Candida auris is a pathogenic yeast that first was isolated in 2009 from a 70-year-old Japanese woman. The name auris comes from Latin what means ear, referring to the first location where it was isolated from. Over the last decade, Candida auris has evolved into an emerging problem as it is highly contagious. Subsequently, it is increasingly contributing to invasive Candida infections, and led to outbreaks in intensive care units with mortality rates between 30 and 60%. It spread from just a few to many different locations throughout the world and in the meantime has caused nosocomial outbreaks in six continents. Five different clades have been detected and stratified by its geographical origin: East Asian, South Asian, South American, African, and Iranian. However, almost all have already spread to different continents.

In addition to being highly infectious, its identification and detection require special attention and laboratory testing. The most common symptoms of invasive Candida infections are fever and chills, and these do not improve after antibiotic treatment for a suspected bacterial infection. Moreover, treatment can be further challenging due to high resistance rates. Some of the strains are resistant to all three available classes of antifungals. 

New drugs that can combat Candida auris infections and de-colonize wounds and skin are urgently wanted. De Groot and colleagues recently published a study in the “Journal of Fungi”, a top-ranked scientific journal about mycology, in which a promising novel treatment is proposed. The researchers investigated whether honey and a CE and FDA approved medical grade honey-based wound care product (L-Mesitran) was able to kill Candida auris in vitro. Medical grade honey is a natural product that exerts antimicrobial activity via multiple different mechanisms, including against those resistant to antibiotics, e.g. MRSA. Moreover, no resistance towards honey has developed over time ever since the ancient Egyptians started using honey for wound care. 

The study showed that different types of pure honey are able to kill Candida auris in a dose-dependent manner (with concentrations of 16% being ineffective, and a concentration of 40% being able to kill more than 99% of the fungus). Interestingly, a supplemented medical grade honey formulation (L-Mesitran Soft) showed enhanced antimicrobial activity. Killing was achieved with a concentration of 6.25% honey in its formulation, while a 16% honey concentration in L-Mesitran Soft was able to kill 99.999% of the Candida auris. The supplements are likely causing a synergistic antimicrobial activity as has been reported recently as well. Although the current study is performed in vitro, L-Mesitran has previously shown to resolve persistent (antimicrobial-resistant) wound infections  and to eradicate biofilms. For this reason, it is presumed that L-Mesitran is a promising treatment option to effectively treat wounds and skin that are colonized with Candida auris. 

It would be interesting to explore the use of L-Mesitran in clinical infections with Candida auris. We are confident that these findings contribute to the fight against Candida auris and offer a potent new treatment option for the often already vulnerable patients.