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<p><i>Candida auris</i> has emerged globally as a multidrug-resistant fungal pathogen with high morbidity and mortality, frequently linked to outbreaks in healthcare settings. Its resilience stems from biofilm formation, environmental persistence, and resistance to multiple antifungal classes, posing urgent challenges for infection control. Novel adjunctive strategies are therefore required to complement conventional antifungals. Probiotics and synbiotics offer multifaceted antifungal activities, including organic acid production, hydrogen peroxide secretion, biosurfactant and bacteriocin release, nutrient sequestration, and quorum-sensing interference. Unlike single-target antifungals, probiotics exert multi-layered pressure on pathogens, reducing the likelihood of resistance development. Evidence from clinical and preclinical studies indicates that probiotics can mitigate <i>Candida</i> colonization in the gastrointestinal tract, oral cavity, and vagina, while topical and device-related applications remain underexplored. Advanced formulations, such as synbiotic microcapsules, topical sprays, and probiotic-coated catheters, expand the feasibility of delivering viable cells or postbiotic metabolites to nearly all relevant body sites. This review synthesizes current evidence for probiotic and synbiotic applications against <i>Candida</i> species, with emphasis on innovative dosage forms and translational potential for <i>C. auris</i>. Future development of targeted formulations could provide sustainable, patient-friendly adjuncts to antifungal stewardship programs.</p>

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Harnessing Probiotics to Combat Acquired Resistance in Candida auris: Emerging Mechanisms and Formulation Strategies

  • 期刊论文

  • 发表日期：

    2026年3月10日

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  • Bahgat Fayed

摘要

Candida auris has emerged globally as a multidrug-resistant fungal pathogen with high morbidity and mortality, frequently linked to outbreaks in healthcare settings. Its resilience stems from biofilm formation, environmental persistence, and resistance to multiple antifungal classes, posing urgent challenges for infection control. Novel adjunctive strategies are therefore required to complement conventional antifungals. Probiotics and synbiotics offer multifaceted antifungal activities, including organic acid production, hydrogen peroxide secretion, biosurfactant and bacteriocin release, nutrient sequestration, and quorum-sensing interference. Unlike single-target antifungals, probiotics exert multi-layered pressure on pathogens, reducing the likelihood of resistance development. Evidence from clinical and preclinical studies indicates that probiotics can mitigate Candida colonization in the gastrointestinal tract, oral cavity, and vagina, while topical and device-related applications remain underexplored. Advanced formulations, such as synbiotic microcapsules, topical sprays, and probiotic-coated catheters, expand the feasibility of delivering viable cells or postbiotic metabolites to nearly all relevant body sites. This review synthesizes current evidence for probiotic and synbiotic applications against Candida species, with emphasis on innovative dosage forms and translational potential for C. auris. Future development of targeted formulations could provide sustainable, patient-friendly adjuncts to antifungal stewardship programs.