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Journal of Clinical Microbiology, May 2001, p. 1702-1706, Vol. 39, No. 5
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.5.1702-1706.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

Outbreak of Pichia anomala Infection in the Pediatric Service of a Tertiary-Care Center in Northern India

A. Chakrabarti,1,* K. Singh,1 A. Narang,2 S. Singhi,2 R. Batra,1 K. L. N. Rao,3 P. Ray,1 S. Gopalan,4 S. Das,1 V. Gupta,1 A. K. Gupta,5 S. M. Bose,6 and M. M. McNeil7,dagger

Departments of Medical Microbiology,1 Pediatrics,2 Pediatric Surgery,3 Obstetrics and Gynecology,4 Hospital Administration,5 and General Surgery,6 Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India, and Mycotic Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 303337

Received 26 September 2000/Returned for modification 24 November 2000/Accepted 17 February 2001

An outbreak of nosocomial fungemia due to the unusual yeast, Pichia anomala occurred in the pediatric wards of our hospital over a period of 23 months (April 1996 to February 1998). A total of 379 neonates and children (4.2% admissions) were infected. The probable index case was admitted to the pediatric emergency ward, with subsequent transmission to the premature nursery, pediatric intensive care units, and other children wards. Carriage on the hands of health care personnel was likely to be responsible for dissemination of the fungus. The outbreak could only be controlled after a health education campaign to improve hand-washing practices was instituted and after nystatin-fluconazole prophylaxis to all premature neonates and high-risk infants was introduced. In a case-control study, we identified a lower gestational age, a very low birth weight (<1,500 g), and a longer duration of hospital stay as significant risk factors associated with P. anomala fungemia in premature neonates. We conducted a culture prevalence survey of 50 consecutive premature neonates and found that 28% were colonized with P. anomala at a skin or mucosal site on the date of delivery and that 20% of these neonates subsequently developed P. anomala fungemia. We performed multilocus enzyme electrophoresis on 40 P. anomala outbreak isolates (including patient and health care workers' hand isolates), and the results suggested that these isolates were identical. Our study highlights the importance of P. anomala as an emerging nosocomial fungal pathogen.

* Corresponding author. Mailing address: Department of Medical Microbiology, PGIMER, Chandigarh 160012, India. Phone: 91-172-711994. Fax: 91-172-744401. E-mail: medinst{at}pgi.nic.in.

dagger Present address: Epidemiology and Surveillance Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, GA 30333.

Journal of Clinical Microbiology, May 2001, p. 1702-1706, Vol. 39, No. 5
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.5.1702-1706.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.


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