Background: Multidrug resistance has been observed in bacteria for many decades, but multidrug resistant yeasts are relatively new development. Candida auris has emerged as a multi-resistant pathogen in hospitalized patients. Decreased activity by targeted antifungals against C. auris has been reported for azoles, caspofungin, and amphotericin. Taurolidine is an established broad spectrum nonspecific antimicrobial that acts through hydrolysis into formaldehyde and methylene glycol. Taurolidine has been previously tested against Candida isolates and found to have MICs ranging from 300- 5,000 mg/L. Taurolidine is currently marketed in Europe, and under study in the US for catheter lock solution (Neutrolin®) and a catheter lock solution at 1,350 mg/L is well tolerated. Methods: A total of 20 C. auris isolates collected from hospitalized patients between 2011 and 2017 and maintained by JMI Laboratories or the CDC were tested against taurolidine, amphotericin B and fluconazole using CLSI reference broth microdilution method. MIC values were determined visually after 24 and 48 h incubation and endpoints were read at 50 and 100% inhibition. Results: The activity of the 3 agents against C. auris isolates is displayed in the table. Taurolidine was active at 512 mg/L against 50% and 90% of the isolates reading at 24h and 48h and 50% inhibition. For 48h and 100% inhibition the MIC90 was 1012 mg/L. Amphotericin B MIC results were 1 or 2 mg/L using different reading conditions. Isolates displayed highly elevated MIC values for fluconazole and the activity of this compound was >128/mg/L regardless of the reading conditions. Conclusions: Taurolidine has reproducible antimicrobial activity against clinical isolates of multiresistant Candida auris.
Full conference title:
- ASM Microbe 2nd (2017)