Epidemiology of invasive yeast infections and antifungal susceptibilities between 2015 and 2023 at Akdeniz University Faculty of Medicine Hospital

Recent advancements in healthcare, coupled with a global increase in the number of immunosuppressed patients, have led to a rise in the incidence of rare opportunistic fungal infections. Invasive fungal infections have emerged as significant causes of morbidity and mortality in these patients. The increased use of antifungals in immunosuppressed individuals has resulted in the emergence of resistant strains among rare fungal species. Prompt initiation of appropriate antifungal therapy and control of the infection source are crucial in treating these patients. In this study analyzed the antifungal susceptibilities of rare Candida species and non-Candida yeast species isolated from patients who presented to hospital between 2015 and 2023, in accordance with EUCAST recommendations. Risk factors potentially associated with these infections were retrospectively assessed, and their relation to mortality was examined. A total of 56 yeast infections caused by 16 different species were identified in 54 patients. The most frequently identified species were C. lusitaniea and K. marxianus. Antifungal susceptibility analysis generally revealed low MIC values for amphotericin B and increased MIC values for azoles, particularly fluconazole. The majority of patients had underlying diseases, previous antibiotic use, sepsis, total parenteral nutrition (TPN) and neutropenia. Statistically significant relationship was found between mortality and being over the age of 65, ICU stay history, sepsis, and neutropenia. Early identification of rare yeasts and initiation of appropriate treatment are essential for the effective management of these infections. Knowledge of the regional antifungal susceptibility profiles will guide appropriate treatment. Keywords: antifungal drug resistance, fungemia, candidemia, yeasts