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Updated: Dec 26, 2025

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Fungaemia due to rare yeasts in a tertiary care university centre within 18 years

Sehnaz Alp1, Dolunay Gulmez2, Caglayan Merve Ayaz1

  • 1Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

Mycoses
|March 8, 2020
PubMed
Abstract

Insights

Rare yeast fungaemia (RY-OTC) presents treatment challenges due to antifungal resistance. Voriconazole and posaconazole show promising in vitro activity against these emerging pathogens.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Clinical Microbiology

Background:

  • Fungaemia caused by rare yeasts (RY-OTC) is an emerging, understudied condition.
  • Intrinsic resistance of RY-OTC to common antifungals like echinocandins and fluconazole complicates empirical treatment strategies.

Purpose of the Study:

  • To characterize the clinical features of patients with RY-OTC fungaemia.
  • To document antifungal agents used and patient outcomes.
  • To determine the in vitro antifungal susceptibility profiles of RY-OTC isolates.

Main Methods:

  • Retrospective evaluation of RY-OTC fungaemia cases from January 2001 to December 2018.
  • Antifungal susceptibility testing performed using CLSI M27-A3 guidelines.

Main Results:

  • Nineteen patients experienced 20 RY-OTC fungaemia episodes, accounting for 2.2% of all fungaemia cases.
  • Haematological malignancy was the most frequent underlying condition (42%).
  • Breakthrough fungaemia occurred in 6 patients on echinocandins, amphotericin B, or fluconazole. Voriconazole and posaconazole demonstrated superior in vitro activity against tested isolates, while amphotericin B MICs were higher and azole activity varied.

Conclusions:

  • Prompt identification of RY-OTC infections is critical.
  • Understanding the susceptibility patterns of rare yeasts is essential for guiding initial antifungal therapy.
  • Worse outcomes were associated with echinocandin use in breakthrough infections.
Keywords:
amphotericin Bantifungal resistanceantifungal treatmentazolesbreakthrough fungaemiaechinocandinsfungaemiarare yeast

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