An Unusual High Prevalence of Cryptococcus (Naganishia) diffluens Colonization in Neonates Hospitalized in a Referral Neonatal Intensive Care Unit.

IF 2.9 4区医学 Q3 IMMUNOLOGY Pediatric Infectious Disease Journal Pub Date : 2024-08-02 DOI:10.1097/INF.0000000000004495

Mahtab Ashrafi Khozani, Mahdi Abastabar, Maryam Moazeni, Mohammad Sadegh Rezai, Roya Farhadi, Jamshid Yazdani Charati, Sabah Mayahi, Iman Haghani, Mona Ghazanfari, Mahin Tavakoli, Javad Javidnia, Emmanuel Roilides, Mohammad Taghi Hedayati

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Abstract

Background: Although the Candida species continue to be the most frequent colonizer of neonatal skin, a clear increase of colonization due to rare yeast-like fungi has been reported. In this study, we report an unusual high prevalence of Cryptococcus diffluens colonization in neonates admitted to the neonatal intensive care unit (NICU) over a 1-month period.

Methods: From January 2020 to June 2021, the study included all neonates who were admitted to the NICU of Bu Ali Sina Hospital at least 28 days old. Skin swabs from different anatomical areas were collected. Sampling was done 3 times/week. Each sample was inoculated into Sabouraud Dextrose Agar containing chloramphenicol and CHROMagar Candida, separately. The plates were incubated at 30 °C and 35 °C, respectively. Identification of the isolates was molecularly confirmed. In vitro antifungal susceptibility testing of the isolates was performed against different antifungal agents using the Clinical Laboratory Standards Institute protocol.

Results: Among 1026 samples collected from 78 neonates, 213 yeast isolates were recovered, of which the Candida species were the most common (77.5%), followed by C. diffluens (16.9%). During the study, 55 isolated yeasts were collected from December 26, 2020, to January 26, 2021, of which 65.5% were C. diffluens , while Candida spp. constituted 100% and 98.3% of the isolates before and after this period, respectively. The most frequent sources of C. diffluens were genital regions (27.8%). Of 36 C. diffluens isolates, 13.9%, 22.2%, 52.8%, and 83.3% were non-wild type to fluconazole, amphotericin B, itraconazole and 5-flucytosine, respectively.

Conclusions: We reported for the first time an unusual high prevalence of C. diffluens colonization in neonates hospitalized in NICU. Our findings also showed the high minimum inhibitory concentration of amphotericin B and 5-flucytosine against C. diffluens .

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在转诊新生儿重症监护病房住院的新生儿中，隐球菌（Naganishia） diffluens 的定植率异常高。

背景：尽管念珠菌仍是新生儿皮肤最常见的定植菌，但有报道称罕见的酵母样真菌导致的定植率明显上升。在本研究中，我们报告了新生儿重症监护室（NICU）收治的新生儿在一个月内不同寻常的高隐球菌定植率：从 2020 年 1 月至 2021 年 6 月，研究对象包括所有在布阿里-西纳医院新生儿重症监护室（NICU）住院的出生至少 28 天的新生儿。采集不同解剖部位的皮肤拭子。每周取样 3 次。将每个样本分别接种到含氯霉素的沙保露葡萄糖琼脂和 CHROMagar 念珠菌琼脂中。平板分别在 30 °C 和 35 °C 下培养。对分离物的鉴定进行了分子确认。根据临床实验室标准研究所的方案，对分离物进行了不同抗真菌剂的体外抗真菌药敏试验：结果：在从 78 名新生儿身上采集的 1026 份样本中，共分离出 213 株酵母菌，其中最常见的是念珠菌（77.5%），其次是艰难梭菌（16.9%）。在研究期间，从 2020 年 12 月 26 日至 2021 年 1 月 26 日，共收集到 55 个分离的酵母菌，其中 65.5%为艰难梭菌，而在此期间之前和之后分离的念珠菌属分别占 100%和 98.3%。扩散念珠菌最常见的来源是生殖器区域（27.8%）。在 36 例艰难梭菌分离株中，分别有 13.9%、22.2%、52.8% 和 83.3% 对氟康唑、两性霉素 B、伊曲康唑和 5-氟尿嘧啶无野生型反应：我们首次报告了在新生儿重症监护室住院的新生儿中弥散性球菌定植的异常高流行率。我们的研究结果还显示，两性霉素 B 和 5-氟尿嘧啶对艰难梭菌的最小抑菌浓度很高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Infectious Disease Journal 医学-传染病学

CiteScore

6.30

自引率

2.80%

发文量

566

审稿时长

2-4 weeks

期刊介绍： The Pediatric Infectious Disease Journal® (PIDJ) is a complete, up-to-the-minute resource on infectious diseases in children. Through a mix of original studies, informative review articles, and unique case reports, PIDJ delivers the latest insights on combating disease in children — from state-of-the-art diagnostic techniques to the most effective drug therapies and other treatment protocols. It is a resource that can improve patient care and stimulate your personal research.