DOI: 10.1128/spectrum.03582-25 ISSN: 2165-0497

Disinfectant tolerance of Candidozyma auris and Candida albicans biofilms evaluated using the bead assay for biofilms

Natalia M. Zmarlak-Feher, Antje Finke, Katharina Konrat, Christoph Schaudinn, Mardjan Arvand, Anja M. Richter

ABSTRACT

Candidozyma auris (formerly Candida auris ) has emerged as a critical nosocomial pathogen, notable for its multidrug resistance and its capability to form biofilms that enable persistence on surfaces. Although effective disinfection strategies are urgently needed, current disinfectant efficacy standards in many regions, such as Europe, are primarily based on testing planktonic Candida albicans and do not adequately reflect the resilience of Candida biofilms, including those of C. albicans and C. auris . To address this gap, the Bead Assay for Biofilms, previously developed for bacterial biofilms, was adapted for the first time to eukaryotic cells. The goal was to cultivate C. auris and C. albicans biofilms and evaluate the efficacy of selected disinfectants across four active substance classes. Cell enumeration demonstrated highly reproducible biofilms, whose architecture was confirmed by scanning electron microscopy. Both an alcohol- and a QAC-based product did not achieve sufficient reduction of at least ≥4 log 10 CFU/mL of biofilm-cells when applied under conditions recommended by the manufacturer (alcohol 1 min: C. auris 0.82, C. albicans 0.54; QAC 1%, 15 min: C. auris 1.94, C. albicans 0.68). This reduced efficacy is consistent with the known increased tolerance of microorganisms in biofilms. In contrast, peracetic acid and glutaraldehyde achieved sufficient reductions, albeit at relatively high concentrations (peracetic acid 0.1%: C. auris 4.75 and 0.05%: C. albicans 4.87; glutaraldehyde 0.5%: C. auris 5.32 and C. albicans 4.15). Our findings underscore the need to adapt disinfection protocols and testing models to consider biofilm formation of C. auris and C. albicans , and species-specific resilience.

IMPORTANCE

This study highlights a critical gap in current disinfection efficacy testing standards; many of which rely on planktonic cell models and do not account for the resilience of biofilm-associated cells or emerging pathogens with unique resistance traits. Although species-specific regulatory guidance for C. auris exists in certain regions (e.g., in the USA), standardized disinfectant testing remains largely based on suspension assays (often using C. albicans ) and does not routinely incorporate biofilm models. Using the Bead Assay for Biofilms, we demonstrate that several commonly used disinfectants may fail to inactivate biofilm-associated C. auris and C. albicans when applied as recommended. This suggests that reliance on planktonic testing may overestimate disinfectant efficacy against clinically relevant pathogenic yeast and highlights the need to expand current testing standards in order to include biofilm-associated pathogens to improve infection prevention strategies. Consequently, our research is of immediate relevance to regulatory bodies, infection control, and public health.

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