Association of quantitative sputum Candida load with respiratory dysbiosis and airway inflammation in suspected invasive pulmonary candidiasis.

Higher sputum Candida species load is linked to respiratory dysbiosis, increased airway inflammation, and worse clinical outcomes in suspected invasive pulmonary candidiasis.

• Why it matters: The clinical significance of Candida in sputum is unclear due to the colonization-infection dilemma, making diagnosis and management challenging. Clarifying its role could improve disease stratification and treatment strategies.
• What they did: The study enrolled 140 hospitalized patients suspected of invasive pulmonary candidiasis, stratified them by Candida load using quantitative culture, and analyzed their microbiome profiles with metagenomic sequencing to explore associations with microbiota, inflammation, and clinical features.
• The result: A high Candida load was associated with prolonged hospitalization, elevated sputum IL-8, greater microbial dysbiosis, depletion of key commensals, and a microbiome signature that distinguished probable from possible IPC with high accuracy, suggesting its potential as a biomarker.