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Skin Colonization by Malassezia spp. in Hospitalized Neonates and Infants in a Tertiary Care Centre in North India

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Abstract

Malassezia, a skin colonizer, is associated with multiple skin disorders in adults, and cephalic pustulosis and folliculitis in children. It can cause fungemia in infants and neonates. The time and pattern of colonization, risk factors associated with colonization and causing fungemia in children, are not well understood. The prospective cohort study was conducted to determine the rate of Malassezia species colonization and associated factors in hospitalized neonates and infants. Consecutive 50 neonates and infants admitted in neonatal and pediatric intensive care units were studied. The skin swabs were collected on the day of admission and every fifth day, thereafter, till the patient was discharged or died. Putative risk factors for the colonization of Malassezia species were recorded. Isolates were identified by phenotypic methods and sequencing of the D1 and D2 region of rDNA. Neonates were not colonized at the time of entry in neonatal ICU or at birth. Nineteen (38 %) neonates were colonized with Malassezia species during their hospital stay. Among the infants, three (6 %) came to ICU with Malassezia colonization and 26 (52 %) acquired Malassezia during ICU stay. Mechanical ventilation, duration of hospital stay, central venous catheterization, and antifungal therapy were the significantly associated factors for colonization. Malassezia furfur was the most common species isolated from the skin of infants and neonates. Colonization by Malassezia species in infants and neonates in a hospital is not uncommon and can be a potential source of nosocomial infection.

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References

  1. Groll A, Tragiannidis A. Malassezia fungemia and invasive infections. In: Boekhout T, Gueho E, Mayser P, Velegraki A, editors. Malassezia and the skin. Berlin: Springer; 2010. p. 229–35.

    Google Scholar 

  2. Chang HJ, Miller HL, Watkins N, Arduino MJ, Ashford DA, Midgley G, et al. An epidemic of Malassezia pachydermatis in an intensive care nursery associated with colonization of health care workers’ pet dogs. N Engl J Med. 1998;338(11):706–11.

    Article  CAS  PubMed  Google Scholar 

  3. Chryssanthou E, Broberger U, Petrini B. Malassezia pachydermatis fungemia in a neonatal intensive care unit. Acta Paediatr. 2001;90(3):323–7.

    Article  CAS  PubMed  Google Scholar 

  4. Welbel SF, McNeil MM, Pramanik A, Silberman R, Oberle AD, Midgley G, et al. Nosocomial Malassezia pachydermatis bloodstream infections in a neonatal intensive care unit. Pediatr Infect Dis J. 1994;13(2):104–8.

    Article  CAS  PubMed  Google Scholar 

  5. Ashbee HR, Leck AK, Puntis JW, Parsons WJ, Evans EG. Skin colonization by Malassezia in neonates and infants. Infect Control Hosp Epidemiol. 2002;23(4):212–6.

    Article  PubMed  Google Scholar 

  6. Ayhan M, Sancak B, Karaduman A, Arikan S, Sahin S. Colonization of neonate skin by Malassezia species: relationship with neonatal cephalic pustulosis. J Am Acad Dermatol. 2007;57(6):1012–8.

    Article  PubMed  Google Scholar 

  7. Zomorodain K, Mirhendi H, Tarazooie B, Kordbacheh P, Zeraati H, Nayeri F. Molecular analysis of Malassezia species isolated from hospitalized neonates. Pediatr Dermatol. 2008;25(3):312–6.

    Article  PubMed  Google Scholar 

  8. Gueho E, Boekhout T, Ashbee HR, Guillot J, Van Belkum A, Faergemann J. The role of Malassezia species in the ecology of human skin and as pathogens. Med Mycol. 1998;36(Suppl 1):220–9.

    PubMed  Google Scholar 

  9. Gueho E, Midgley G, Guillot J. The genus Malassezia with description of four new species. Antonie Van Leeuwenhoek. 1996;69(4):337–55.

    Article  CAS  PubMed  Google Scholar 

  10. Kurtzman CP, Robnett CJ. Identification of clinically important ascomycetous yeasts based on nucleotide divergence in the 5′ end of the large-subunit (26S) ribosomal DNA gene. J Clin Microbiol. 1997;35(5):1216–23.

    CAS  PubMed Central  PubMed  Google Scholar 

  11. Yamamoto A, Serizawa S, Ito M, Sato Y. Effect of aging on sebaceous gland activity and on the fatty acid composition of wax esters. J Invest Dermatol. 1987;89(5):507–12.

    Article  CAS  PubMed  Google Scholar 

  12. Ahtonen P, Lehtonen OP, Kero P, Tunnela E, Havu V. Malassezia furfur colonization of neonates in an intensive care unit. Mycoses. 1990;33(11–12):543–7.

    CAS  PubMed  Google Scholar 

  13. Abraham Z, Berderly A, Lefler E. Pityrosporum orbiculare in children. Mykosen. 1987;30(12):581–3.

    Article  CAS  PubMed  Google Scholar 

  14. Faergemann J, Fredriksson T. Age incidence of Pityrosporum orbiculare on human skin. Acta Derm Venereol. 1980;60(6):531–3.

    CAS  PubMed  Google Scholar 

  15. Silva V, Di Tilia C, Fischman O. Skin colonization by Malassezia furfur in healthy children up to 15 years old. Mycopathologia. 1995;132(3):143–5.

    Article  PubMed  Google Scholar 

  16. Nagata R, Nagano H, Ogishima D, Nakamura Y, Hiruma M, Sugita T. Transmission of the major skin microbiota, Malassezia, from mother to neonate. Pediatr Int. 2012;54(3):350–5.

    Article  CAS  PubMed  Google Scholar 

  17. Bell LM, Alpert G, Slight PH, Campos JM. Malassezia furfur skin colonization in infancy. Infect Control Hosp Epidemiol. 1988;9(4):151–3.

    Article  CAS  PubMed  Google Scholar 

  18. Powell DA, Hayes J, Durrell DE, Miller M, Marcon MJ. Malassezia furfur skin colonization of infants hospitalized in intensive care units. J Pediatr. 1987;111(2):217–20.

    Article  CAS  PubMed  Google Scholar 

  19. Bernier V, Weill FX, Hirigoyen V, Elleau C, Feyler A, Labreze C, et al. Skin colonization by Malassezia species in neonates: a prospective study and relationship with neonatal cephalic pustulosis. Arch Dermatol. 2002;138(2):215–8.

    Article  PubMed  Google Scholar 

  20. Gupta AK, Kohli Y. Prevalence of Malassezia species on various body sites in clinically healthy subjects representing different age groups. Med Mycol. 2004;42(1):35–42.

    Article  PubMed  Google Scholar 

  21. Gonzalez-Cuevas A, Alayeto J, Juncosa T, Garcia-Fructuoso MT, Moreno J, Latorre C. Neonatal sepsis by Malassezia furfur. Rev Iberoam Micol. 1999;16(3):158–60.

    CAS  PubMed  Google Scholar 

  22. Marcon MJ, Powell DA. Human infections due to Malassezia spp. Clin Microbiol Rev. 1992;5(2):101–19.

    CAS  PubMed Central  PubMed  Google Scholar 

  23. Weiss SJ, Schoch PE, Cunha BA. Malassezia furfur fungemia associated with central venous catheter lipid emulsion infusion. Heart Lung. 1991;20(1):87–90.

    CAS  PubMed  Google Scholar 

  24. Iatta R, Cafarchia C, Cuna T, Montagna O, Laforgia N, Gentile O, et al. Bloodstream infections by Malassezia and Candida species in critical care patients. Med Mycol. 2014;52(3):264–9.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

We duly acknowledge the Indian Council of Medical Research (ICMR), New Delhi, India, for the financial support for the research proposal and providing financial aid to purchase a DNA sequencer. The study was supported by the Institutional Research Grant, Postgraduate Institute of Medical Education and Research, Chandigarh-160012, India.

Conflict of interest

There are no conflicts of interest to declare for any of the authors in the study.

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Authors and Affiliations

  1. Mycology Division, Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India

    Prerna Gupta, Arunaloke Chakrabarti, Prasanna Honnavar & Shivaprakash M. Rudramurthy

  2. Advanced Paediatric Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India

    Sunit Singhi & Praveen Kumar

Authors
  1. Prerna Gupta
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  2. Arunaloke Chakrabarti
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  3. Sunit Singhi
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  4. Praveen Kumar
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  5. Prasanna Honnavar
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  6. Shivaprakash M. Rudramurthy
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Correspondence to Shivaprakash M. Rudramurthy.

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Gupta, P., Chakrabarti, A., Singhi, S. et al. Skin Colonization by Malassezia spp. in Hospitalized Neonates and Infants in a Tertiary Care Centre in North India. Mycopathologia 178, 267–272 (2014). https://doi.org/10.1007/s11046-014-9788-7

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  • DOI: https://doi.org/10.1007/s11046-014-9788-7

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