{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"bioRxiv"}],"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T07:44:05Z","timestamp":1784619845314,"version":"3.55.0"},"posted":{"date-parts":[[2025,11,7]]},"group-title":"Microbiology","reference-count":75,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T00:00:00Z","timestamp":1762473600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["R01AI177875"],"award-info":[{"award-number":["R01AI177875"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["R21AI171742"],"award-info":[{"award-number":["R21AI171742"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["R01DK128805"],"award-info":[{"award-number":["R01DK128805"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["R01DK051406"],"award-info":[{"award-number":["R01DK051406"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100020392","name":"Good Ventures","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100020392","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000038","name":"Natural Sciences and Engineering Research Council of Canada","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000038","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001659","name":"German Research Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2025,11,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:p>\n                  <jats:underline>Urinary<\/jats:underline>\n                  catheterization, a common procedure in hospitals and nursing home facilities, is a primary driver of hospital-acquired infections (HAI). These devices frequently lead to catheter-associated urinary tract infections (CAUTIs), which often progress to severe complication, sepsis, and ultimately death. The fungus\n                  <jats:italic>Candida albicans<\/jats:italic>\n                  has emerged as the second most common causative agent of CAUTIs; yet, its pathogenesis is poorly understood, which complicates development of efficient treatments. Previously, we identified the transcription factor Efg1 as a critical virulence driver in\n                  <jats:italic>C. albicans<\/jats:italic>\n                  CAUTIs. However, its specific downstream targets within the unique bladder microenvironment remained unknown. This study identifies, for the first time, the complete Efg1 regulon that is active during growth in human urine. We confirmed the clinical relevance of this discovery, finding that many of these Efg1-regulated factors are present and significantly upregulated in catheter samples from patients with\n                  <jats:italic>C. albicans<\/jats:italic>\n                  infections. Furthermore, we characterized two of these key factors,\n                  <jats:italic>ECE1<\/jats:italic>\n                  and\n                  <jats:italic>EED1<\/jats:italic>\n                  , validating their roles both\n                  <jats:italic>in vitro<\/jats:italic>\n                  in urine conditions and\n                  <jats:italic>in vivo<\/jats:italic>\n                  using a CAUTI mouse model. Identifying the tissue-specific downstream targets of Efg1 elucidates the precise mechanism of fungal CAUTI. This knowledge provides a new roadmap for developing targeted therapeutics, offering vital antimicrobial-sparing strategies to combat these life-threatening infections.\n                <\/jats:p>\n                <jats:sec>\n                  <jats:title>SIGNIFICANCE<\/jats:title>\n                  <jats:p>\n                    Catheter-associated urinary tract infections (CAUTIs) are common hospital-acquired infections that can lead to severe complications and death. Although most are caused by bacteria, the fungus\n                    <jats:italic>Candida albicans<\/jats:italic>\n                    is an increasingly prevalent cause, yet the pathogenesis of fungal CAUTIs is poorly understood. Previous research identified Efg1 as necessary for CAUTI, and now this study defines the urine-specific Efg1 regulon, validating its clinical relevance in catheter samples from infected patients. We further assessed how key downstream factors, Ece1 and Eed1, contribute to bladder infection. This first report of the urine-specific\n                    <jats:italic>EFG1<\/jats:italic>\n                    network provides new targets for diagnosing and treating these life-threatening infections.\n                  <\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2025.11.06.686417","type":"posted-content","created":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T02:35:26Z","timestamp":1762569326000},"source":"Crossref","is-referenced-by-count":4,"title":["The Unique Efg1 Fungal Virulence Regulon in the Catheterized Bladder Environment"],"prefix":"10.64898","author":[{"given":"Alyssa Ann","family":"La Bella","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas C.","family":"Gervais","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurt N.","family":"Kohler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chloe L.P.","family":"Obernuefemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilse D.","family":"Jacobsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca S.","family":"Shapiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael G.","family":"Caparon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott J.","family":"Hultgren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4610-4246","authenticated-orcid":false,"given":"Ana Lidia","family":"Flores-Mireles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6453-4904","authenticated-orcid":false,"given":"Felipe Hiram","family":"Santiago-Tirado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2025111011200686000_2025.11.06.686417v1.1","unstructured":"W. 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