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Nevertheless, there is still a lot to discover in how co-infections of C. Since insight into host-pathogen interactions are of fundamental concern, this topic should be addressed in future research Figure 1C ; Morales and Hogan, Finding an efficient treatment strategy for polymicrobial infections is a major challenge since traditional therapies most often only target individual causative agents within specific kingdoms Brogden et al. Combination therapy is being studied as a possible alternative to overcome this challenge.
It was demonstrated that anidulafungin and tigecycline act synergistically on S. Other potential drug sources are also being investigated for combination therapy against polymicrobial infections. Recently, other important components of mixed communities of fungi and bacteria, such as quorum sensing and the production of ECM in biofilms, are being explored as possible targets. The effect of quorum quenching enzymes against C. Two promising quorum quenching enzymes QQ-5 and QQ-7 , identified through functional screening of metagenomic large insert libraries, were found able to inhibit C.
Moreover, they both inhibited S. Such quorum quenching molecules are promising drugs to combat mixed species infections Weiland-Brauer et al. Small amphiphilic peptides are another class of antimicrobial proteins explored for their activity against poly microbial biofilms Gupta et al.
Recently, valine-glycine dipeptide-derived cholic acid, or CAP3, was found to exhibit broad-spectrum antimicrobial activity against both single and mixed C. Its effect was attributed to both biofilm structure disruption and membrane permeabilization Gupta et al. Furthermore, the activity of guanylated polymethacrylates, a new class of antimicrobial agents, was assessed against polymicrobial C. Guanylated polymethacrylates are synthetic structural mimics of antimicrobial peptides. They were found to be effective against established polymicrobial biofilms and they outperformed multiple other antimicrobial drug combinations.
Finally, the sterilization of catheters against the formation of polymicrobial biofilms is also under investigation.
Unfortunately, effective measures to deal with polymicrobial infections consisting of C. Mixed infections of C. The enhanced antimicrobial tolerance, increased virulence, and altered infection outcome due to the interaction of both species makes it even more challenging to find efficient treatment strategies. Although our knowledge on polymicrobial infections has been greatly expanded recently, there are still questions which remain to be solved in the future.
The effect of mixed species infections on the host immune response is still not clear and should be further addressed. In addition, since candidemia is increasingly caused by non- albicans Candida species, it is interesting to study the interaction of Staphylococcus species with other Candida species such as C. Since our current knowledge on biofilms is still predominantly based on studies concerning monomicrobial or dual species biofilms, it would be interesting to include even more than two microorganisms. An environment where this is particularly important is within the oral cavity since it has a rich and diverse microbial flora.
Understanding the complex interspecies communication and the microbial behavior when two or more species live together could help to improve our knowledge on polymicrobial infections and to develop effective treatment strategies. HC and KD contributed equally to this publication. All authors contributed to the writing of this manuscript.
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The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Adam, B. Mixed species biofilms of Candida albicans and Staphylococcus epidermidis. Albuquerque, P.
How do you get Candida overgrowth?
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Yeast Infection (Candida, Candidiasis) in Men, Women, Children, and Babies
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