Candidemia caused by <i>Meyerozyma guilliermondii</i> species complex in patients with cancer: A systematic review of case reports

Meyerozyma guilliermondii represents an opportunistic pathogen complex threatening immunocompromised patients, notably those with cancer, leading to candidemia characterized by increasing incidence and high mortality risk. However, understanding of candidemia in cancer patients is limited. This study aims to elucidate the epidemiological and clinical features of candidemia by the M. guilliermondii species complex (MGSC) in cancer patients, thereby enhancing disease diagnosis and treatment. A systematic review was performed, analyzing cases from 1967 to 2024 documented in PubMed, Scopus, Embase, and Web of Science using specific terms related to M. guilliermondii and cancer. Additionally, two cancer-related invasive candidiasis cases by M. guilliermondii sensu stricto from Jiangxi Cancer Hospital were included. The review identified 282 cases, with 225 specifying tumor types: 114 hematologic malignancies and 111 solid tumors. A significant increase in cases was noted over the last two decades (92.2%). Predominantly, adults were affected, with a male-to-female ratio of 97:53. Among the precisely identified species in recent years, M. guilliermondii sensu stricto was the most recorded species (83.6%), with nine cases of candidemia due to M. caribbica in cancer patients. The overall mortality was 33.0%. Common factors included central venous catheter (CVC) placement (75.8%), prior broad-spectrum antibiotics (68.5%), and parenteral nutrition (46.1%). Timely CVC removal is crucial for cancer patients with prolonged CVC placement to prevent MGSC-related candidemia. Cancer patients with multiple risk factors are highly susceptible to MGSC-caused candidemia, which is increasing in incidence and mortality risk. Prompt antifungal therapy is essential for improving prognosis.