<p><i>Candida auris</i> is a multidrug-resistant fungal pathogen that presents significant challenges in healthcare settings due to its robust biofilm-forming ability. Conventional antifungal treatments frequently prove ineffective, emphasizing the urgent need for innovative disinfection strategies, including the potential repurposing of existing agents. To evaluate the in vitro and in vivo antifungal and antibiofilm activity of cephalexin, cefixime, and cefotaxime against <i>C. auris</i>. The efficacy of cephalosporins was tested using in vitro assays for minimum inhibitory concentration (MIC), biofilm inhibition, biofilm eradication, cell membrane integrity, nucleotide leakage, sorbitol protection assay, and efflux pump inhibition. An in vivo model using <i>Tenebrio molitor</i> larvae assessed survival rates and fungal burden after treatment. Cephalexin, cefixime, and cefotaxime exhibited MICs of 64&#xa0;mg/L against <i>C. auris</i>. Cephalosporins significantly inhibited biofilm formation, with cephalexin completely eradicating mature biofilms within 45&#xa0;min, demonstrating superior activity compared to chlorhexidine. Cephalexin, cefixime, and cefotaxime do not cause damage to the fungal cell wall or interfere with <i>C. auris</i> efflux pumps. Instead, their activity triggers the externalization of nucleotides without promoting protein leakage. In <i>T. molitor</i> larvae, both cephalexin and cefixime significantly improved survival rates and reduced fungal burden, further supporting their therapeutic potential in managing <i>C. auris</i> infections. These findings highlight the potential of cephalexin and cefixime for repurposing as effective agents against superficial infections. Their demonstrated antibiofilm activity, biofilm eradication capabilities, and ability to reduce fungal burden in vivo underscore their promise in mitigating <i>C. auris</i> infections and enhancing infection control strategies.</p>

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Antifungal activity of cephalosporins as an alternative for the combat of Candida auris

  • Milena Izabel dos Santos Rodrigues,
  • Fabíola Lucini,
  • Gabrieli Argueiro da Silva,
  • Mariana Carvalho Sturaro,
  • Osmar Nascimento Silva,
  • Thiago Mendonça de Aquino,
  • Lavinia Leite Pintan Careaga,
  • Alex Polatto Carvalho,
  • Fabricio Fagundes Pereira,
  • Simone Simionatto,
  • Luana Rossato

摘要

Candida auris is a multidrug-resistant fungal pathogen that presents significant challenges in healthcare settings due to its robust biofilm-forming ability. Conventional antifungal treatments frequently prove ineffective, emphasizing the urgent need for innovative disinfection strategies, including the potential repurposing of existing agents. To evaluate the in vitro and in vivo antifungal and antibiofilm activity of cephalexin, cefixime, and cefotaxime against C. auris. The efficacy of cephalosporins was tested using in vitro assays for minimum inhibitory concentration (MIC), biofilm inhibition, biofilm eradication, cell membrane integrity, nucleotide leakage, sorbitol protection assay, and efflux pump inhibition. An in vivo model using Tenebrio molitor larvae assessed survival rates and fungal burden after treatment. Cephalexin, cefixime, and cefotaxime exhibited MICs of 64 mg/L against C. auris. Cephalosporins significantly inhibited biofilm formation, with cephalexin completely eradicating mature biofilms within 45 min, demonstrating superior activity compared to chlorhexidine. Cephalexin, cefixime, and cefotaxime do not cause damage to the fungal cell wall or interfere with C. auris efflux pumps. Instead, their activity triggers the externalization of nucleotides without promoting protein leakage. In T. molitor larvae, both cephalexin and cefixime significantly improved survival rates and reduced fungal burden, further supporting their therapeutic potential in managing C. auris infections. These findings highlight the potential of cephalexin and cefixime for repurposing as effective agents against superficial infections. Their demonstrated antibiofilm activity, biofilm eradication capabilities, and ability to reduce fungal burden in vivo underscore their promise in mitigating C. auris infections and enhancing infection control strategies.