Fungaemia due to rare yeasts in paediatric intensive care units: A prospective study

Background Considering the emergence of fungaemia due to rare yeasts at our centre, we performed a systematic epidemiologic study on fungaemia due to rare yeast. Objectives We undertook the present prospective observational study to explore the epidemiological features and clinical characteristics o...

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Bibliographic Details
Published in:Mycoses 2021-11, Vol.64 (11), p.1387-1395
Main Authors: Kaur, Harsimran, Singh, Shreya, Rudramurthy, Shivaprakash Mandya, Jayashree, Muralidharan, Peters, Nitin James, Ray, Pallab, Samujh, Ram, Ghosh, Anup, Chakrabarti, Arunaloke
Format: Article
Language:English
Subjects:
Amphotericin B
antifungal susceptibility
candidaemia
Echinocandins
Epidemiology
fungaemia
Gastrointestinal diseases
Intensive care units
MALDI‐TOF
Neonates
paediatric intensive care units
Patients
Pediatrics
rare yeast
Yeast
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Summary:Background Considering the emergence of fungaemia due to rare yeasts at our centre, we performed a systematic epidemiologic study on fungaemia due to rare yeast. Objectives We undertook the present prospective observational study to explore the epidemiological features and clinical characteristics of fungaemia due to rare yeasts in paediatric ICUs at our centre. Methods The successive yeasts isolated from blood at our PICUs during December 2017 through March 2019 were identified by molecular methods. Fungaemia due to yeasts other than C. albicans, C. tropicalis, C. glabrata, C. krusei and C. parapsilosis was categorised as rare yeasts. Antifungal susceptibility testing of the yeast isolates was performed as per clinical and laboratory standards institute (CLSI) guidelines. We also compared different clinical parameters of fungaemia due to common versus rare yeasts, and rare yeasts in neonates versus non‐neonates. Results During the study period, 212 yeast isolates were obtained from 159 patients at PICUs of our hospital, and 127 isolates from 98 patients (61.6%) were categorised as rare yeasts. Neonates acquired fungaemia significantly earlier after ICU admission than non‐neonates (median:4 vs 6 days; p = .005). Regarding epidemiology study of rare yeast fungaemia, Wickerhamomyces anomalus (43.8%) and Candida utilis (40.8%) were common isolates; surgical intervention and gastrointestinal disease were significantly associated; overall, azole, echinocandin and amphotericin B resistance was at 9.1%, 1.02% and 1.02%, respectively; overall mortality was 65.3%. Conclusions The emergence of rare yeasts especially W. anomalus and C. utilis causing fungaemia in our children demands urgent attention to control the spread.
ISSN:0933-7407
1439-0507
DOI:10.1111/myc.13297