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Malassezia pachydermatis fungaemia in a neonatal intensive care unit
E Chryssanthou1, U Broberger, B Petrini
1Department of Clinical Microbiology, Karolinska Institute and Hospital, Stockholm, Sweden.
Unlabelled:
Malassezia pachydermatis, a non-obligatory lipophilic yeast, has occasionally been implicated in nosocomial fungaemias. This study investigated a cluster of eight cases of M. pachydermatis infection and colonization in a neonatal intensive care unit over a 6 mo period. All patients were preterm with very low birthweight and suffered from various underlying diseases. Prolonged use of indwelling catheters and parenteral lipid formulations were important predisposing factors for their infection. All M. pachydermatis strains were susceptible to amphotericin B, fluconazole and itraconazole but resistant against flucytosine.
Conclusion:
Molecular typing by random amplification of polymorphic DNA showed distinct banding profiles for each blood isolate. Since no epidemiological association among the strains could be shown, the reason for this cluster of nosocomial fungaemias remains unclear.
Insights
A cluster of Malassezia pachydermatis infections occurred in a neonatal intensive care unit. Despite risk factors like catheters and lipid use, the source of these fungaemias remains unclear.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Neonatal Care
Background:
- Malassezia pachydermatis is a yeast occasionally linked to hospital-acquired bloodstream infections (fungaemias).
- Neonatal intensive care units (NICUs) are vulnerable settings for opportunistic infections in preterm infants.
Observation:
- A cluster of eight cases of M. pachydermatis infection and colonization was observed in an NICU over six months.
- All affected patients were preterm infants with very low birthweight and significant underlying health issues.
- Prolonged use of indwelling catheters and parenteral lipid formulations were identified as key predisposing factors.
Findings:
- All M. pachydermatis isolates demonstrated susceptibility to amphotericin B, fluconazole, and itraconazole.
- Resistance to flucytosine was noted across all investigated M. pachydermatis strains.
- Molecular typing using random amplification of polymorphic DNA (RAPD) revealed distinct genetic profiles for each blood isolate.
Implications:
- The distinct genetic profiles suggest independent acquisition or a source not identified by RAPD.
- The unclear origin of this fungaemia cluster highlights the need for enhanced surveillance and infection control in NICUs.
- Understanding risk factors and yeast susceptibility is crucial for managing M. pachydermatis in vulnerable neonatal populations.