MixInYeast: A Multicenter Study on Mixed Yeast Infections

Area of Science:

• Mycology
• Infectious Diseases
• Clinical Microbiology

Background:

• Invasive candidiasis is a prevalent systemic mycosis.
• Mixed yeast (MY) infections are increasingly documented.
• Understanding MY epidemiology and characteristics is vital.

Purpose of the Study:

• To describe the epidemiology, clinical, and microbiological features of MY infections causing invasive candidiasis.
• To analyze data from a multicenter prospective study involving 34 centers in 14 countries.
• To provide insights into the common species combinations and antifungal susceptibility.

Main Methods:

• Prospective, multicenter study design.
• Yeast cultures collected from April to September 2018.
• Species identification via sequencing and antifungal susceptibility testing (EUCAST guidelines).

Main Results:

• 150 out of 6895 (2.2%) yeast cultures represented MY infections.
• Europe had the highest MY rate (4.2%).
• Common combinations included Candida albicans/C. glabrata (34.4%), C. albicans/C. parapsilosis (14%), and C. glabrata/C. tropicalis (6.5%).
• All isolates were susceptible to amphotericin B; 6.4% were fluconazole-resistant, and 1.6% were echinocandin-resistant.

Conclusions:

• Accurate identification of yeast species in MY infections is essential.
• This aids in guiding appropriate antifungal treatment strategies.
• Further research into MY infections can improve patient management.