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Vulvovaginal candidiasis (VVC) is a commonly occurring yeast infection caused by Candida species in women. Among Candida species, C. albicans is the predominant member that causes vaginal candidiasis followed by Candida glabrata. Biofilm formation by Candida albicans on the vaginal mucosal tissue leads to VVC infection and is one of the factors for a commensal organism to get into virulent form leading to disease. In addition to that, morphological switching from yeast to hyphal form increases the risk of pathogenesis as it aids in tissue invasion. In this study, jacalin, a phytolectin complexed copper sulfide nanoparticles (NPs) have been explored to eradicate the mono and mixed species biofilms formed by fluconazole-resistant C. albicans and C. glabrata isolated from VVC patients. NPs along with standard antifungals like micafungin and amphotericin B have been evaluated to explore interaction behavior and we observed synergistic interactions between them. Microscopic techniques like light microscopy, phase contrast microscopy, scanning electron microscopy, confocal laser scanning microscopy were used to visualize the inhibition of biofilm by NPs and in synergistic combinations with standard antifungals. Real-time PCR analysis was carried out to study the expression pattern of the highly virulent genes which are responsible for yeast to hyphal switch, drug resistance and biofilm formation upon treatment with NPs in combination with standard antifungals. The current study shows that lectin-conjugated NPs with standard antifungals might be a different means to disrupt the mixed species population of Candida spp. that causes VVC. Lay Summary The present study focuses on exploiting the high biding affinity between the cell surface glycans present in Candida cells and the plant lectin, Jacalin. Jacalin serves as a 'Trojan Horse' wherein the lectin-coupled nanoparticles show a high efficacy when compared with the unconjugated nanoparticles. The present approach also improves the anti-biofilm activity of the antifungal drugs against drug-resistant Candida strains. [ABSTRACT FROM AUTHOR]

Rationale: Candida auris is a potential emerging pathogen among Candida and causes serious health threats globally. Patient concerns: We reported a case of vulvovaginal candidiasis caused by Candida auris. A 26-year-old female presented with complaints of vaginal discharge, itching and low back pain. Diagnosis: High vaginal swab culture yielded Candida. The strain was confirmed as Candida auris by amplification and sequencing the internal transcribed spacer region. Antifungal susceptibility testing revealed that the isolate was resistant to fluconazole, amphotericin B and clotrimazole and susceptible to ketoconazole and nystatin. The isolate also exhibited biofilm forming ability. Interventions: Her symptoms did not subside with initial management with fluconazole and clotrimazole. Later, she was started on ketoconazole therapy. The patient responded well to ketoconazole. Outcome and lessons: To the best of our knowledge, this is the first report about the presence of a drug resistant biofilm forming Candida auris strain isolated from a vaginal swab sample from Chennai area. Biofilm forming ability might contribute to its drug resistance. Nucleic acid analysis helps in rapid and accurate identification of such rare species. [ABSTRACT FROM AUTHOR]