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Enhanced Virulence of Candida albicans by Staphylococcus aureus: Evidence in Clinical Bloodstream Infections and Infected Zebrafish Embryos

Coinfection with Candida and Staphylococcus results in higher mortality in animal studies. However, the pathogenesis and interplay between C. albicans and S. aureus in bloodstream infections (BSIs) is unclear. This study determines the clinical features and outcomes of mixed C. albicans/S. aureus (C...

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Autores principales: Wu, Yen-Mu, Huang, Po-Yen, Cheng, Yi-Chuan, Lee, Chih-Hua, Hsu, Meng-Chieh, Lu, Jang-Jih, Wang, Shao-Hung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8706905/
https://www.ncbi.nlm.nih.gov/pubmed/34947081
http://dx.doi.org/10.3390/jof7121099
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author Wu, Yen-Mu
Huang, Po-Yen
Cheng, Yi-Chuan
Lee, Chih-Hua
Hsu, Meng-Chieh
Lu, Jang-Jih
Wang, Shao-Hung
author_facet Wu, Yen-Mu
Huang, Po-Yen
Cheng, Yi-Chuan
Lee, Chih-Hua
Hsu, Meng-Chieh
Lu, Jang-Jih
Wang, Shao-Hung
author_sort Wu, Yen-Mu
collection PubMed
description Coinfection with Candida and Staphylococcus results in higher mortality in animal studies. However, the pathogenesis and interplay between C. albicans and S. aureus in bloodstream infections (BSIs) is unclear. This study determines the clinical features and outcomes of mixed C. albicans/S. aureus (CA/SA) BSIs and biofilm formation on pathogenesis during coinfection. Demographics and outcomes for mixed BSIs and monomicrobial candidemia were compared. Compared to 115 monomicrobial C. albicans BSIs, 22 patients with mixed CA/SA BSIs exhibited a significantly higher mortality rate and shorter survival time. In vitro and in vivo biofilm analysis showed that C. albicans accounted for the main biofilm architecture, and S. aureus increased its amount. Antibiotic tolerance in S. aureus, which adhered to Candida hyphae observed by scanning electron microscope, was demonstrated by the presence of wild-type C. albicans co-biofilm. Upregulation in exotoxin genes of S. aureus was evidenced by quantitative RT-PCR when a co-biofilm was formed with C. albicans. Mixed CA/SA BSIs result in a higher mortality rate in patients and in vivo surrogate models experiments. This study demonstrates that the virulence enhancement of C. albicans and S. aureus during co-biofilm formation contributes to the high mortality rate.
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spelling pubmed-87069052021-12-25 Enhanced Virulence of Candida albicans by Staphylococcus aureus: Evidence in Clinical Bloodstream Infections and Infected Zebrafish Embryos Wu, Yen-Mu Huang, Po-Yen Cheng, Yi-Chuan Lee, Chih-Hua Hsu, Meng-Chieh Lu, Jang-Jih Wang, Shao-Hung J Fungi (Basel) Article Coinfection with Candida and Staphylococcus results in higher mortality in animal studies. However, the pathogenesis and interplay between C. albicans and S. aureus in bloodstream infections (BSIs) is unclear. This study determines the clinical features and outcomes of mixed C. albicans/S. aureus (CA/SA) BSIs and biofilm formation on pathogenesis during coinfection. Demographics and outcomes for mixed BSIs and monomicrobial candidemia were compared. Compared to 115 monomicrobial C. albicans BSIs, 22 patients with mixed CA/SA BSIs exhibited a significantly higher mortality rate and shorter survival time. In vitro and in vivo biofilm analysis showed that C. albicans accounted for the main biofilm architecture, and S. aureus increased its amount. Antibiotic tolerance in S. aureus, which adhered to Candida hyphae observed by scanning electron microscope, was demonstrated by the presence of wild-type C. albicans co-biofilm. Upregulation in exotoxin genes of S. aureus was evidenced by quantitative RT-PCR when a co-biofilm was formed with C. albicans. Mixed CA/SA BSIs result in a higher mortality rate in patients and in vivo surrogate models experiments. This study demonstrates that the virulence enhancement of C. albicans and S. aureus during co-biofilm formation contributes to the high mortality rate. MDPI 2021-12-20 /pmc/articles/PMC8706905/ /pubmed/34947081 http://dx.doi.org/10.3390/jof7121099 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Wu, Yen-Mu
Huang, Po-Yen
Cheng, Yi-Chuan
Lee, Chih-Hua
Hsu, Meng-Chieh
Lu, Jang-Jih
Wang, Shao-Hung
Enhanced Virulence of Candida albicans by Staphylococcus aureus: Evidence in Clinical Bloodstream Infections and Infected Zebrafish Embryos
title Enhanced Virulence of Candida albicans by Staphylococcus aureus: Evidence in Clinical Bloodstream Infections and Infected Zebrafish Embryos
title_full Enhanced Virulence of Candida albicans by Staphylococcus aureus: Evidence in Clinical Bloodstream Infections and Infected Zebrafish Embryos
title_fullStr Enhanced Virulence of Candida albicans by Staphylococcus aureus: Evidence in Clinical Bloodstream Infections and Infected Zebrafish Embryos
title_full_unstemmed Enhanced Virulence of Candida albicans by Staphylococcus aureus: Evidence in Clinical Bloodstream Infections and Infected Zebrafish Embryos
title_short Enhanced Virulence of Candida albicans by Staphylococcus aureus: Evidence in Clinical Bloodstream Infections and Infected Zebrafish Embryos
title_sort enhanced virulence of candida albicans by staphylococcus aureus: evidence in clinical bloodstream infections and infected zebrafish embryos
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8706905/
https://www.ncbi.nlm.nih.gov/pubmed/34947081
http://dx.doi.org/10.3390/jof7121099
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