Wickerhamomyces anomalus: A Rare Fungal Sepsis in Neonates

Abstract

To the Editor: Recently, we came across two cases of rare invasive fungal sepsis in our neonatal unit caused by Wickerhamomyces anomalus (WA).The first case was an outborn full-term 2.2 kg female neonate, referred to us on day 4 of life with worsening respiratory distress since 2 h after delivery. The neonate required mechanical ventilation (MV) with other supportive management. Blood culture through BACTEC system grew fungal colonies on Sabouraud agar. Matrix-assisted laser desorption ionizationtime of flight mass spectrometry (MALDI-TOF MS) used for species identification confirmed the growth of WA.The second case was a late-preterm male weighing 2 kg, referred to us at 20 h of life for respiratory distress noted soon after birth. The neonate required MV, surfactant administration, and inotropic support. Blood culture showed similar fungal growth, which, on MALDI-TOF, showed the same species of WA.Both the cases were outborn, normally delivered, lowbirth-weight neonates with uneventful antenatal and perinatal history. Initial presentation was respiratory distress, which progressively increased in severity requiring MV. Sepsis screen was negative. Cerebrospinal fluid examination was normal, and culture was sterile. Both neonates recovered uneventfully after 14 d therapy with amphotericin-B.WA is an ascomycetes yeast-a free-living form in plants, soil, and other organic matters [1]. It can multiply in varied * Mayank Priyadarshi

Fungemia by Wickerhamomyces anomalus—A Narrative Review

“…A total of 243 articles from PubMed and Scopus were screened. Finally, 36 met the present study’s inclusion criteria [ 19 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 ]. These 36 studies involved 170 patients in total.…”

“…Given the rarity of fungemia by this pathogen, its epidemiology and clinical characteristics have not been adequately described. Indeed, only scarce case reports with literature reviews or small series can be found in the literature [ 28 , 29 ]. The present review aimed to provide data on the epidemiology, antifungal resistance, clinical characteristics, treatment, and outcomes of fungemia by W. anomalus by extracting all the available information from published original reports in the literature.…”

Update of the list of qualified presumption of safety (QPS) recommended microbiological agents intentionally added to food or feed as notified to EFSA 18: Suitability of taxonomic units notified to EFSA until March 2023

“…Both studies employed traditional biochemical tests for species identification, but no molecular confirmation. Shubham et al (2021) reported two cases of nosocomial blood infection with W. anomalus in a neonatal unit in India. Both patients required mechanical ventilation and other supportive measures.…”

Update of the list of QPS‐recommended biological agents intentionally added to food or feed as notified to EFSA 15: suitability of taxonomic units notified to EFSA until September 2021

“…Seven publications reported potential safety concerns. Several studies reported opportunistic infections with W. anomalus in humans or neonate children with various predisposing conditions but could not be evaluated appropriately due to uncertainties or problems with the methodology used for identification of yeasts (Alp et al, 2021;Shubham et al, 2021;Zhang et al, 2021). Desnos-Ollivier et al (2021) reported antimycotic susceptibility of 36 strains of W. anomalus in a retrospective study of more than 9.000 clinical strains.…”