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Pichia anomala outbreak in a nursery: exogenous source?
P A Aragão1, I C Oshiro, E I Manrique
1Infection Control Department, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil.
The Pediatric Infectious Disease Journal
|December 6, 2001
Summary
Pichia anomala fungemia in newborns is linked to central venous catheters, total parenteral nutrition, and invasive procedures. Interventions reduced subsequent infections, suggesting exogenous acquisition of this rare pathogen.
Area of Science:
- Medical Mycology
- Neonatal Intensive Care
- Infectious Diseases
Background:
- Pichia anomala is an infrequent cause of fungemia, particularly in neonatal intensive care settings.
- An outbreak of eight fungemia cases occurred between February and April 1998, with four cases attributed to P. anomala.
Purpose of the Study:
- To identify risk factors for fungemia in neonatal intensive care units, with a specific focus on P. anomala.
- To investigate the source and contributing factors of P. anomala fungemia in neonates.
Main Methods:
- A cohort study involving 59 newborns was conducted.
- Statistical analysis was used to determine factors associated with fungemia and P. anomala fungemia.
Main Results:
- Central venous catheter use, total parenteral nutrition (TPN), lipid emulsions, prior antimicrobial therapy, and invasive procedures were significantly associated with fungemia.
- P. anomala fungemia was specifically linked to central venous catheters, TPN, previous antibiotic use, and invasive procedures.
- Technical issues in TPN administration were identified as a potential source, leading to implemented changes in formulation and technique.
Conclusions:
- Catheter use, invasive procedures, and TPN are key risk factors for fungemia in this neonatal population.
- The findings suggest that P. anomala infections were acquired exogenously, likely related to TPN handling.
- Post-intervention, a significant reduction in fungemia cases was observed.