{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T06:45:41Z","timestamp":1776840341631,"version":"3.51.2"},"reference-count":60,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Yeast infections from sterile body fluids are increasingly encountered in tertiary care, yet contemporary links between species ecology, antifungal susceptibility, and patient outcomes remain underdefined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective cohort study of 231 consecutive sterile-site yeast isolates at Nanjing Drum Tower Hospital (2019\u20132023). Species were identified by CHROMagar and MALDI-TOF MS; antifungal MICs were determined using YeastOne and interpreted by CLSI M27-Ed3. Clinical data were abstracted from electronic records. Variables with\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.10 in univariate testing entered multivariable logistic regression to identify independent predictors of fungemia, sepsis, and in-hospital mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The four major Candida species showed distinct susceptibility profiles, with\n                      <jats:italic>C. albicans<\/jats:italic>\n                      broadly susceptible,\n                      <jats:italic>C. tropicalis<\/jats:italic>\n                      exhibiting notable azole resistance,\n                      <jats:italic>Nakaseomyces glabratus<\/jats:italic>\n                      (\n                      <jats:italic>C. glabrata<\/jats:italic>\n                      ) displaying high azole MICs but good echinocandin activity, and\n                      <jats:italic>C. parapsilosis<\/jats:italic>\n                      maintaining low azole MICs but intrinsically higher echinocandin MICs. Clinically, bloodstream involvement was frequent. Fungemia was independently associated with blood transfusion and hemodialysis catheterization, whereas surgery was protective (OR 0.320, 95% CI 0.171\u20130.599). Sepsis occurred in 23.8% and was independently associated with ICU admission (OR 7.119, 95% CI 2.811\u201318.026); surgical treatment again showed a protective association (OR 0.426, 95% CI 0.190\u20130.954). Overall mortality was 26.8%; acute kidney injury (AKI) independently predicted death (OR 3.354, 95% CI 1.563\u20137.198).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      In this five-year cohort,\n                      <jats:italic>Candida<\/jats:italic>\n                      \u2014led by\n                      <jats:italic>C. albicans<\/jats:italic>\n                      with a rising\n                      <jats:italic>non-albicans<\/jats:italic>\n                      share\u2014dominated sterile-site infections. Echinocandins and amphotericin B retained broad activity, whereas azole activity was reduced in\n                      <jats:italic>C. tropicalis\/N. glabratus<\/jats:italic>\n                      . Across outcomes, transfusion and hemodialysis catheters increased fungemia risk, ICU admission increased sepsis risk, AKI drove mortality, and early surgical source control was consistently protective. These findings support prompt device removal, restrictive transfusion, proactive renal management, and echinocandin-first strategies in high-risk patients.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmicb.2026.1773098","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T05:48:11Z","timestamp":1776836891000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Yeast infections in sterile body fluids: species distribution, antifungal susceptibility, and cross-cutting risk factors for fungemia, sepsis, and mortality (2019\u20132023)"],"prefix":"10.3389","volume":"17","author":[{"given":"Jiaxing","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing","place":["Jiangsu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mei","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing","place":["Jiangsu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fan","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing","place":["Jiangsu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuo","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing","place":["Jiangsu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wanqing","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing","place":["Jiangsu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Han","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing","place":["Jiangsu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoli","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing","place":["Jiangsu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing","place":["Jiangsu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2879","DOI":"10.1007\/s42770-023-01163-3","article-title":"The impact of increasing non-albicans Candida trends on diagnostics in immunocompromised patients","volume":"54","author":"Abdel-Hamid","year":"2023","journal-title":"Braz. 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