Epidemiology and molecular identification of mixed yeast isolates in Malaysia: A way forward

Background and Purpose: Invasive candidiasis is one of the most common systemic mycoses, and studies have shown mixed yeast infections. Malaysia lacks mixed yeast culture data. Materials and Methods: Yeast isolates were collected in Sultan Abdul Halim Hospital, North Malaysia, from October 2020 to October 2021. Chromogenic Candida differential agar media and PCR-RFLP were used to identify yeast species. Results: A total of 206 yeast isolates were collected from different body sites of patients. The majority of the yeast isolates (n=104) were obtained from the urine. Other isolates were extracted from blood (n=52), vaginal swabs (n=45), ear discharge (n=2), tracheal aspirate (n=2), tissue (n=2), skin (n=1), nail (n=1), sputum (n=1), and cerebrospinal fluid (n=1). In total, 200 yeast samples were identified as single species, and six isolates were a mixture of Candida species. Conclusion: Malaysia lacks accurate epidemiological data on mixed yeast infections. We identified all samples to the species level, including mixed yeast cultures, using the MspI enzyme and PCR-RFLP.