Table 1.
Fungal organ burden scoring system for neutrophil germ-free mice infected with C. auris. A comparison of the routes of infection and neutrophil depletion shows the following: Lesion scoring (HE): - within normal limits (WNL); + minimal to mild suppurative inflammation, scattered macrophages, and rare microabscessation; ++ mild to moderate suppurative inflammation, moderate numbers of macrophages, and microabscesses; +++ severe multifocal necrotizing suppurative inflammation, numerous macrophages, and microabscesses; ++++ severe multifocal to coalescing necrotizing suppurative inflammation, numerous macrophages, and microabscesses.
| Sample | Liver | Kidney | Spleen | Heart | Uterus | Lung | Urinary Bl | Brain | Stomach | Small Intestine | Large Intestine | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HE | IHC | HE | IHC | HE | IHC | HE | IHC | HE | IHC | HE | IHC | HE | IHC | HE | IHC | HE | IHC | HE | IHC | HE | IHC | |
| Control | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | NA | NA | NA | NA |
| Control | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | NA | NA | NA | NA |
| Control | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - |
| i.v. | ++ | ++ | + | + | - | ++ | ++ | ++ | - | - | - | - | NA | NA | + | + | - | + | NA | NA | NA | NA |
| i.v. | + | ++ | - | + | - | + | + | ++ | - | - | - | - | - | - | - | - | - | + | NA | NA | NA | NA |
| i.v. | + | ++ | + | + | - | + | + | + | - | - | - | - | - | - | - | + | - | + | - | + | - | + |
| i.v + 1A8 | + | +++ | +++ | +++ | - | ++ | ++++ | ++++ | - | + | - | ++ | + | + | + | + | + | + | NA | NA | NA | NA |
| i.v + 1A8 | + | +++ | +++ | +++ | - | ++ | ++++ | ++++ | - | - | - | + | - | - | - | + | + | + | NA | NA | NA | NA |
| i.v + 1A8 | + | +++ | +++ | +++ | - | ++ | ++++ | ++++ | - | § | - | + | - | - | - | + | - | + | ++ | + | - | + |
| Gavage | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | + | NA | NA | NA | NA |
| Gavage | - | - | - | - | - | - | - | - | - | - | - | + | - | - | - | - | - | + | NA | NA | NA | NA |
| Gavage | - | - | - | - | - | - | - | - | - | - | - | - | NA | NA | - | - | - | + | - | + | - | + |
| Gavage + 1A8 | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | NA | NA | NA | NA |
| Gavage + 1A8 | EMH | - | - | - | - | - | - | - | - | - | - | ++ | - | - | - | - | - | - | NA | NA | NA | NA |
| Gavage + 1A8 | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | + | - | + |
Severity of histopathological changes as observed in hematoxylin and eosin (H&E) stain: (-) within normal limits; (+) mild extramedullary hematopoiesis (EMH) with a distinct expansion of the megakaryoblast and myeloblast lines (liver) with rare macrophage infiltration and microgranulomas (liver); (++) prominent EMH of the megakaryoblast and myeloblast lines (liver), macrophage infiltration admixed with few necrotic cells, and rare microgranulomas (liver); (+++) extensive macrophage infiltration admixed with few necrotic cells; (++++) prominent macrophage infiltration and necrosis with numerous intralesional fungal elements. Extent and distribution of C. auris antigen (immunohistochemistry): (-) no antigen detected; (+) intracytoplasmic staining of a few tissue macrophages, granulomas, meninges, and rare yeast; (++) intracytoplasmic staining of numerous tissue macrophages and tubular epithelial cells, granulomas, meninges, and yeasts; (+++) intracytoplasmic staining of numerous tissue macrophages, granulomas, tubular epithelial cells, and meninges. Prominent staining of numerous intralesional yeasts and necrotic debris. § Positive granulomas in peritoneal fat.