genome. In addition, a pathogen may acquire substitutions in epitopes over a period of time which could cause its escape from the immune response thus rendering the vaccine ineffective. To lower this possibility in our design, we eliminated all rapidly evolving genes of C. auris with positive selection. We further employed highly conserved regions of multiple C. auris strains and identified two immunogenic and antigenic T-cell epitopes that could generate the most effective immune response against C. auris. The antigenicity scores of our predicted vaccine candidates were calculated as 0.85 and 1.88 where 0.5 is the threshold for prediction of fungal antigenic sequences. Based on our results, we conclude that our vaccine candidates have the potential to be successfully employed for the treatment of C. auris infection. However, in vivo experiments are imperative to further demonstrate the efficacy of our design.

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Successful treatment of a Candida auris intra-articular infection

Abstract: A 78-year-old woman with a long-term ankle spacer with antibacterials developed an intra-articular Candida auris infection. Treatment with systemic antifungal therapy plus an amphotericin B moulded cement spacer was successful.

Cited by 9 publications

References 18 publications

Candida auris Infection and Biofilm Formation: Going Beyond the Surface

Candida auris Infection and Biofilm Formation: Going Beyond the Surface

In Vitro Interaction and Killing-Kinetics of Amphotericin B Combined with Anidulafungin or Caspofungin against Candida auris

Genome-wide scan for potential CD4+ T-cell vaccine candidates in Candida auris by exploiting reverse vaccinology and evolutionary information

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