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Non- albicans Candida  species (NACS) are often isolated along with  Candida albicans  in cases of oropharyngeal candidiasis.  C. albicans  readily forms biofilms in conjunction with other oral microbiota including both bacteria and yeast. Adhesion between species is important to the establishment of these mixed biofilms, but interactions between  C. albicans  and many NACS are not well-characterized. We adapted a real-time flow biofilm model to study adhesion interactions and biofilm establishment in  C. albicans  and NACS in mono- and co-culture. Out of five NACS studied, only the filamenting species  C. tropicalis  and  C. dubliniensis  were capable of adhesion with  C. albicans , while  C. parapsilosis, C. lusitaniae, and C. krusei  were not. Over the early phase (0–4 h) of biofilm development, both mono- and co-culture followed similar kinetics of attachment and detachment events, indicating that initial biofilm formation is not influenced by inter-species interactions. However, the NACS showed a preference for inter-species cell-cell interactions with  C. albicans , and at later time points (5–11 h) we found that dual-species interactions impacted biofilm surface coverage. Dual-species biofilms of  C. tropicalis  and  C. albicans  grew more slowly than  C. albicans  alone, but achieved higher surface coverage than  C. tropicalis  alone. Biofilms of  C. dubliniensis  with  C. albicans  increased surface coverage more rapidly than either species alone. We conclude that dual culture biofilm of  C. albicans  with  C. tropicalis  or  C. dubliniensis  offers a growth advantage for both NACS. Furthermore, the growth and maintenance, but not initial establishment, of dual-species biofilms is likely facilitated by interspecies cell-cell adherence.

Filamentous Non-albicans Candida Species Adhere to Candida albicans and Benefit From Dual Biofilm Growth