OBJECTIVE: To report an outbreak of Pichia anomala fungemia that occurred in a Brazilian pediatric intensive care unit (ICU) from October 2002 to January 2004. DESIGN: Unmatched case-control study. METHODS: We randomly selected four control-patients for each case-patient from a list of all patients admitted to the ICU for at least 48 hours during the outbreak. A second control group was composed of all consecutive patients with nosocomial candidemia in the ICU during the outbreak. An environmental study was performed, and genetic relatedness among the clinical isolates was characterized by randomly amplified polymorphic DNA assay. RESULTS: During the study period, 1,046 children were admitted to the pediatric ICU, 17 of whom developed P. anomala fungemia (attack rate, 1.6%). The median age was 1.1 years, and the main underlying conditions were congenital malformations (35.3%) and neoplastic diseases (11.8%). The overall mortality rate was 41.2%. Two patients received no antifungal treatment; all of the others were treated with amphotericin B. On multivariate analysis, only the presence of a central venous catheter was significantly associated with P. anomala fungemia. The yeast was not found on healthcare workers' hands or in the environment. Molecular studies showed that the outbreak was caused by a single strain. The distribution of risk factors was similar between patients with P. anomala fungemia and control-patients with candidemia. CONCLUSIONS: This study highlights the importance of P. anomala as an emerging nosocomial fungal pathogen. Patients with P. anomala fungemia seem to have risk factors in common with those who have candidemia.
OBJECTIVE: To report an outbreak of Pichia anomala fungemia that occurred in a Brazilian pediatric intensive care unit (ICU) from October 2002 to January 2004. DESIGN: Unmatched case-control study. METHODS: We randomly selected four control-patients for each case-patient from a list of all patients admitted to the ICU for at least 48 hours during the outbreak. A second control group was composed of all consecutive patients with nosocomial candidemia in the ICU during the outbreak. An environmental study was performed, and genetic relatedness among the clinical isolates was characterized by randomly amplified polymorphic DNA assay. RESULTS: During the study period, 1,046 children were admitted to the pediatric ICU, 17 of whom developed P. anomala fungemia (attack rate, 1.6%). The median age was 1.1 years, and the main underlying conditions were congenital malformations (35.3%) and neoplastic diseases (11.8%). The overall mortality rate was 41.2%. Two patients received no antifungal treatment; all of the others were treated with amphotericin B. On multivariate analysis, only the presence of a central venous catheter was significantly associated with P. anomala fungemia. The yeast was not found on healthcare workers' hands or in the environment. Molecular studies showed that the outbreak was caused by a single strain. The distribution of risk factors was similar between patients with P. anomala fungemia and control-patients with candidemia. CONCLUSIONS: This study highlights the importance of P. anomala as an emerging nosocomial fungal pathogen. Patients with P. anomala fungemia seem to have risk factors in common with those who have candidemia.
Authors: Vânia Lúcia Ribeiro da Matta; Márcia de Souza Carvalho Melhem; Arnaldo Lopes Colombo; Maria Luiza Moretti; Laura Rodero; Gisele Madeira Duboc de Almeida; Marilena dos Anjos Martins; Silvia Figueiredo Costa; Maria Beatriz G Souza Dias; Márcio Nucci; Anna S Levin Journal: Antimicrob Agents Chemother Date: 2007-01-29 Impact factor: 5.191
Authors: Arnaldo L Colombo; Marcio Nucci; Benjamin J Park; Simone A Nouér; Beth Arthington-Skaggs; Daniel A da Matta; David Warnock; Juliette Morgan Journal: J Clin Microbiol Date: 2006-08 Impact factor: 5.948
Authors: Carolina Maria da Silva; Ana Maria Rabelo de Carvalho Parahym; Mariele Porto Carneiro Leão; Neiva Tinti de Oliveira; Rosemary de Jesus Machado Amorim; Rejane Pereira Neves Journal: Mycopathologia Date: 2012-12-12 Impact factor: 2.574
Authors: D J Diekema; S A Messer; L B Boyken; R J Hollis; J Kroeger; S Tendolkar; M A Pfaller Journal: J Clin Microbiol Date: 2009-08-26 Impact factor: 5.948