{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T22:31:18Z","timestamp":1768516278321,"version":"3.49.0"},"reference-count":56,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T00:00:00Z","timestamp":1714348800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceutics"],"abstract":"<jats:p>Background: Relapse of Candida albicans urinary tract infection (UTI) is frequent despite appropriate treatment, as commonly used antifungals such fluconazole and flucytosine are only fungistatics. To improve treatment of Candida UTI and decrease relapses, understanding the long-term metabolic activity and survival of C. albicans in urine containing antifungals at minimal inhibitory concentration (MIC) is needed. Methods: we monitored the survival, metabolic activity and consumption of glucose and proteins by C. albicans using conventional methods and isothermal microcalorimetry (IMC). We also investigated the influence of dead Candida cells on the growth of their living counterparts. Results: For 33 days, weak activity was observed in samples containing antifungals in which C. albicans growth rate was reduced by 48%, 60% and 88%, and the lag increased to 172 h, 168 h and 6 h for amphotericin, flucytosine and fluconazole, respectively. The metabolic activity peaks corresponded to the plate counts but were delayed compared to the exhaustion of resources. The presence of dead cells promoted growth in artificial urine, increasing growth rate and reducing lag in similar proportions. Conclusions: Even with antifungal treatment, C. albicans relapses are possible. The low metabolic activity of surviving cells leading to regrowth and chlamydospore formation possibly supported by autophagy are likely important factors in relapses.<\/jats:p>","DOI":"10.3390\/pharmaceutics16050605","type":"journal-article","created":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T03:57:56Z","timestamp":1714622276000},"page":"605","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Again and Again\u2014Survival of Candida albicans in Urine Containing Antifungals"],"prefix":"10.3390","volume":"16","author":[{"given":"Nevio","family":"Facchini","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering, University of Basel, Hegenheimermattweg 167B\/C, 4123 Allschwil, Switzerland"},{"name":"Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056 Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lukas","family":"Wernli","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, University of Basel, Hegenheimermattweg 167B\/C, 4123 Allschwil, Switzerland"},{"name":"Department of Urology, Kantonsspital Baselland, Rheinstrasse 26, 4410 Liestal, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malte","family":"Rieken","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056 Basel, Switzerland"},{"name":"alta uro AG, Centralbahnplatz 6, 4051 Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gernot","family":"Bonkat","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056 Basel, Switzerland"},{"name":"alta uro AG, Centralbahnplatz 6, 4051 Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dieter","family":"Wirz","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, University of Basel, Hegenheimermattweg 167B\/C, 4123 Allschwil, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0659-755X","authenticated-orcid":false,"given":"Olivier","family":"Braissant","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, University of Basel, Hegenheimermattweg 167B\/C, 4123 Allschwil, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15226\/sojmid.2014.00116","article-title":"Candiduria: Epidemiology, Resistance, Classical and Alternative Antifungals Drugs","volume":"2","author":"Voltan","year":"2014","journal-title":"SOJ Microbiol. 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