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Volume 32, Number 9—September 2026
Research
Invasive Wickerhamomyces anomalus Infections among Injecting Drug Users, France, 2012–20241
, and WAIT-IV Study Group,3
Table
Demographic and clinical characteristics of invasive Wickerhamomyces anomalus infection cases reported through multicentric prospective national surveillance programs, France, 2012–2024*
| Characteristic | All patients, N = 35 | IDU, n = 26 | Non-IDU, n = 9 | p value† |
|---|---|---|---|---|
| Age median (IQR) |
42 (36–50) |
41 (36–45) |
55 (36–68) |
0.11 |
| Sex | ||||
| M | 27/35 (77) | 20/26 (77) | 7/9 (78) | >0.9 |
| F |
||||
| Invasive fungal disease | 0.6 | |||
| Fungemia | 31/35 (89) | 22/26 (85) | 9/9 (100) | |
| Osteoarticular infection |
4/35 (11) |
4/26 (15) |
0/9 (0) |
|
| IFD risk factor other than IDU‡ | ||||
| HIV infection | 2/31 (6.5) | 2/26 (7.7) | 0/5 (0) | >0.9 |
| Recent surgery | 2/35 (5.7) | 0/26 (0) | 2/9 (22) | 0.061 |
| Central vascular catheter | 9/35 (26) | 2/26 (7.7) | 7/9 (78) | <0.001 |
| Intensive care unit | 7/35 (20) | 3/26 (12) | 4/9 (44) | 0.055 |
| Other underlying conditions‡ | 4/35 (11) | 1/26 (4) | 4/9 (33) | 0.010 |
| >1 risk factor other than IDU | 13/35 (37) | 6/26 (23) | 8/9 (89) | <0.001 |
| IFD history |
8/33 (24) |
7/25 (28) |
1/8 (13) |
0.6 |
| Community onset |
17/34 (50) |
16/26 (62) |
1/8 (13) |
0.039 |
| Associated deep-seated IFD | 0.8 | |||
| Spondylodiscitis | 3/35 (8.6) | 3/26 (12) | 0/9 (0) | |
| Septic arthritis | 2/35 (5.7) | 2/26 (7.7) | 0/9 (0) | |
| Endocarditis | 1/35 (2.9) | 1/26 (3.8) | 0/9 (0) | |
| Endophthalmia | 1/35 (2.9) | 1/26 (3.8) | 0/9 (0) | |
| None |
28/35 (80) |
19/26 (73) |
9/9 (100) |
|
| Bacterial co-infection | 8/35 (23) | 5/26 (19) | 3/9 (33) | 0.4 |
| Invasive fungal co-infection |
7/35 (20) |
4/26 (15) |
3/9 (33) |
0.3 |
| First-line antifungal treatment | 0.5 | |||
| Echinocandin monotherapy | 25/35 (71) | 19/26 (73) | 6/9 (67) | |
| Fluconazole monotherapy | 3/35 (8.6) | 3/26 (12) | 0/9 (0) | |
| Voriconazole monotherapy | 2/35 (5.7) | 1/26 (3.8) | 1/9 (11) | |
| Combination therapy | 2/35 (5.7) | 1/26 (3.8) | 1/9 (11) | |
| No antifungals |
3/35 (8.6) |
2/26 (7.7) |
1/9 (11) |
|
| Median length of hospital stay, d (IQR) |
15 (7–31) |
12 (6–23) |
55 (22–64) |
0.005 |
| Recurrence |
5/30 (17) |
5/22 (23) |
0/8 (0) |
0.3 |
| 90-d all-cause mortality | 1/30 (3.3) | 0/22 (0) | 1/8 (13) | 0.3 |
*Values are no. (%) except as indicated. Data reported through Reseau de Surveillance des Infections Fongiques invasives (RESSIF) and Surveillance des Infections Fongiques Invasives (SINFONI). Denominators lower than the N/n value for each category indicate missing data. IDU, injecting drug user; IFD, invasive fungal disease; IQR, interquartile range. †Determined by Wilcoxon rank sum test or Fisher exact test. ‡Other underlying conditions were hematologic malignancy (n = 1), solid organ malignancy (n = 1), premature neonate (n = 1), and severe malnutrition (n = 1).
1Preliminary results from this study were presented at ESCMID Global 2025; April 11–15, 2025; Vienna, Austria; and at the annual congress of the Société Française de Mycologie Médicale; June 18–20, 2025; Amiens, France.
2These authors contributed equally to this article.
3Additional members of the WAIT-IV Study Group are listed at the end of this article.