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. 2020 Dec 29;7(1):13.
doi: 10.3390/jof7010013.

MixInYeast: A Multicenter Study on Mixed Yeast Infections

Narda Medina  1 , Juan Carlos Soto-Debrán  1 , Danila Seidel  2   3   4 , Isin Akyar  5   6 , Hamid Badali  7 , Aleksandra Barac  8 , Stéphane Bretagne  9   10 , Yasemin Cag  11   12 , Carole Cassagne  13 , Carmen Castro  14 , Arunaloke Chakrabarti  15 , Eric Dannaoui  16 , Celia Cardozo  17 , Julio Garcia-Rodriguez  18 , Juliette Guitard  19 , Petr Hamal  20 , Martin Hoenigl  21 , Tomasz Jagielski  22 , Sadegh Khodavaisy  23 , Giuliana Lo Cascio  24 , María Carmen Martínez-Rubio  25 , Joseph Meletiadis  26 , Patricia Muñoz  27   28 , Elżbieta Ochman  29 , Teresa Peláez  30 , Ana Perez-Ayala Balzola  31 , Juergen Prattes  32 , Emmanuel Roilides  33 , Maite Ruíz-Pérez de Pipaón  34 , Raphael Stauf  35   36 , Jörg Steinmann  35   36 , Ana Isabel Suárez-Barrenechea  37 , Rocío Tejero  38 , Laura Trovato  39   40 , Lourdes Viñuela  41 , Thanwa Wongsuk  42 , Iwona Żak  43 , Hossein Zarrinfar  44 , Cornelia Lass-Flörl  45 , Sevtap Arikan-Akdagli  46 , Ana Alastruey-Izquierdo  1
Affiliations

MixInYeast: A Multicenter Study on Mixed Yeast Infections

Narda Medina et al. J Fungi (Basel). .

Abstract

Invasive candidiasis remains one of the most prevalent systemic mycoses, and several studies have documented the presence of mixed yeast (MY) infections. Here, we describe the epidemiology, clinical, and microbiological characteristics of MY infections causing invasive candidiasis in a multicenter prospective study. Thirty-four centers from 14 countries participated. Samples were collected in each center between April to September 2018, and they were sent to a reference center to confirm identification by sequencing methods and to perform antifungal susceptibility testing, according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST). A total of 6895 yeast cultures were identified and MY occurred in 150 cases (2.2%). Europe accounted for the highest number of centers, with an overall MY rate of 4.2% (118 out of 2840 yeast cultures). Of 122 MY cases, the most frequent combinations were Candida albicans/C. glabrata (42, 34.4%), C. albicans/C. parapsilosis (17, 14%), and C. glabrata/C. tropicalis (8, 6.5%). All Candida isolates were susceptible to amphotericin B, 6.4% were fluconazole-resistant, and two isolates (1.6%) were echinocandin-resistant. Accurate identification of the species involved in MY infections is essential to guide treatment decisions.

Keywords: Candida; chrome agar; invasive candidiasis; mix infections; polymicrobial infections; yeast.

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Conflict of interest statement

S.A.A. has received speaker honoraria or travel grant from Astellas, Gilead, and Pfizer in the last five years outside the submitted work. A.A.-I. has received research grants or honoraria as a speaker or advisor from Astellas, Gilead Sciences, MSD, Pfizer, F2G, Amplyx and Scynexis in the last five years outside the submitted work. MH has received research funding from Gilead and Pfizer. ER has received research grants from Astellas, Gilead, Merck and Pfizer Inc.; he is a scientific advisor and member of speaker bureaus for Astellas, Gilead, Merck and Pfizer Inc. The rest of the authors none to declare.

Figures

Figure 1
Figure 1
Rates, numbers, and species combinations found per country. (A) MY cases in Europe and Asia. (B) MY cases in the United States. The percentages shown inside each country represented the rate of MY per positive yeast cultures in each country and pie charts represent the MY combinations for each country.
See this image and copyright information in PMC

References

    1. Lamoth F., Lockhart S.R., Berkow E.L., Calandra T. Changes in the epidemiological landscape of invasive candidiasis. J. Antimicrob. Chemother. 2018;73:i4–i13. doi: 10.1093/jac/dkx444. - DOI - PMC - PubMed
    1. Arendrup M.C. Epidemiology of invasive candidiasis. Curr. Opin. Crit. Care. 2010;16:445–452. doi: 10.1097/MCC.0b013e32833e84d2. - DOI - PubMed
    1. Pappas P.G., Lionakis M.S., Arendrup M.C., Ostrosky-Zeichner L., Kullberg B.J. Invasive candidiasis. Nat. Rev. Dis. Prim. 2018;4:1–20. doi: 10.1038/nrdp.2018.26. - DOI - PubMed
    1. Pappas P.G., Kauffman C.A., Andes D.R., Clancy C.J., Marr K.A., Ostrosky-Zeichner L., Reboli A.C., Schuster M.G., Vazquez J.A., Walsh T.J., et al. Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. Clin. Infect. Dis. 2015;62:e1–e50. doi: 10.1093/cid/civ933. - DOI - PMC - PubMed
    1. Pfaller M.A., Andes D.R., Diekema D.J., Horn D.L., Reboli A.C., Rotstein C., Franks B., Azie N.E. Epidemiology and outcomes of invasive candidiasis due to non-albicans species of Candida in 2,496 patients: Data from the Prospective Antifungal Therapy (PATH) registry 2004–2008. PLoS ONE. 2014;9:e0101510. doi: 10.1371/journal.pone.0101510. - DOI - PMC - PubMed