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. 2023 May 9;14:2673. doi: 10.1038/s41467-023-38058-8

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© The Author(s) 2023

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 1 — a Study design. Indicated are the total number of taxonomic and functional features annotated in our study and, in parentheses, their average per sample. Created with BioRender.com. b Fungal genus relative abundance profile (by total-sum scaling, TSS). The top 10 genera by highest median abundance are indicated by colour, with grey indicating the abundance of the remaining fungi. c, d Distance-based redundancy analysis (dbRDA) of fungal species beta diversity (Aitchison distance). Explanatory factors are c fungal genera and d bacterial species’ relative abundance. Only significant terms are shown (raw P < 0.05; PERMANOVA). Displayed are cumulative explained variances of full, non-redundant models (black) and single-term statistics (grey). Important fungal and bacterial taxa are coloured red or green, respectively. e Principal coordinate analysis (PCoA) biplot of fungal species beta diversity (Aitchison). Axes show explained variance. Samples are coloured by Candida centre log ratio-normalised abundance. The top features by ordination correlation (raw P < 0.05; envfit) are bacterial (green), fungal (red), and patient characteristic (blue) arrows indicating the direction of covariance between feature abundances and the first two ordination axes. Samples are in a gradient from high (red) to low (green) Candida abundance. f, g Boxplots showing f the total number of Candida internal transcribed spacer (ITS) reads and g the total number of ITS reads per patient (n = 75). Centre lines denote median values, boxes contain the Q1 and Q3 quartiles (IQR), whiskers extend up to 1.5 × IQR. Values beyond these bounds are considered outliers. Significance was assessed using non-parametric generalized linear models (Rfit drop-test) controlled for body mass index and sex. ΔR² is the variance explained by differences in Candida grouping. h PCoA of fungal genera beta diversity. Candida grouping (High vs. Low) shows significant separation (P = 0.001; PERMANOVA). Circles indicate the 95% confidence interval of within-group diversity.