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.Deep-seated fungal infections are important causes of morbidity and mortality in hospitalized patients (1, 2, 5, 13). Disseminated candidiasis is the most common nosocomial fungal infection, and Candida albicans has been reported to account for 50% to more than 70% cases of invasive candidiasis (2,5,6,8). However, recent reports have also suggested the emergence of infections caused by non-C. albicans candidas (3,14,21). In addition, less-common pathogenic yeasts (Malassezia, Trichosporon, Hansenula, and Rhodotorula spp.) have recently been reported, with increased frequency, as causes of nosocomial infections (7).Although a rare clinical isolate, the ascosporogenous yeast, Pichia anomala (formerly Hansenula anomala) has been implicated in causing fungemia in a neonatal intensive care unit (10), interstitial lung disease (19), endocarditis (12), and enteritis (9). In addition, there have been two reports of nosocomial outbreaks due to P. anomala: one in a Neonatal Intensive Care Unit in Liverpool, United Kingdom (10), and the other in an oncology hospital in Brazil (18). We describe here an outbreak of invasive P. anomala infection in the pediatric wards of our medical center that occurred during April 1996 to February 1998, with an attack rate of 4.2%. MATERIALS AND METHODSEpidemiologic investigation. The Nehru Hospital, affiliated with the Postgraduate Institute of Medical Education and Research, Chandigarh, India, is a 1,200-bed tertiary adult and pediatric referral center. The pediatric depa...

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Background: In the absence of treatment and unclear prognosis, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) itself, and public health measures like lockdown enforced by the government to limit the spread of the virus poses a threat to the psychological health of the general population. Aim: To assess the psychological status of the Indian population during the initial phase of lockdown. Method: It was a cross-sectional online survey where the questionnaire was disbursed by snowballing. The link to the survey was shared in different social networking platforms between 6th and 22nd of April 2020. The questionnaire collected responses related to the sociodemographic variables, exposure history, precautionary measures used, and the Depression, Anxiety, and Stress Scale (DASS-21) score. Results: A total of 541 participants responded to the questionnaire. Only 422 respondents' responses from 23 states of India who completed the questionnaire were included for assessment. The mean age of the participants was 30.5 (SD=10.9) years. Female constituted 60.4% (n=255) of the respondents. The pre-existing medical illness that the respondents had were diabetes mellitus, four per cent (n=17), hypertension, five per cent (n=21), thyroid dysfunction, nine per cent (n=38), and mental illness, five per cent (n=21). The median (IQR) of the DASS-21 item scale was found to be 16 (4-32). The percentage of the respondents who reported stress was 35.5% (n=149), anxiety, 32% (n=135), and depression, 34.7% (n=146). Respondents with sociodemographic variables like being single, student status, competed education till graduation, homemakers, working in public sector, and history of mental illness were more likely to experience stress, anxiety, and depression. A majority of the respondents were practicing hand hygiene and social distancing. Respondents who were unaware of their exposure status were more likely to have depression. Conclusion: The Indian population is experiencing the psychological impact of the coronavirus disease 2019 (COVID-19), which may increase with the spread of the infection. India needs to gear up to face mental health consequences. People with a pre-existing physical and psychological illness needs extra care and precaution to prevent any relapse or development of complications.

Background:The coronavirus disease 2019 (COVID-19) pandemic has affected people globally by causing psychological, social, and economic chaos. The Assam Police, India started telephone helplines to address the psychological issues. Aims: To evaluate the sociodemographic profile of the distress callers, their psychosocial concerns, the interventions provided by the service provider, and whether the service users were satisfied with the intervention(s) or not. Method: It was a cross-sectional study done during the period of lockdown (7-24 April 2020). All the callers who called the helpline were screened for anxiety, depression, suicidal thoughts (when required), and the psychosocial issues which they were facing were explored. They were provided the psychological intervention(s) at the appropriate time, and they were asked to rate their experience at the end. Results: A total of 239 callers used the tele-counselling services. The majority of callers were male (79.1%). Most of the callers were between 19-35 years of age group (66.5%), married (52.5%), and graduates (31%). Two-thirds of the callers called to seek guidance for their own issues and one-third for their relatives or friends. Callers had anxiety (46%), depressive disorder (8.3%), and depressive symptoms not qualifying for depressive disorder (14%), and suicidal thoughts (5.44%). The commonest intervention provided to the callers was supportive (77.8%), followed by psychoeducation (30.5%), cognitive behaviour therapy (24.7%), relaxation (23.6%) and behaviour therapy (13.4%). Most of the callers utilised more than one type of therapy. Overall, most of the callers were satisfied and appreciated the tele-counselling services. Conclusion: The findings could help in formulating psychological interventions to improve the mental health of vulnerable groups in the post-COVID-19 period to reduce psychiatric morbidity and mortality.