Abstract
Although Candida species remain the leading cause of invasive fungal infections (IFI), the list of other isolated fungal pathogens is increasing. The aim of the study was to report cases of IFI caused by rare yeasts in the largest tertiary Greek pediatric hospital. A retrospective study was performed from 6/2008–6/2020 regarding IFI caused by rare species. Identification of isolates was attained by conventional, molecular, and MALDI TOF MS methods, and susceptibility testing was performed according to the Clinical and Laboratory Standards (CLSI) methodology. During a 12-year period, 14 different rare fungal species in 33 neonates and children with IFI hospitalized in intensive care and oncology units were isolated from blood, central catheters, peritoneal, pleural, or pericardial fluid specimens. It is the first time for IFI caused by Wickerhamomyces anomalus (Candida pelliculosa), Pichia fermentans (Candida lambica), Yarrowia (Candida) lipolytica, Pichia (Hansenula) kluyveri, Rhodotorula mucilaginosa, Wickerhamiella (Candida) pararugosa and Cyberlindnera (Candida) fabianii in Greek neonates and children to be reported. For most of these rare fungal species isolated in the present study, no official antifungal breakpoints have been defined, and there are no guidelines for their treatment. Clinical laboratories should be aware of uncommon and emerging yeast pathogens and be able to detect them with molecular and proteomic methods.
Highlights
Invasive fungal infections (IFI) occur mainly in neonates and children who are immunocompromised or in a critically ill condition [1,2]
This is a 750-bed tertiary hospital that is a referral center for almost 75% of the Greek pediatric population and includes 3 neonatal intensive care units (NICU), 1 pediatric ICU (PICU), 2 hematology–oncology units (HOU), 1 bone marrow transplantation unit, 5 surgical units (SU), and 1 department of cardiovascular surgery (DCS)
49 incidences of rare fungi species were detected in 45 neonates and children with IFI and non-IFI infections
Summary
Invasive fungal infections (IFI) occur mainly in neonates and children who are immunocompromised or in a critically ill condition [1,2]. These infections are characterized by high rates of morbidity and mortality, and timely diagnosis and initiation of appropriate antifungal therapy is always considered crucial [3]. Some of them are considered frequent colonizers of skin or mucosal surfaces. Their clinical significance varies from superficial infections in normal hosts to invasive infections in immunocompromised individuals.
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