Outbreak of Pichia kudriavzevii fungaemia in a neonatal intensive care unit
Autor: | T. Nagarathnamma, K. R. Vineetha, Jillwin Joseph, Sneha K. Chunchanur, Shivaprakash M Rudramurthy, Karthik Ramamurthy, R. Ambica |
---|---|
Rok vydání: | 2017 |
Předmět: |
Male
0301 basic medicine Microbiology (medical) medicine.medical_specialty Antifungal Agents Neonatal intensive care unit health care facilities manpower and services 030106 microbiology Microbial Sensitivity Tests Biology Microbiology Pichia Disease Outbreaks 03 medical and health sciences 0302 clinical medicine Drug Resistance Multiple Fungal Intensive Care Units Neonatal Internal medicine Intensive care medicine Humans Infant Very Low Birth Weight Infection control 030212 general & internal medicine Amplified Fragment Length Polymorphism Analysis DNA Fungal Intensive care medicine Fungemia Voriconazole Infection Control Neonatal sepsis Broth microdilution Infant Outbreak General Medicine medicine.disease Thrombocytopenia Female Morbidity Infant Premature medicine.drug |
Zdroj: | Journal of Medical Microbiology. 66:1759-1764 |
ISSN: | 1473-5644 0022-2615 |
Popis: | Purpose. Fungaemia is associated with substantial morbidity and mortality in neonates admitted to neonatal intensive care units (NICUs). We report an outbreak of fungaemia in a NICU due to rare yeast, Pichia kudriavzevii (a teleomorph of Candida krusei). To the best of our knowledge, this is the first report of neonatal sepsis due to P. kudriavzevii. Methodology. Between August and September 2014, blood cultures from nine neonates diagnosed with late-onset sepsis in the NICU yielded yeast-like organisms. The molecular identification and typing of these isolates was performed by sequencing the D1/D2 region of 26S rDNA and fluorescent amplified fragment length polymorphism (FAFLP) respectively. Antifungal susceptibility was tested by broth microdilution as per the Clinical Laboratory Standards Institute (CLSI) guidelines. Sampling from environmental sources and the hands of healthcare workers (HCWs) in the NICU was performed. Results. Of the nine neonates, eight were preterm and six had very low birth weight (VLBW). Thrombocytopenia was present in two neonates. Sequencing identified all the isolates as P. kudriavzevii and FAFLP showed their clonal origin. Antifungal susceptibility testing revealed the susceptibility of all isolates to the antifungals tested. Treatment with voriconazole was advised. However, only seven neonates were treated successfully and discharged after improvement, whereas two were lost for follow-up. Cultures from the environment and the hands of HCWs were negative. The outbreak was controlled by the strict implementation of infection control practices. Conclusion. This study emphasizes the importance of accurate identification of the aetiological agent of sepsis and vigilant monitoring for the possibility of an outbreak in NICUs. |
Databáze: | OpenAIRE |
Externí odkaz: |