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Invasive fungal infections caused by rare yeast-like fungi in adult patients: results of a prospective study

Summary

This study examined rare fungal infections in 30 critically ill adult patients over 18 years, finding that infections caused by uncommon yeasts like Trichosporon and Rhodotorula affected mainly long-term ICU patients with central lines. Despite treatment with antifungal medications, about 37% of patients died, highlighting the serious nature of these infections. The research emphasizes the importance of quickly identifying the specific fungus causing infection and using appropriate medications, along with removing infected catheters, to improve patient survival.

Background

Invasive fungal infections caused by rare yeast-like pathogens are an increasingly significant healthcare problem with high morbidity and mortality. While common fungal infections are caused by Candida and Aspergillus species, breakthrough infections from rare fungi like Trichosporon, Rhodotorula, Geotrichum, Saccharomyces, and Malassezia have emerged with increasing frequency in immunocompromised patients.

Objective

To investigate the etiology, clinical manifestations, risk factors, underlying diseases, diagnostic methods, and treatment efficacy of severe invasive fungal infections caused by rare yeast-like pathogens in adult patients during a prospective observational study.

Results

Of 310 patients, 30 (10%) had rare yeast-like fungal infections with a mortality rate of 37% at 4 weeks. Trichosporon spp. and Rhodotorula spp. were the main pathogens (73% combined). The typical patient was a 30-year-old male in the ICU for over 14 days with fungemia in 77% of cases. Central venous catheter use longer than 14 days and ICU stay longer than 14 days were major risk factors.

Conclusion

Early diagnosis and species identification of rare yeast-like fungal pathogens with antimycotic susceptibility testing is critical for improving patient outcomes. Daily examination of biological substrates for fungi when standard therapy fails, early targeted antifungal therapy, amphotericin B or lipid forms as initial treatment, and central venous catheter replacement were associated with improved survival.
  • Published in:Current Medical Mycology,
  • Study Type:Prospective Observational Study,
  • Source: PMID: 40662147, DOI: 10.22034/cmm.2025.345265.1559
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