Plastic pollution as a novel reservoir for the environmental survival of the drug resistant fungal pathogen Candida auris

The WHO recently classified Candida auris as a fungal pathogen of "critical concern". Evidence suggests that C. auris emerged from the natural environment, yet the ability of this pathogenic yeast to survive in the natural environment is still poorly understood. The aim of this study, therefore, was to quantify the persistence of C. auris in simulated environmental matrices and explore the role of plastic pollution for facilitating survival and potential transfer of C. auris. Multi-drug resistant strains of C. auris persisted for over 30 days in river water or seawater, either planktonically, or in biofilms colonising high-density polyethylene (HDPE) or glass. C. auris could be transferred from plastic beads onto simulated beach sand, particularly when the sand was wet. Importantly, all C. auris cells recovered from plastics retained their pathogenicity; therefore, plastic pollution could play a significant role in the widescale environmental dissemination of this recently emerged pathogen.</p

Tolerance of Pseudomonas aeruginosa in in vitro biofilms to high level peracetic acid disinfection

Biofilm has been suggested as a cause of disinfection failures in flexible endoscopes where no lapses in the decontamination procedure can be identified. To test this theory, the activity of peracetic acid (PAA), one of the commonly used disinfectants in the reprocessing of flexible endoscopes, was evaluated against both planktonic and sessile communities of Pseudomonas aeruginosa. To investigate the ability of P. aeruginosa biofilm to survive high level PAA disinfection. The susceptibility of planktonic cells of P. aeruginosa and biofilms 24, 48, 96 and 192 h old to PAA was evaluated by estimating their viability using resazurin viability and plate count methods. The biomass of the P. aeruginosa biofilms was also quantified using crystal violet assay. Planktonic cells of P. aeruginosa were treated with 5 - 30 ppm concentration of PAA in the presence of 3.0 g/L of Bovine serum albumin (BSA) for 5 min. Biofilms of P. aeruginosa were also treated with various PAA concentrations (100 - 3000 ppm) for 5 min. Planktonic cells of P. aeruginosa were eradicated by 20 ppm of PAA, whereas biofilms showed an age dependent tolerance to PAA, and 96 h old biofilm was only eradicated at PAA concentration of 2500 ppm. 96 h old P. aeruginosa biofilm survives 5 min treatment with 2000 ppm of PAA, which is the working concentration used in some endoscope washer disinfectors. This implies that disinfection failure of flexible endoscopes could occur when biofilms are allowed to build up in the lumens of endoscopes

Plastic pollution and fungal, protozoan, and helminth pathogens – a neglected environmental and public health issue?

Plastic waste is ubiquitous in the environment and can become colonised by distinct microbial biofilm communities, known collectively as the ‘plastisphere.’ The plastisphere can facilitate the increased survival and dissemination of human pathogenic prokaryotes (e.g., bacteria); however, our understanding of the potential for plastics to harbour and disseminate eukaryotic pathogens is lacking. Eukaryotic microorganisms are abundant in natural environments and represent some of the most important disease-causing agents, collectively responsible for tens of millions of infections, and millions of deaths worldwide. While prokaryotic plastisphere communities in terrestrial, freshwater, and marine environments are relatively well characterised, such biofilms will also contain eukaryotic species. Here, we critically review the potential for fungal, protozoan, and helminth pathogens to associate with the plastisphere, and consider the regulation and mechanisms of this interaction. As the volume of plastics in the environment continues to rise there is an urgent need to understand the role of the plastisphere for the survival, virulence, dissemination, and transfer of eukaryotic pathogens, and the effect this can have on environmental and human health

Environmental reservoirs of the drug-resistant pathogenic yeast Candida auris

Candia auris is an emerging human pathogenic yeast; yet, despite phenotypic attributes and genomic evidence suggesting that it probably emerged from a natural reservoir, we know nothing about the environmental phase of its life cycle and the transmission pathways associated with it. The thermotolerant characteristics of C. auris have been hypothesised to be an environmental adaptation to increasing temperatures due to global warming (which may have facilitated its ability to tolerate the mammalian thermal barrier that is considered a protective strategy for humans against colonisation by environmental fungi with pathogenic potential). Thus, C. auris may be the first human pathogenic fungus to have emerged as a result of climate change. In addition, the release of antifungal chemicals, such as azoles, into the environment (from both pharmaceutical and agricultural sources) is likely to be responsible for the environmental enrichment of resistant strains of C. auris; however, the survival and dissemination of C. auris in the natural environment is poorly understood. In this paper, we critically review the possible pathways through which C. auris can be introduced into the environment and evaluate the environmental characteristics that can influence its persistence and transmission in natural environments. Identifying potential environmental niches and reservoirs of C. auris and understanding its emergence against a backdrop of climate change and environmental pollution will be crucial for the development of effective epidemiological and environmental management responses

Development of a high throughput and low cost model for the study of semi-dry biofilms

The persistence of microorganisms as biofilms on dry surfaces resistant to the usual terminal cleaning methods may pose an additional risk of transmission of infections. In this study, the Centre for Disease Control (CDC) dry biofilm model (DBM) was adapted into a microtiter plate format (Model 1) and replicated to create a novel in vitro model that replicates conditions commonly encountered in the healthcare environment (Model 2). Biofilms of Staphylococcus aureus grown in the two models were comparable to the biofilms of the CDC DBM in terms of recovered log10 CFU well−1. Assessment of the antimicrobial tolerance of biofilms grown in the two models showed Model 2 a better model for biofilm formation. Confirmation of the biofilms’ phenotype with an extracellular matrix deficient S. aureus suggested stress tolerance through a non-matrix defined mechanism in microorganisms. This study highlights the importance of conditions maintained in bacterial growth as they affect biofilm phenotype and behaviour

Potential reservoirs of <i>Candida auris</i>.

Candia auris is an emerging human pathogenic yeast; yet, despite phenotypic attributes and genomic evidence suggesting that it probably emerged from a natural reservoir, we know nothing about the environmental phase of its life cycle and the transmission pathways associated with it. The thermotolerant characteristics of C. auris have been hypothesised to be an environmental adaptation to increasing temperatures due to global warming (which may have facilitated its ability to tolerate the mammalian thermal barrier that is considered a protective strategy for humans against colonisation by environmental fungi with pathogenic potential). Thus, C. auris may be the first human pathogenic fungus to have emerged as a result of climate change. In addition, the release of antifungal chemicals, such as azoles, into the environment (from both pharmaceutical and agricultural sources) is likely to be responsible for the environmental enrichment of resistant strains of C. auris; however, the survival and dissemination of C. auris in the natural environment is poorly understood. In this paper, we critically review the possible pathways through which C. auris can be introduced into the environment and evaluate the environmental characteristics that can influence its persistence and transmission in natural environments. Identifying potential environmental niches and reservoirs of C. auris and understanding its emergence against a backdrop of climate change and environmental pollution will be crucial for the development of effective epidemiological and environmental management responses.</div

Possible pathways for <i>Candida auris</i> introduction into the environment.

Possible pathways for Candida auris introduction into the environment.</p

Reported isolation of common pathogenic <i>Candida</i> species from environmental samples.

Reported isolation of common pathogenic Candida species from environmental samples.</p

Cumulative number of countries with reported detection of <i>Candida auris</i>.

Cumulative number of countries with reported detection of Candida auris.</p

Reduction of <i>Pseudomonas aeruginosa</i> biofilm formation through the application of nanoscale vibration

Bacterial biofilms pose a significant burden in both healthcare and industrial environments. With the limited effectiveness of current biofilm control strategies, novel or adjunctive methods in biofilm control are being actively pursued. Reported here, is the first evidence of the application of nanovibrational stimulation (nanokicking) to reduce the biofilm formation of Pseudomonas aeruginosa. Nanoscale vertical displacements (approximately 60 nm) were imposed on P. aeruginosa cultures, with a significant reduction in biomass formation observed at frequencies between 200 and 4000 Hz at 24 h. The optimal reduction of biofilm formation was observed at 1 kHz, with changes in the physical morphology of the biofilms. Scanning electron microscope imaging of control and biofilms formed under nanovibrational stimulation gave indication of a reduction in extracellular matrix (ECM). Quantification of the carbohydrate and protein components of the ECM was performed and showed a significant reduction at 24 h at 1 kHz frequency. To model the forces being exerted by nanovibrational stimulation, laser interferometry was performed to measure the amplitudes produced across the Petri dish surfaces. Estimated peak forces on each cell, associated with the nanovibrational stimulation technique, were calculated to be in the order of 10 pN during initial biofilm formation. This represents a potential method of controlling microbial biofilm formation in a number of important settings in industry and medical related processes