Abstract
Between 23 and 27 July 1987, three infants at one hospital developed severe bronchopneumonia associated with respiratory failure, thrombocytopenia, and leukocytosis. Two infants died; at postmortem examination, Malassezia furfur was identified in their lung tissues. M. furfur was isolated from cultures of blood, urine, and stool samples from the infant who survived. All documented M. furfur infections occurred in infants with a birth weight of less than 1,000 g; the attack rate was 42.9% (three of seven infants). A case-control study comparing the three cases and nine infants randomly selected from infants in the neonatal intensive care unit during the outbreak showed the following variables to be significantly associated with case-infants: younger gestational age (less than 26 weeks), hyaline membrane disease, duration of ventilation, duration of antimicrobial therapy, and the presence of a Broviac catheter. In a second case-control study, in which case-infants were compared with birth weight-matched controls, only the duration of antimicrobial therapy was significantly associated with case-infants. A point prevalence culture survey showed that 2 of 10 infants and 2 of 11 personnel were colonized with M. furfur. This cluster suggests that M. furfur can be transmitted from an infected or colonized infant to other infants. Infection control practices should be aimed at (i) identifying high-risk infants and (ii) reemphasizing the importance of hand washing.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Aschner J. L., Punsalang A., Jr, Maniscalco W. M., Menegus M. A. Percutaneous central venous catheter colonization with Malassezia furfur: incidence and clinical significance. Pediatrics. 1987 Oct;80(4):535–539. [PubMed] [Google Scholar]
- Dankner W. M., Spector S. A., Fierer J., Davis C. E. Malassezia fungemia in neonates and adults: complication of hyperalimentation. Rev Infect Dis. 1987 Jul-Aug;9(4):743–753. doi: 10.1093/clinids/9.4.743. [DOI] [PubMed] [Google Scholar]
- Klotz S. A., Drutz D. J., Huppert M., Johnson J. E. Pityrosporum folliculitis. Its potential for confusion with skin lesions of systemic candidiasis. Arch Intern Med. 1982 Nov;142(12):2126–2129. [PubMed] [Google Scholar]
- Long J. G., Keyserling H. L. Catheter-related infection in infants due to an unusual lipophilic yeast--Malassezia furfur. Pediatrics. 1985 Dec;76(6):896–900. [PubMed] [Google Scholar]
- Marcon M. J., Powell D. A., Durrell D. E. Methods for optimal recovery of Malassezia furfur from blood culture. J Clin Microbiol. 1986 Nov;24(5):696–700. doi: 10.1128/jcm.24.5.696-700.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Powell D. A., Aungst J., Snedden S., Hansen N., Brady M. Broviac catheter-related Malassezia furfur sepsis in five infants receiving intravenous fat emulsions. J Pediatr. 1984 Dec;105(6):987–990. doi: 10.1016/s0022-3476(84)80096-7. [DOI] [PubMed] [Google Scholar]
- Powell D. A., Hayes J., Durrell D. E., Miller M., Marcon M. J. Malassezia furfur skin colonization of infants hospitalized in intensive care units. J Pediatr. 1987 Aug;111(2):217–220. doi: 10.1016/s0022-3476(87)80070-7. [DOI] [PubMed] [Google Scholar]
- Powell D. A., Marcon M. J., Durrell D. E., Pfister R. M. Scanning electron microscopy of Malassezia furfur attachment to Broviac catheters. Hum Pathol. 1987 Jul;18(7):740–745. doi: 10.1016/s0046-8177(87)80246-0. [DOI] [PubMed] [Google Scholar]
- Redline R. W., Dahms B. B. Malassezia pulmonary vasculitis in an infant on long-term Intralipid therapy. N Engl J Med. 1981 Dec 3;305(23):1395–1398. doi: 10.1056/NEJM198112033052307. [DOI] [PubMed] [Google Scholar]
- Redline R. W., Redline S. S., Boxerbaum B., Dahms B. B. Systemic Malassezia furfur infections in patients receiving intralipid therapy. Hum Pathol. 1985 Aug;16(8):815–822. doi: 10.1016/s0046-8177(85)80253-7. [DOI] [PubMed] [Google Scholar]
- Roberts S. O. Pityrosporum orbiculare: incidence and distribution on clinically normal skin. Br J Dermatol. 1969 Apr;81(4):264–269. doi: 10.1111/j.1365-2133.1969.tb13978.x. [DOI] [PubMed] [Google Scholar]