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Fig 1.

A schematic illustration of the synthetic route of the PLA-HA membrane and its antifungal applications in C. auris planktonic cells and biofilms, as well as the corresponding infected wound healing.

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Fig 2.

Visual appearance and surface morphologies of PLA and PLA-HA nanofibrous membranes.

Scale = 5 μm, 2 μm and 0.5 μm from low magnification to high magnification in SEM images.

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Fig 3.

In vitro antifungal activities and biosafety of PLA-HA and PLA.

(A) Spread plate results of C. auris growth under different conditions. The images from left to right represent PLA and PLA-HA were repeatedly used for four times. (B) SEM and TEM images of C. auris under different conditions. CM indicates the cytoplasmic membrane, CW represents the cell wall, N indicates the nucleus and L refers to lipid inclusion. (C) Corresponding survival rate results of C. auris with PLA and PLA-HA treatment (n = 3). (D) Hemolysis assay. The inset shows the image directly observed after adding PLA and PLA-HA for 2 h. Distilled water was used as a positive control, and PBS was used as a negative control. (E) Cell toxicity evaluation of PLA and PLA-HA on mouse fibroblast L929 cells for 24 h, 48 h and 72 h. Data are presented as the mean ± s.d.

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Fig 4.

Biofilm formation and capacity of C. auris biofilm eradication.

(A) Observed C. auris biofilm formation at different times using Styo9 staining. Scale = 200 μm. (B) Growth curve of C. auris biofilm by the XTT reduction method. (C) Capacity of C. auris biofilm eradication of PLA and PLA-HA with and without illumination using the XTT reduction method. (D) Live/Dead staining of C. auris biofilms observed by CLSM. Scale = 10 μm. E. SEM images of C. auris biofilm with PLA and PLA-HA treatment. Data are presented as the mean ± s.d. n = 3.

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Fig 5.

Antifungal efficacy and compatibility of PLA-HA in treating cutaneous C. auris infections.

(A)Schematic diagram of cutaneous wound infection with C. auris and treatment with PLA-HA. Rats were evaluated on the 3rd and 21st days. (B) Survival rate of C. auris in the infected wound sites treated with PLA-HA and PLA. (C) Corresponding wound healing rate of rats in different groups. (D) Representative photographs of wounds and fungal burden of PLA-HA and PLA treated rats on days 3 and day 21. (E) Infected skin wound tissue evaluated by H&E staining (day 21, scale = 100 μm), PAS staining (day 3, scale = 50 μm) and IHC of IL-6 (day 3, scale = 20 μm) after PLA-HA treatment. (F) H&E staining of lung, liver, spleen, kidney and heart in different groups after treatment (scale = 20 μm). Data are presented as the mean ± s.d.

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Table 1.

The expression level of IL-6 in C. auris-infected tissue sites of different groups.

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Fig 6.

ROS levels of PLA-HA mediated aPDT.

(A) The detected principle of intracellular ROS. (B) DCFH-DA detected by fluorescence microscopy (scale = 20 μm). (C) Fluorescence microscopy images of SOSG-stained C. auris (scale = 20 μm). (D) Changes in intracellular ROS levels after treatment with PLA-HA. (E) Absorbance of DPBF treated with PLA-HA. (F) UV-visible spectroscopic monitoring of the photooxidation of KI to I3- by PLA-HA. Data are presented as the mean ± s.d.

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Fig 7.

Antifungal Mechanism of PLA-HA mediated aPDT.

(A) TUNEL, DAPI and Metacaspase detected by fluorescence microscopy. Scale = 10 μm. (B)Apoptosis of C. auris cells by staining with Annexin V-FITC and PI. (C) Mitochondrial membrane potential was evaluated using JC-1 staining. (D&E) Cytochrome C release from mitochondria to cytoplasm was assayed after treatment. Data are presented as the mean ± s.d.

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