Yeast infections in sterile body fluids: species distribution, antifungal susceptibility, and cross-cutting risk factors for fungemia, sepsis, and mortality (2019–2023)

Background: 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. Methods: < 0.10 in univariate testing entered multivariable logistic regression to identify independent predictors of fungemia, sepsis, and in-hospital mortality. Results: 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 0.171-0.599). Sepsis occurred in 23.8% and was independently associated with ICU admission (OR 7.119, 95% CI 2.811-18.026); surgical treatment again showed a protective association (OR 0.426, 95% CI 0.190-0.954). Overall mortality was 26.8%; acute kidney injury (AKI) independently predicted death (OR 3.354, 95% CI 1.563-7.198). Conclusions: . 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.