{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T03:10:51Z","timestamp":1782875451109,"version":"3.54.5"},"reference-count":82,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:00:00Z","timestamp":1772668800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoF"],"abstract":"<jats:p>Invasive infections attributed to rare yeasts are increasingly recognized and often exhibit resistance to echinocandins or fluconazole. Despite geographical variability, epidemiological data from Greece are limited. To bridge this gap, we conducted a 15-year retrospective study of rare yeast fungaemia at a tertiary teaching hospital in Athens. All microbiologically confirmed cases in hospitalized patients (2010\u20132024) were included. Demographic and clinical data were retrieved from medical records. Incidence was calculated per 1000 admissions and 10,000 bed days. Isolates were identified using Vitek 2 and, when available, further characterized by MALDI-TOF MS and tested for antifungal susceptibility based on EUCAST guidelines. A total of 29 episodes (3% of all fungaemias) were identified, with an incidence of 0.04\/1000 admissions and 0.09\/10,000 bed days. Hematological malignancies (31%) were the most common underlying condition. All patients had central venous catheters and were receiving antibiotics; 38% were non-neutropenic\/non-immunosuppressed. The most frequently isolated species were Rhodotorula mucilaginosa (41%), Saccharomyces cerevisiae (31%) and Trichosporon asahii (21%), with single cases of Apiotrichum loubieri and Magnusiomyces capitatus. Amphotericin B exhibited good in vitro activity against all species; echinocandins were active only against S. cerevisiae, and azole activity was species dependent. The median time from hospital admission to fungaemia onset was 27 days; one-third of cases were breakthrough infections, and in 19%, diagnosis was established post-mortem. Despite antifungal therapy, crude mortality was 53%. Although infrequent, rare yeast fungaemia at our centre was associated with high breakthrough rates and substantial mortality. Regional epidemiological insight and heightened clinical awareness are key to optimizing outcomes.<\/jats:p>","DOI":"10.3390\/jof12030187","type":"journal-article","created":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T10:31:14Z","timestamp":1772706674000},"page":"187","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Beyond Candida: Epidemiological Insights into Rare Yeast Fungaemia in Greece from a 15-Year Hospital-Based Study and Literature Review"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5924-1007","authenticated-orcid":false,"given":"Maria","family":"Siopi","sequence":"first","affiliation":[{"name":"Clinical Microbiology Laboratory, \u201cAttikon\u201d University General Hospital, Medical School, National and Kapodistrian University of Athens, Rimini 1, 12462 Athens, Greece"},{"name":"Molecular Microbiology and Immunology Laboratory, Department of Biomedical Sciences, University of West Attica, Agiou Spiridonos 28, 12243 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Mitsopoulos","sequence":"additional","affiliation":[{"name":"Molecular Microbiology and Immunology Laboratory, Department of Biomedical Sciences, University of West Attica, Agiou Spiridonos 28, 12243 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angeliki","family":"Alevra","sequence":"additional","affiliation":[{"name":"Molecular Microbiology and Immunology Laboratory, Department of Biomedical Sciences, University of West Attica, Agiou Spiridonos 28, 12243 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margarita","family":"Vargiami","sequence":"additional","affiliation":[{"name":"Clinical Microbiology Laboratory, \u201cAttikon\u201d University General Hospital, Medical School, National and Kapodistrian University of Athens, Rimini 1, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6298-9577","authenticated-orcid":false,"given":"Spyros","family":"Pournaras","sequence":"additional","affiliation":[{"name":"Clinical Microbiology Laboratory, \u201cAttikon\u201d University General Hospital, Medical School, National and Kapodistrian University of Athens, Rimini 1, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8869-1509","authenticated-orcid":false,"given":"Joseph","family":"Meletiadis","sequence":"additional","affiliation":[{"name":"Clinical Microbiology Laboratory, \u201cAttikon\u201d University General Hospital, Medical School, National and Kapodistrian University of Athens, Rimini 1, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1917","DOI":"10.12688\/f1000research.11124.1","article-title":"Rare Fungal Infectious Agents: A Lurking Enemy","volume":"6","author":"Skiada","year":"2017","journal-title":"F1000Research"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e375","DOI":"10.1016\/S1473-3099(21)00203-6","article-title":"Global Guideline for the Diagnosis and Management of Rare Yeast Infections: An Initiative of the ECMM in Cooperation with ISHAM and ASM","volume":"21","author":"Chen","year":"2021","journal-title":"Lancet Infect. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e0006423","DOI":"10.1128\/cmr.00064-23","article-title":"An Update on Clinically Relevant, Rare, and Emerging Candida and Saccharomycotina Yeasts That Have Been Recently Reclassified from Candida","volume":"38","author":"Francisco","year":"2025","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e01594-21","DOI":"10.1128\/mBio.01594-21","article-title":"All You Need To Know and More about the Diagnosis and Management of Rare Yeast Infections","volume":"12","author":"Sprute","year":"2021","journal-title":"MBio"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"i2","DOI":"10.1093\/jac\/dkaf004","article-title":"Clinical Aspects and Recent Advances in Fungal Diseases Impacting Human Health","volume":"80","author":"Pagano","year":"2025","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1007\/s40588-017-0073-7","article-title":"Rare Yeast Infections: Risk Factors, Clinical Manifestations, Treatment, and Special Considerations","volume":"4","author":"Byrne","year":"2017","journal-title":"Curr. Clin. Microbiol. Rep."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Astvad, K.M.T., Arikan-Akdagli, S., and Arendrup, M.C. (2022). A Pragmatic Approach to Susceptibility Classification of Yeasts without EUCAST Clinical Breakpoints. J. Fungi, 8.","DOI":"10.3390\/jof8020141"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"White, T.J., Bruns, T., Lee, S., and Taylor, J. (1990). Amplification and Direct Sequencing of Fungal Ribosomal Rna Genes For Phylogenetics. PCR Protocols, Elsevier.","DOI":"10.1016\/B978-0-12-372180-8.50042-1"},{"key":"ref_9","unstructured":"EUCAST (2023). EUCAST Definitive Document E.Def 7.4 Method for the Determination of Broth Dilution Minimum Inhibitory Concentrations of Antifungal Agents for Yeasts, EUCAST."},{"key":"ref_10","unstructured":"EUCAST (2025, October 22). Overview of Antifungal ECOFFs and Clinical Breakpoints for Yeasts, Moulds and Dermatophytes Using the EUCAST E.Def 7.4, E.Def 9.4 and E.Def 11.0 Procedures. Version 6.0. Available online: https:\/\/www.eucast.org\/fileadmin\/eucast\/pdf\/AFST\/clinical_breakpoints\/AFST_BP-ECOFF_v6.0_non-protected_Final_26_Jun_2025_MaCA.pdf."},{"key":"ref_11","unstructured":"EUCAST (2024). EUCAST Guidance on Interpretation of MICs for Rare Yeast Without Breakpoints in Breakpoint Tables, EUCAST."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"101258","DOI":"10.1016\/j.mycmed.2022.101258","article-title":"Fungemia Due to Moesziomyces Aphidis (Pseudozyma aphidis) in a Premature Neonate. Challenges in Species Identification and Antifungal Susceptibility Testing of Rare Yeasts","volume":"32","author":"Mpakosi","year":"2022","journal-title":"J. Med. Mycol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1111\/jpc.14740","article-title":"Saccharomyces Cerevisiae Fungaemia in an Immunocompetent Toddler","volume":"56","author":"Gkentzi","year":"2020","journal-title":"J. Paediatr. Child Health"},{"key":"ref_14","first-page":"109","article-title":"Saprochaete Capitata (Former Name of Geotrichum capitatum) Fungemia in a Patient with Chronic Neurological and Hematological Disease","volume":"62","author":"Vrioni","year":"2017","journal-title":"Acta Microbiol. Hell."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1007\/s11046-012-9552-9","article-title":"Rhodotorula Fungemia of an Intensive Care Unit Patient and Review of Published Cases","volume":"174","author":"Spiliopoulou","year":"2012","journal-title":"Mycopathologia"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1097\/01.mph.0000164865.70522.d7","article-title":"Fungemia Due to Trichosporon Asahii in a Neutropenic Child Refractory to Amphotericin B: Clearance with Voriconozole","volume":"27","author":"Antachopoulos","year":"2005","journal-title":"J. Pediatr. Hematol. Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1111\/j.1439-0507.2005.01098.x","article-title":"Fatal Blastoschizomyces Capitatus Sepsis in a Neutropenic Patient with Acute Myeloid Leukemia: First Documented Case from Greece","volume":"48","author":"Christakis","year":"2005","journal-title":"Mycoses"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1097\/00006454-200202000-00018","article-title":"Trichosporon Asahii: An Unusual Cause of Invasive Infection in Neonates","volume":"21","author":"Panagopoulou","year":"2002","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1007\/s15010-001-1066-1","article-title":"Transient Fungemia Due to Rhodotorula Rubra in a Cancer Patient: Case Report and Review of the Literature","volume":"29","author":"Samonis","year":"2001","journal-title":"Infection"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1046\/j.1469-0691.2001.00203.x","article-title":"Rhodotorula Septicemia: Case Report and Minireview","volume":"7","author":"Prifti","year":"2001","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1111\/j.1468-3083.1999.tb01010.x","article-title":"Rhodotorula Rubra Fungaemia in an Immunosuppressed Patient","volume":"12","author":"Papadogeorgakis","year":"1999","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.ijid.2006.02.004","article-title":"Rhodotorula Glutinis Fungemia Successfully Treated with Fluconazole: Report of Two Cases","volume":"11","author":"Kofteridis","year":"2007","journal-title":"Int. J. Infect. Dis."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Ventoulis, I., Sarmourli, T., Amoiridou, P., Mantzana, P., Exindari, M., Gioula, G., and Vyzantiadis, T.A. (2020). Bloodstream Infection by Saccharomyces Cerevisiae in Two COVID-19 Patients after Receiving Supplementation of Saccharomyces in the ICU. J. Fungi, 6.","DOI":"10.3390\/jof6030098"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e01516-19","DOI":"10.1128\/AAC.01516-19","article-title":"Epidemiological Trends of Fungemia in Greece with a Focus on Candidemia during the Recent Financial Crisis: A 10-Year Survey in a Tertiary Care Academic Hospital and Review of Literature","volume":"64","author":"Siopi","year":"2020","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"101386","DOI":"10.1016\/j.mycmed.2023.101386","article-title":"Fungemia Due to Rare Non-Candida Yeasts between 2018 and 2021 in a Greek Tertiary Care University Hospital","volume":"33","author":"Spiliopoulou","year":"2023","journal-title":"J. Med. Mycol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Noni, M., Stathi, A., Velegraki, A., Mika, M., Kalampaliki, A., Zachariadou, L., and Michos, A. (2020). Rare Invasive Yeast Infections in Greek Neonates and Children, a Retrospective 12-Year Study. J. Fungi, 6.","DOI":"10.3390\/jof6040194"},{"key":"ref_27","unstructured":"(2023, July 27). M57SEd4|Epidemiological Cutoff Values for Antifungal Susceptibility Testing, 4th Edition. Available online: https:\/\/clsi.org\/standards\/products\/microbiology\/documents\/m57s\/."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"4565","DOI":"10.1128\/AAC.02670-14","article-title":"Antifungal Resistance to Fluconazole and Echinocandins Is Not Emerging in Yeast Isolates Causing Fungemia in a Spanish Tertiary Care Center","volume":"58","author":"Escribano","year":"2014","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1007\/s10096-007-0448-4","article-title":"A First Portuguese Epidemiological Survey of Fungaemia in a University Hospital","volume":"27","year":"2008","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_30","first-page":"9","article-title":"Fungemia Due to Rare Yeasts Other Than Candida: 10 Years of Single-Center Experience","volume":"12","author":"Tepe","year":"2023","journal-title":"Mediterr. J. Infect. Microbes Antimicrob."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1111\/myc.12852","article-title":"The Epidemiology of Non-Candida Yeast Isolated from Blood: The Asia Surveillance Study","volume":"62","author":"Lin","year":"2019","journal-title":"Mycoses"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e01564-17","DOI":"10.1128\/JCM.01564-17","article-title":"Update from a 12-Year Nationwide Fungemia Surveillance: Increasing Intrinsic and Acquired Resistance Causes Concern","volume":"56","author":"Astvad","year":"2018","journal-title":"J. Clin. Microbiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1093\/mmy\/myw055","article-title":"Fungemia Due to Rare Opportunistic Yeasts: Data from a Population-Based Surveillance in Spain","volume":"55","author":"Guinea","year":"2017","journal-title":"Med. Mycol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"E218","DOI":"10.1111\/1469-0691.12111","article-title":"Candidaemia in Sweden: A Nationwide Prospective Observational Survey","volume":"19","author":"Ericsson","year":"2013","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_35","first-page":"176","article-title":"Species Distribution and Susceptibility Profile of Yeasts Isolated from Blood Cultures: Results of a Multicenter Active Laboratory-Based Surveillance Study in Argentina","volume":"43","author":"Vivot","year":"2011","journal-title":"Rev. Argent. Microbiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"276","DOI":"10.17843\/rpmesp.2020.372.5026","article-title":"Characteristics of Fungemias in a Peruvian Referral Center: 5-Year Retrospective Analysis","volume":"37","author":"Villanueva","year":"2020","journal-title":"Rev. Peru. Med. Exp. Salud Publica"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1093\/cid\/civ293","article-title":"Epidemiology and Outcome of Fungemia in a Cancer Cohort of the Infectious Diseases Group (IDG) of the European Organization for Research and Treatment of Cancer (EORTC 65031)","volume":"61","author":"Cornely","year":"2015","journal-title":"Clin. Infect. Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.jinf.2011.11.002","article-title":"Rare Opportunistic (Non-Candida, Non-Cryptococcus) Yeast Bloodstream Infections in Patients with Cancer","volume":"64","author":"Chitasombat","year":"2011","journal-title":"J. Infect."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"myad014","DOI":"10.1093\/mmy\/myad014","article-title":"Epidemiology of Saccharomyces Fungemia: A Systematic Review","volume":"61","author":"Vinayagamoorthy","year":"2023","journal-title":"Med. Mycol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1111\/myc.12856","article-title":"Rhodotorula Species Infections in Humans: A Systematic Review","volume":"62","author":"Ioannou","year":"2019","journal-title":"Mycoses"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"de Almeida, J.N., and Hennequin, C. (2016). Invasive Trichosporon Infection: A Systematic Review on a Re-Emerging Fungal Pathogen. Front. Microbiol., 7.","DOI":"10.3389\/fmicb.2016.01629"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e01834-21","DOI":"10.1128\/aac.01834-21","article-title":"Bloodstream Infections Caused by Magnusiomyces Capitatus and Magnusiomyces Clavatus: Epidemiological, Clinical, and Microbiological Features of Two Emerging Yeast Species","volume":"66","author":"Noster","year":"2022","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1111\/myc.13072","article-title":"Fungaemia Due to Rare Yeasts in a Tertiary Care University Centre within 18 Years","volume":"63","author":"Alp","year":"2020","journal-title":"Mycoses"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Yamamoto, M., Takakura, S., Hotta, G., Matsumura, Y., Matsushima, A., Nagao, M., Ito, Y., and Ichiyama, S. (2013). Clinical Characteristics and Risk Factors of Non-Candida Fungaemia. BMC Infect. Dis., 13.","DOI":"10.1186\/1471-2334-13-247"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e23149","DOI":"10.1002\/jcla.23149","article-title":"Diagnostic Efficacy of Serum Cytokines and Chemokines in Fungal Bloodstream Infection in Febrile Patients","volume":"34","author":"Wang","year":"2020","journal-title":"J. Clin. Lab. Anal."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1111\/j.1600-0609.2010.01410.x","article-title":"Fatal Trichosporon Fungemia in Patients with Hematologic Malignancies","volume":"84","author":"Suzuki","year":"2010","journal-title":"Eur. J. Haematol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e0160721","DOI":"10.1128\/JCM.01607-21","article-title":"B-1,3-D-Glucan and Galactomannan as Biomarkers for the Detection of Invasive Geotrichum and Magnusiomyces Infections: A Retrospective Evaluation","volume":"60","author":"Forster","year":"2022","journal-title":"J. Clin. Microbiol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e638","DOI":"10.1016\/j.ijid.2012.03.009","article-title":"Serum Glucuronoxylomannan May Be More Appropriate for the Diagnosis and Therapeutic Monitoring of Trichosporon Fungemia than Serum \u03b2-d-Glucan","volume":"16","author":"Liao","year":"2012","journal-title":"Int. J. Infect. Dis."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1128\/JCM.37.3.694-699.1999","article-title":"PCR Detection of DNA Specific for Trichosporon Species in Serum of Patients with Disseminated Trichosporonosis","volume":"37","author":"Nagai","year":"1999","journal-title":"J. Clin. Microbiol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"000285","DOI":"10.1099\/acmi.0.000285","article-title":"Detection of Invasive Trichosporon Asahii in Patient Blood by a Fungal PCR Array","volume":"3","author":"Weber","year":"2021","journal-title":"Access Microbiol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2556","DOI":"10.1128\/JCM.00876-17","article-title":"Molecular Identification of Saprochaete Capitata in Human Blood and Paraffinized Tissue Samples","volume":"55","author":"Moragues","year":"2017","journal-title":"J. Clin. Microbiol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"e02096-19","DOI":"10.1128\/JCM.02096-19","article-title":"Multicenter Evaluation of a PCR-Based Digital Microfluidics and Electrochemical Detection System for the Rapid Identification of 15 Fungal Pathogens Directly from Positive Blood Cultures","volume":"58","author":"Zhang","year":"2020","journal-title":"J. Clin. Microbiol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"e00179-24","DOI":"10.1128\/jcm.00179-24","article-title":"Evaluation of False-Positive Rhodotorula Detections by a Multiplex PCR-Based Fungal Panel Performed on Positive Blood Culture Bottles","volume":"62","author":"Streva","year":"2024","journal-title":"J. Clin. Microbiol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1111\/j.1469-0691.2009.02828.x","article-title":"Rapid Identification of Fungal Pathogens in Positive Blood Cultures Using Oligonucleotide Array Hybridization","volume":"16","author":"Hsiue","year":"2010","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"3944","DOI":"10.1128\/AAC.00285-15","article-title":"Antifungal Susceptibility Profiles of Bloodstream Yeast Isolates by Sensititre YeastOne over Nine Years at a Large Italian Teaching Hospital","volume":"59","author":"Posteraro","year":"2015","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1093\/jac\/dkx436","article-title":"Fungaemia Caused by Rare Yeasts: Incidence, Clinical Characteristics and Outcome over 10\u2009Years","volume":"73","author":"Vena","year":"2018","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"3","DOI":"10.3390\/aerobiology1010002","article-title":"Indoor Air Contamination by Yeasts in Healthcare Facilities: Risks of Invasive Fungal Infection","volume":"1","author":"Santos","year":"2023","journal-title":"Aerobiology"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.jhin.2022.02.006","article-title":"ICU Environmental Surfaces Are a Reservoir of Fungi: Species Distribution in Northern Italy","volume":"123","author":"Prigitano","year":"2022","journal-title":"J. Hosp. Infect."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1007\/s10661-021-08908-3","article-title":"Evaluation of Rhodotorula Spp. Contamination in Hospital Environments","volume":"193","author":"Sanna","year":"2021","journal-title":"Environ. Monit. Assess."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Witherden, E.A., Shoaie, S., Hall, R.A., and Moyes, D.L. (2017). The Human Mucosal Mycobiome and Fungal Community Interactions. J. Fungi, 3.","DOI":"10.3390\/jof3040056"},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Adams, R.I., Bhangar, S., Pasut, W., Arens, E.A., Taylor, J.W., Lindow, S.E., Nazaroff, W.W., and Bruns, T.D. (2015). Chamber Bioaerosol Study: Outdoor Air and Human Occupants as Sources of Indoor Airborne Microbes. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0128022"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1017\/S0950268808001763","article-title":"Bloodstream Yeast Infections: A 15-Month Survey","volume":"137","author":"Swinne","year":"2009","journal-title":"Epidemiol. Infect."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"e70093","DOI":"10.1111\/myc.70093","article-title":"Epidemiology, Significance and Clinical Outcomes of Bloodstream Infections Caused by Non-Candida and Non-Cryptococcus Yeasts","volume":"68","author":"Stewart","year":"2025","journal-title":"Mycoses"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1111\/myc.12595","article-title":"Invasive Infections Due to Saprochaete and Geotrichum Species: Report of 23 Cases from the FungiScope Registry","volume":"60","author":"Seidel","year":"2017","journal-title":"Mycoses"},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Yavuz, B., Turhan, \u00d6., \u00d6zyurt, \u00d6.K., \u00c7etinkaya, \u00d6., Ayaz, \u00c7.M., \u00d6zhak, B., and Mam\u0131ko\u011flu, L. (2025). Epidemiology and Antifungal Susceptibilities of Rare Yeast Infections in a Tertiary Care Center. BMC Microbiol., 25.","DOI":"10.1186\/s12866-025-04016-1"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"2439","DOI":"10.1128\/JCM.00802-15","article-title":"Are the Conventional Commercial Yeast Identification Methods Still Helpful in the Era of New Clinical Microbiology Diagnostics? A Meta-Analysis of Their Accuracy","volume":"53","author":"Posteraro","year":"2015","journal-title":"J. Clin. Microbiol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1093\/mmy\/myw044","article-title":"Rapid Identification of Moulds and Arthroconidial Yeasts from Positive Blood Cultures by MALDI-TOF Mass Spectrometry","volume":"54","author":"Sztajnbok","year":"2016","journal-title":"Med. Mycol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"e0161224","DOI":"10.1128\/jcm.01612-24","article-title":"Comparison of MALDI-TOF MS Instruments and Databases for the Identification of Uncommon Yeasts, Aspergillus Spp. and Rare Filamentous Fungi","volume":"63","author":"Dutkiewicz","year":"2025","journal-title":"J. Clin. Microbiol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.mmcr.2019.07.009","article-title":"Magnusiomyces Capitatus Fungemia: The Value of Direct Microscopy in Early Diagnosis","volume":"25","author":"Alobaid","year":"2019","journal-title":"Med. Mycol. Case Rep."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"4012","DOI":"10.1128\/AAC.00685-10","article-title":"In Vitro Antifungal Activities of Isavuconazole and Comparators against Rare Yeast Pathogens","volume":"54","author":"Guinea","year":"2010","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Gil, \u00d3., Hern\u00e1ndez-Pab\u00f3n, J.C., Tabares, B., Lugo-S\u00e1nchez, C., and Firacative, C. (2023). Rare Yeasts in Latin America: Uncommon Yet Meaningful. J. Fungi, 9.","DOI":"10.3390\/jof9070747"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1111\/myc.13148","article-title":"Breakthrough Invasive Fungal Infections: Who Is at Risk?","volume":"63","author":"Jenks","year":"2020","journal-title":"Mycoses"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.jinf.2023.05.005","article-title":"Breakthrough Invasive Fungal Infection among Patients with Haematologic Malignancies: A National, Prospective, and Multicentre Study","volume":"87","author":"Ramos","year":"2023","journal-title":"J. Infect."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"e0208121","DOI":"10.1128\/aac.02081-21","article-title":"Factors Associated with Breakthrough Fungemia Caused by Candida, Trichosporon, or Fusarium Species in Patients with Hematological Disorders","volume":"66","author":"Kimura","year":"2022","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"ofaf163","DOI":"10.1093\/ofid\/ofaf163","article-title":"Incidence of Breakthrough Fungal Infections in Patients With Isavuconazole Prophylaxis: A Systematic Review and Meta-Analysis","volume":"12","author":"Ishida","year":"2025","journal-title":"Open Forum Infect. Dis."},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Furuya, K., Ito, K., Sugiyama, K., Tokuda, S., Kanemoto, H., Kamei, K., and Shimada, T. (2023). A Case of Bloodstream Co-Infection of Saccharomyces Cerevisiae and Candida Glabrata While Using Micafungin. BMC Infect. Dis., 23.","DOI":"10.1186\/s12879-023-08287-9"},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Sipsas, N.V., Pagoni, M.N., Kofteridis, D.P., Meletiadis, J., Vrioni, G., Papaioannou, M., Antoniadou, A., Petrikkos, G., and Samonis, G. (2018). Management of Invasive Fungal Infections in Adult Patients with Hematological Malignancies in Greece during the Financial Crisis: Challenges and Recommendations. J. Fungi, 4.","DOI":"10.3390\/jof4030094"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"2300661","DOI":"10.2807\/1560-7917.ES.2024.29.29.2300661","article-title":"Increase in Candidemia Cases and Emergence of Fluconazole-Resistant Candida Parapsilosis and C. Auris Isolates in a Tertiary Care Academic Hospital during the COVID-19 Pandemic, Greece, 2020 to 2023","volume":"29","author":"Siopi","year":"2024","journal-title":"Eurosurveillance"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"e12664","DOI":"10.1111\/tid.12664","article-title":"Pseudozyma and Other Non-Candida Opportunistic Yeast Bloodstream Infections in a Large Stem Cell Transplant Center","volume":"19","author":"Pande","year":"2017","journal-title":"Transpl. Infect. Dis."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1097\/IPC.0000000000000271","article-title":"Non- Candida Yeasts Fungemia in Cancer Patients: A Retrospective Analysis at a Referral Cancer Center, 1999\u20132014","volume":"23","author":"Prodhan","year":"2015","journal-title":"Infect. Dis. Clin. Pract."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"576","DOI":"10.4103\/0255-0857.167320","article-title":"Rare Yeasts Causing Fungemia in Immunocompromised and Haematology Patients: Case Series from Delhi","volume":"33","author":"Capoor","year":"2015","journal-title":"Indian J. Med. Microbiol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"e00009-19","DOI":"10.1128\/CMR.00009-19","article-title":"Practical Guidance for Clinical Microbiology Laboratories: A Comprehensive Update on the Problem of Blood Culture Contamination and a Discussion of Methods for Addressing the Problem","volume":"33","author":"Doern","year":"2019","journal-title":"Clin. Microbiol. Rev."}],"container-title":["Journal of Fungi"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2309-608X\/12\/3\/187\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T11:10:51Z","timestamp":1772709051000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2309-608X\/12\/3\/187"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,5]]},"references-count":82,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["jof12030187"],"URL":"https:\/\/doi.org\/10.3390\/jof12030187","relation":{},"ISSN":["2309-608X"],"issn-type":[{"value":"2309-608X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,5]]}}}