@article{oai:nagasaki-u.repo.nii.ac.jp:00000148,
 author = {Sumiyoshi, Makoto and Miyazaki, Taiga and Makau, Juliann Nzembi and Mizuta, Satoshi and Tanaka, Yoshimasa and Ishikawa, Takeshi and Makimura, Koichi and Hirayama, Tatsuro and Takazono, Takahiro and Saijo, Tomomi and Yamaguchi, Hiroyuki and Shimamura, Shintaro and Yamamoto, Kazuko and Imamura, Yoshifumi and Sakamoto, Noriho and Obase, Yasushi and Izumikawa, Koichi and Yanagihara, Katsunori and Kohno, Shigeru and Mukae, Hiroshi},
 issue = {1},
 journal = {Scientific Reports},
 month = {Oct},
 note = {chinocandins, including caspofungin, micafungin, and anidulafungin, are first-line antifungal agents for the treatment of 
invasive candidiasis. They exhibit fungicidal activity by inhibiting the synthesis of β-1,3-d-glucan, an essential 
component of the fungal cell wall. However, they are active only against proliferating fungal cells and unable to completely eradicate fungal cells even after a 24 h drug exposure in standard time-kill assays. Surprisingly, we found that caspofungin, when dissolved in low ionic solutions, had rapid and potent antimicrobial activities against multidrug-resistant (MDR) Candida and bacteria cells even in non-growth conditions. This effect was not observed in 0.9% NaCl or other ion-containing solutions and was not exerted by other echinocandins. Furthermore, caspofungin dissolved in 
low ionic solutions drastically reduced mature biofilm cells of MDR Candida auris in only 5 min, as well as Candida-bacterial polymicrobial biofilms in a catheter-lock therapy model. Caspofungin displayed 
ion concentration-dependent conformational changes and intracellular accumulation with increased reactive oxygen species production, indicating a novel mechanism of action in low ionic conditions. Importantly, caspofungin dissolved in 5% glucose water did not exhibit increased toxicity to human cells. This study facilitates the development of new therapeutic strategies in the management of catheter-related biofilm infections., Scientific Reports, 10(1), art.no.17745; 2020},
 title = {Novel and potent antimicrobial effects of caspofungin on drug-resistant Candida and bacteria},
 volume = {10},
 year = {2020}
}