While health officials in New Jersey, Illinois and New York State are trying to stem the spread of a highly contagious and deadly fungus, microbiologists at the Beth Israel Deaconess Medical Center (BIDMC) have shown that a combination of antifungal and antifungal bacterial drugs can provide one effective weapon against the recently discovered multi-resistant Candida auris (1
Thea Brennan-Krohn, MD of BIDMC, presented the results on Friday, June 21, 2019, at ASM Microbe 2019, the annual meeting of the American Society for Microbiology.
"For patients with Candida auris that causes invasive, life-threatening infections, usually in patients who are already critically ill or have a weakened immune system," said Dr. Brennan-Krohn, a post-doctoral student in the lab of James E. Kirby, MD, director of the Clinical Microbiology Laboratory at BIDMC. "There is an alarming tendency to spread from patient to patient and to survive on surfaces in rooms, resulting in hospital outbreaks."
First discovered in Japan in 2009, C. Auris was detected in patients in more than 20 countries and has 643 in April 2019, according to the US Centers for Control and Disease Prevention (CDC) Americans in 11 US states made ill. Currently, most cases of C. Auris are resistant to at least one antifungal, with about one third being resistant to two or more.
To identify new therapeutic approaches for C. Auris Brennan-Krohn and colleagues used a modified inkjet printer – a method developed in the Kirby Laboratory for rapid and consistent antimicrobial screening – to test three antifungals, one from each of the major classes of antimycotics with two antibacterial agents antibiotics, which in themselves have no effect against fungal infections.
Using inkjet technology to deliver uniform samples of C. auris into each of the 96 wells in a standard laboratory test plate, Brennan-Krohn tested 10 combinations against 10 strains of C. auris a tedious process that would have taken at least 50 hours for manual processing. In total, it took less than two hours for Brennan-Krohn to use the inkjet dispenser to find three novel combinations of antimycotics and antibiotics that showed efficacy against this insidious new pathogen.
Brennan-Krohn showed that two of the antibacterial-antimycotic treatments not only prevented the action of C. Auris did not grow, but he also managed to kill some of the tested strains.
While the drugs have not yet been tested in combination in humans who were infected with C. Auris are all drugs tested by Brennan-Krohn – the antifungals amphotericin and caspofungin, as well as the antibiotics minocycline and rifampin – FDA approved antibiotics currently used in patients with a variety of infections. When the combined power of the drugs to inhibit or kill C. auris that they have demonstrated in the laboratory has been confirmed in human studies. This could mean that doctors look after patients with C. auris Infections already have access to effective treatment options.
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Drug combination can fight deadly drug-resistant fungus (2019, 22 June)
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