Iron chelators enhance the potency of Echinocandins against Candida auris

The growing prevalence and spread of multidrug-resistant Candida auris exhibit a significant global public health threat. C. auris exhibits resistance to all three major classes of antifungal agents, making treatment particularly difficult. Additionally, it has the ability to form biofilms and survive at elevated temperatures, up to 42 °C. Some Clades have also been observed to display pseudohyphal growth and melanin production under high-temperatures conditions. Furthermore, newly emerging clades show varied resistance profiles, which complicate treatment strategies. These factors underscore the urgent need for novel therapeutic approaches. Currently, effective treatment options for C. auris infections are limited, and standardized prevention and control protocols for healthcare settings are lacking. In this study, we demonstrated that iron chelators, deferiprone (DPR) and deferoxamine (DFO), when combined with echinocandins (caspofungin, micafungin and anidulafungin), displayed potent synergistic effects against C. auris isolates. Time-kill assays revealed that the combination of iron chelators and echinocandins completely suppressed fungal growth within 28-44 hours. Furthermore, this combination markedly reduced the biofilm-forming ability of C. auris . These outcomes signify that the combination of echinocandins with iron chelators warrants further exploration as a promising therapeutic strategy for treating C. auris infections.