Fungemia by Candida pelliculosa (Pichia anomala) in a Neonatal Intensive Care Unit: A Possible Clonal Origin

Silva, Carolina Maria da; Parahym, Ana Maria Rabelo de Carvalho; Leão, Mariele Porto Carneiro; Oliveira, Neiva Tinti de; Amorim, Rosemary de Jesus Machado; Neves, Rejane Pereira

doi:10.1007/s11046-012-9605-0

Cited by 23 publications

(19 citation statements)

References 13 publications

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“…Nosocomial outbreaks caused by other Candida species (mostly C. parapsilosis ) have been reported in NICU settings in the United States, Mexico, Taiwan, and Brazil ( 5 , 11 – 13 , 19 , 20 ). However, none of these outbreaks was as large as the outbreak we describe.…”

Section: Discussionmentioning

confidence: 99%

“…Known risk factors for candidemia among neonates include very low birthweight (VLBW), prematurity, central venous catheter use, necrotizing enterocolitis (NEC), total parenteral nutrition (TPN), and prior or prolonged broad-spectrum antibacterial drug use, among others ( 1 , 2 , 6 – 10 ). Worldwide, outbreaks of candidemia in neonatal intensive care units (NICUs) are often caused by C. parapsilosis and associated with suboptimal adherence to infection prevention and control practices ( 5 , 11 – 13 ). In South Africa, C. parapsilosis is the most common Candida species among neonates; 2% of candidemia case-patients among all age groups test positive for C. krusei ( 14 ).…”

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confidence: 99%

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Large Outbreaks of Fungal and Bacterial Bloodstream Infections in a Neonatal Unit, South Africa, 2012–2016

Schalkwyk¹,

Iyaloo²,

Naicker³

et al. 2018

Emerg. Infect. Dis.

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Candidemia is a major cause of healthcare-associated infections. We describe a large outbreak of Candida krusei bloodstream infections among infants in Gauteng Province, South Africa, during a 4-month period; a series of candidemia and bacteremia outbreaks in the neonatal unit followed. We detected cases by using enhanced laboratory surveillance and audited hospital wards by environmental sampling and epidemiologic studies. During July–October 2014, among 589 patients, 48 unique cases of C. krusei candidemia occurred (8.2% incidence). Risk factors for candidemia on multivariable analyses were necrotizing enterocolitis, birthweight <1,500 g, receipt of parenteral nutrition, and receipt of blood transfusion. Despite initial interventions, outbreaks of bloodstream infection caused by C. krusei, rarer fungal species, and bacterial pathogens continued in the neonatal unit through July 29, 2016. Multiple factors contributed to these outbreaks; the most functional response is to fortify infection prevention and control.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Large Outbreaks of Fungal and Bacterial Bloodstream Infections in a Neonatal Unit, South Africa, 2012–2016

Schalkwyk¹,

Iyaloo²,

Naicker³

et al. 2018

Emerg. Infect. Dis.

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“…Exogenous acquisition of Candida species is common among several Candida species including C. krusei, C. tropicalis, C. parapsilosis, C. pelliculosa, C. lusitaniae and recently C. auris [22][23][24][25][26][27][28][29]. Table 3 shows the previous C. krusei candidemia outbreaks across the world [11-13, 18, 22, 30-32].…”

Section: Discussionmentioning

confidence: 99%

Prolonged Outbreak of Candida krusei Candidemia in Paediatric Ward of Tertiary Care Hospital

et al. 2020

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Background A sudden rise of Candida krusei candidemia cases was noticed in our hospital within 1 year with maximum cases from paediatric unit. The present study reports the results of epidemiological investigation of possible outbreak of candidemia by C. krusei in paediatric unit at our tertiary care centre. Methods Clinical characteristics and risk factors associated with C. krusei candidemia were evaluated. Yeast identification and antifungal susceptibility testing was performed according to standard protocol. To find the potential source of C. krusei in hospital environment and hand colonization, swabs were collected from different fomites (n = 40) and hand washings from 24 health care workers (HCW), respectively. Infection control and prevention practices were intensified following the recognition of outbreak. Genetic typing was done by fluorescent amplified fragment length polymorphism (FAFLP) technique. Case-control comparison was performed with C. tropicalis and C. pelliculosa cases.

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“…According to Kalkancı et al (6) report in 2010 including the literature review on C. pelliculosa, 31 C. pelliculosa cases and epidemic was reported. In the following periods, two case reports (meningitis in the HIV patients and fungemia in sickle-cell anemia) and 2 neonatal intensive care unit epidemic reports were included in the literature (8,(20)(21)(22). According to the data, 11 epidemic and 24 case reports were reported and 9 were detected in the pediatric unit and 2 in the adult patient unit.…”

Section: Discussionmentioning

confidence: 99%

“…Antifungal sensitivity of the C. pelliculosa strains was implemented via the E-test method in the Mueller-Hinton agar medium including 2% glucose and 0.5% methylene blue (21) (Figure 4). Therefore, the suspension prepared Minimal inhibition concentration (MIC) sensitivity values for fluconazole (≤8 µg/mL sensitive, 16-32 µg/mL dosesensitive, ≥64 µg/mL resistant) and for voriconazole (≤1 µg/ mL sensitive, 2 µg/mL dose-sensitive, ≥4 µg/mL resistant) were implemented according to CLSI recommendations (22). MIC value for caspofungin (≤2 µg/mL sensitive) was evaluated based on the reference of a study (23).…”

Section: Antifungal Sensitivity Testmentioning

confidence: 99%

Candida Pelliculosa Fungemia Cases in Pediatric Intensive Care Unit

Otağ¹,

Yarpuzlu²,

Gülbudak³

et al. 2015

Çocuk Enf Derg

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Candida pelliculosa (teleomorph: Wickerhamomyces anomalus) is an opportunistic pathogen that rarely causes fungemia. Here we present two cases with C. pelliculosa fungemia in the pediatric intensive care unit. The fungemia developed as a result of horizontal transmission from a patient who was transferred from another hospital with the same condition. Strains isolated from blood cultures of the two patients were identified as Candida pelliculosa with API ID 32C (bioMerieux France) commercial kit. All strains were resistant to the same antibiotic and random amplified polymorphic DNA analysis type. E-test antifungal MIC levels were found in the order of 0.125 ug/mL, 24 ug/mL, 0.50 ug/mL, and 0.64 ug/mL for caspofungin, fluconazole, voriconazole, and amphotericin-B, respectively. Environmental samples for C. pelliculosa were negative. After measures to control the infection were implemented in the unit, the outbreak ended. In the case of hindering precautions, it should be taken into account that hospital-acquired infections can develop even from rarely encountered non-albicans Candida strains.

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Fungemia by Candida pelliculosa (Pichia anomala) in a Neonatal Intensive Care Unit: A Possible Clonal Origin

Abstract: Neonatal candidemia can occur, however, infections caused by Candida pelliculosa are rare. Here, we describe an outbreak of candidemia caused by C. pelliculosa among babies hospitalized in a neonatal intensive care unit.

Cited by 23 publications

References 13 publications

Large Outbreaks of Fungal and Bacterial Bloodstream Infections in a Neonatal Unit, South Africa, 2012–2016

Large Outbreaks of Fungal and Bacterial Bloodstream Infections in a Neonatal Unit, South Africa, 2012–2016

Prolonged Outbreak of Candida krusei Candidemia in Paediatric Ward of Tertiary Care Hospital

Candida Pelliculosa Fungemia Cases in Pediatric Intensive Care Unit

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