Maxime Lefranc, Adrien Pain, Fréderic Dalle, Pierre Baudino, Claudio Plaisant, Taieb Chouaki, Josephine Dorin, Anne-Pauline Bellanger, Julie Bonhomme, Maxime Moniot, Celia Rouges, Françoise Botterel, Gregoire Pasquier, Lilia Hasseine, Estelle Perraud-Cateau, Jean-Pierre Gangneux, Laurence Delhaes, Damien Costa, Juliette Guitard, Alexandre Alanio, Valerie Letscher-Bru, Emilie Guemas, Guillaume Desoubeaux, Karine Boukris-Sitbon, Olivier Lortholary, Fanny Lanternier, WAIT-IV Study Group,, Marie Desnos-Ollivier, Sebastien Imbert
Wickerhamomyces anomalus is a yeast rarely involved in human invasive fungal diseases (IFD). We retrospectively analyzed 44 episodes of W. anomalus IFD in France during 2012-2024. Injecting drug use (IDU) was the main risk factor among 26/35 (74.3%) incident cases. Most infections were community acquired; overall 3-month mortality rate was 1/30 (3.3%). Short tandem repeat (STR) genotyping and whole-genome sequencing analyses revealed substantial genetic diversity among isolates. However, 1 STR genotype was shared by 2 IDU patients, suggesting common exposure. In addition, 1 isolate obtained from a cotton filter used for drug preparation was identical by STR genotyping to the bloodstream isolate from the same patient, indicating direct inoculation via contaminated material or poor injection practices. Our findings highlight the increased risk for W. anomalus IFD among IDU patients and emphasize the importance of targeted preventive measures within that population.