Candida-Klebsiella interactions rewire fungal morphogenesis to create a host environment favoring pathogen survival with enhanced tissue pathology

Clinically relevant infections commonly develop within polymicrobial environments where interkingdom interactions shape host responses and disease trajectories. Candida albicans and Klebsiella pneumoniae are critical pathogens that can co-exist in the respiratory tract, yet the consequences of their interaction in terms of fungal physiology, pathogenicity and impact on disease outcomes remain poorly understood. Here, we show that K. pneumoniae enhances C. albicans virulence traits suggesting that co-infections could exacerbate lung disease. Mechanistically, bacterial presence induces fungal hyphal morphogenesis via MAPK–CEK signaling, coupled to metabolic rewiring and alterations in cell wall remodeling and septation, resulting in highly elongated hyphae that escape faster from macrophages. At the host level, co-infection reprograms macrophages into a non-canonical state characterized by overlapping pro- and anti-inflammatory modules, integrating type I interferon and IL-10 signaling. This response contributes to tissue damage and facilitates fungal persistence. Our findings reveal that the bacterial–fungal interactions coordinately reprogram pathogen behavior and host immunity, promoting pathogenic synergy and potentially conferring a negative impact on disease outcomes.