Perfil de sensibilidade a drogas antifúngicas e tipagem molecular de isolados de Pichia anomala provenientes de pacientes com fungemia nosocomial / Susceptibility profile to antifungal drugs and molecular typing of Pichia anomala isolated from patients presenting nosocomial fungemia

Nos últimos anos, as infecções fúngicas têm se caracterizado pelo seu aumento em freqüência e gravidade das infecções, bem como pela diversidade dos fungos isolados. Candida spp representa o quarto grupo de patógenos nosocomiais mais comumente isolados no sangue, porém fungemias causadas por Pichia anomala têm sido descritas com relativa freqüência. No presente estudo, 42 isolados de P. anomala de hemocultura foram analisados. /In the last years, fungal infections have been characterized by increased frequency and gravity of the infections, as well as for the diversity of isolated fungi. Candida spp represents the fourth group of nosocomial pathogens more frequently isolated in peripheral blood. However, fungemias caused by Pichia anomala have been described with relative frequency. In the present study, 42 blood isolates of P. anomala were analyzed. Approximately 100 per cent of them showed susceptibility to fluconazole, voriconazole and amphotericin B, In respect to itraconazole, 32 per cent of the isolates were susceptible, 66 per cent, susceptible-dose dependent and 2 per cent, resistant to this antifungal drug. Electrophoretic karyotyping evidenced different types and subtypes among non- related isolates. Identical karyotype patterns were determined among sequential samples from the same patient and samples from an outbreak. This work presents the greatest number of P. anomala isolates already analyzed in respect to the yeast susceptibility to antifungal agents as well as it demonstrates that electrophoretic karyotyping ...

Yeast colonisation & fungaemia in preterm neonates in a tertiary care centre.

Seventy consecutive preterm neonates who stayed in the hospital for more than seven days between March and October 1996, were studied for colonisation at oral, umbilical, groin, and rectal areas and for fungaemia. Overall, 71.4 per cent of the neonates were colonised and colonisation occurred within 24 h in 38 per cent preterm neonates. Neonates weighing less than 1500 g were colonised more frequently at more than one site and had higher load of yeast. Candida albicans (19%), Pichia (Hansenula) anomala (17.5%), C. tropicalis (13.2%), C. parapsilosis (12.3%) and Trichosporon cutaneum (10.0%) were the predominant colonising yeasts. Fungaemia was detected in 22.8 per cent of preterm neonates with predominance of P. anomala fungaemia (62.5%). Prematurity, male sex, broad spectrum antibiotic therapy, intubation and higher colonising rate were identified as significant risk factors for development of fungaemia. Except one strain of C. tropicalis, all yeast strains were sensitive to commonly used systemic antifungal agents. Study highlights the importance of routine surveillance of yeast colonisation of preterm neonates with identifying possible risk factors.