Abstract
Background
Bloodstream infections due to Candida auris are an emerging public health concern due to high prevalence of antifungal resistance and significant rates of patient mortality. C. auris is typically azole-resistant; however, several strains have been identified with elevated MICs to all major classes of antifungals. Previously we reported that a synergistic combination of MEDTA+EtOH was highly effective in a clinical trial that evaluated salvage of catheters in patients with bacterial CLABSI. We have also previously reported in vitro studies that demonstrated this combination was capable of eradicating ordinary yeast CLABSI pathogens. In this study we evaluated the ability MEDTA+EtOH lock to rapidly eradicate C. auris biofilms.
Methods
Biofilm eradication of C. auris was evaluated in 10 strains. Candida auris biofilm was grown on silicone discs for 24 hours. Discs were then washed to remove any nonadherent organisms and exposed for 60 minutes to 1 mg/mL Minocycline + 30 mg/mL EDTA + 25% Ethanol (MEDTA+EtOH) lock solution. 1.35% Taurolidine + 3.5% Citrate + 1000U Heparin (TCH) lock solution was used as a comparator. Discs were exposed to Muller–Hinton broth as a control. Subsequently discs were sonicated for 15 minutes in 5 mL of saline and quantitatively cultured onto sabouraud dextrose agar. Plates were incubated at 37°C for 48 hours and counted for growth. All testing was conducted with 6 replicates.
Results
Median and range of recovered viable colonies are presented below. MEDTA+EtOH was significantly more efficacious compared with control (P = 0.002 for all strains) in completely eradicating all replicates in all 10 strains of C. auris tested. MEDTA+EtOH was also superior compared with TCH lock solution (P = 0.002) for all strains.
Conclusion
MEDTA+EtOH is highly effective and was superior to TCH and positive control in the rapid in vitro eradication of all 10 strains of C. auris biofilms tested.
Disclosures
All authors: No reported disclosures.
Session: 142. HAI, Device-Associated: Vascular Devices
Friday, October 4, 2019: 12:15 PM