The in vitro efficacy of Anidulafungin with and without Nikkomycin Z against C. auris isolates.

Abstract

This thesis investigates the in vitro antifungal efficacy of anidulafungin alone and in combination with nikkomycin Z against 15 Candida auris isolates representing four major genetic clades. Candida auris is a multidrug-resistant pathogen posing serious clinical challenges, with echinocandin resistance often linked to mutations in the FKS1 gene. The study employed MIC testing and time–kill assays to evaluate fungistatic and fungicidal effects. Anidulafungin monotherapy was generally fungistatic, while the combination with nikkomycin Z achieved synergistic and occasionally fungicidal effects, particularly in isolates without FKS1 hot-spot mutations. Importantly, synergy was observed even in some isolates with high nikkomycin Z MICs. These findings support the potential of dual cell wall inhibition as a strategy to enhance antifungal activity against resistant C. auris strains.