Prolonged growth of Candida albicans reveals co-isolated bacteria from single yeast colonies

Bacterial species are associated with Candida albicans in at least 25% of patients with bloodstream infection (Candidemia). These polymicrobial infections are usually caused by coagulase-negative staphylococci, most commonly Staphylococcus epidermidis and are associated with significantly worse clinical outcomes as compared to monomicrobial infections. Here we show that bacteria are present in C. albicans cultures started from isolated single colonies. These bacteria can only be detected by the use of specific media, and prolonged incubation periods of at least 8 days. The detection of these bacteria is sensitive to the polymerase enzyme used for 16S rDNA gene amplification and is often missed in clinical laboratory analysis because of short incubation periods, media and temperatures, used in mycology clinical routine, that are unfavorable for bacterial growth. We identified bacteria in cultures of different C. albicans isolates in long-term, continuous growth by molecular analysis and microscopy. Also, we confirmed the presence of these bacteria by identification of S. epidermidis genome segments in sequencing reads of the C. albicans reference strain SC5314 genome sequencing project raw data deposited in GenBank. Our results show that the presence of associated bacteria correlates with antifungal resistance alterations observed in growth under hypoxia. Our findings reveal the intense interaction between C. albicans yeasts and bacteria and have direct implications in yeast clinical procedures, especially concerning patient treatment.