An Epidemic of<i>Malassezia pachydermatis</i>in an Intensive Care Nursery Associated with Colonization of Health Care Workers' Pet Dogs

Chang, Helen; Miller, Hilary L.; Watkins, Nancy; Arduino, Matthew J.; Ashford, David A.; Midgley, G.; Aguero, Sonia M.; Pinto-Powell, Roshini; Reyn, C. Fordham von; Edwards, William; McNeil, Michael M.; Jarvis, William R.; Pruitt, Ruth

doi:10.1056/nejm199803123381102

Cited by 261 publications

(190 citation statements)

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“…The organism is not restricted to dogs alone, as it has been isolated from several other mammalian species and birds (Scott, 1992). Zoonotic transfer has been documented from dogs to immunocompromised patients by health care workers who own dogs (Chang et al, 1998).…”

Section: Introductionmentioning

confidence: 99%

Malassezia Species Associated With Dermatitis in Dogs and Their Antifungal Susceptibility

Seetha¹,

Kumar²,

Pillai³

et al. 2018

Int.J.Curr.Microbiol.App.Sci

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Section: Introductionmentioning

confidence: 99%

Malassezia Species Associated With Dermatitis in Dogs and Their Antifungal Susceptibility

Seetha¹,

Kumar²,

Pillai³

et al. 2018

Int.J.Curr.Microbiol.App.Sci

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“…This group of basidiomycetous yeasts, long known to be the causal agents of pityriasis (tinea) versicolor, is also increasingly being associated with the causation of folliculitis, papillomatosis, and invasive human infections, as well as potential immunogenic triggering of atopic dermatitis, seborrheic dermatitis, and dandruff (6,9,11,14,18,25,26,29). Malassezia species are listed among the new and emerging yeast pathogens (22,24).…”

mentioning

confidence: 99%

Identification and Typing of Malassezia Species by Amplified Fragment Length Polymorphism and Sequence Analyses of the Internal Transcribed Spacer and Large-Subunit Regions of Ribosomal DNA

et al. 2004

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Malassezia yeasts are associated with several dermatological disorders. The conventional identification of Malassezia species by phenotypic methods is complicated and time-consuming, and the results based on culture methods are difficult to interpret. A comparative molecular approach based on the use of three molecular techniques, namely, amplified fragment length polymorphism (AFLP) analysis, sequencing of the internal transcribed spacer, and sequencing of the D1 and D2 domains of the large-subunit ribosomal DNA region, was applied for the identification of Malassezia species. All species could be correctly identified by means of these methods. The results of AFLP analysis and sequencing were in complete agreement with each other. However, some discrepancies were noted when the molecular methods were compared with the phenotypic method of identification. Specific genotypes were distinguished within a collection of Malassezia furfur isolates from Canadian sources. AFLP analysis revealed significant geographical differences between the North American and European M. furfur strains.The genus Malassezia has received considerable attention in recent years from dermatologists and other clinicians. This group of basidiomycetous yeasts, long known to be the causal agents of pityriasis (tinea) versicolor, is also increasingly being associated with the causation of folliculitis, papillomatosis, and invasive human infections, as well as potential immunogenic triggering of atopic dermatitis, seborrheic dermatitis, and dandruff (6,9,11,14,18,25,26,29). Malassezia species are listed among the new and emerging yeast pathogens (22,24).The genus Malassezia, until recently, was characterized on the basis of rRNA sequences as consisting of seven species, including the lipid-dependent species M. furfur, M. sympodialis, M. globosa, M. obtusa, M. restricta, and M. slooffiae and the lipophilic species M. pachydermatis (12, 13). Recently, two new species have been identified: M. dermatis (39), which was isolated from atopic dermatitis patients, and M. equi (unpublished), a species that was isolated from the skin of horses (32). The latter species has only tentatively been named and still awaits formal description; the present study deals only with the eight described species.Guillot et al. (17) introduced a physiological system based on lipid assimilation and other phenotypic characteristics for identifying the various Malassezia species. This phenotypic system has been used as the conventional method of identification, though in practice, the test results are not always easy to read. Therefore, several research groups have explored the use of molecular techniques, such as pulsed-field gel electrophoresis (3, 4, 36), randomly amplified polymorphic DNA analysis (1, 3), amplified fragment length polymorphism (AFLP) analysis (40), denaturing gradient gel electrophoresis (40), multilocus enzyme electrophoresis (30), sequencing analysis (37), restriction analysis of PCR amplicons of ribosomal sequences (8,15,16,20,28), and chitin synthase ...

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“…The terminal fragment length polymorphism (tFLP) method uses only three different primer sets, minimizing the potential bias related to amplification efficiency. Because it has been documented that the efficacies of antifungal drugs can vary depending upon the species (30,39), timely clinical assessments are critical for the prompt administration of the appropriate therapy, especially when Malassezia yeasts are responsible for nosocomial bloodstream infections (9,35).…”

mentioning

confidence: 99%

Fast, Noninvasive Method for Molecular Detection and Differentiation of Malassezia Yeast Species on Human Skin and Application of the Method to Dandruff Microbiology

et al. 2002

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Malassezia fungi have been the suspected cause of dandruff for more than a century. Previously referred to as Pityrosporum ovale, Pityrosporum orbiculare, or Malassezia, these fungi are now known to consist of at least seven Malassezia species. Each species has a specific ecological niche, as well as specific biochemical and genetic characteristics. Malassezia yeasts have fastidious culture conditions and exceedingly different growth rates. Therefore, the results of surveys of Malassezia based on culture methods can be difficult to interpret. We developed a molecular technique, terminal fragment length polymorphism analysis, to more accurately survey the ecology of Malassezia yeasts without bias from culture. This technique involves fluorescent nested PCR of the intergenic transcribed spacer (ITS) ITS I and ITS II region ribosomal gene clusters. All known Malassezia species can be differentiated by unique ITS fragment lengths. We have used this technique to directly analyze scalp samples from subjects enrolled in a demographic scalp health study. Results for subjects assigned composite adherent scalp flaking scores (ASFS) <10 were compared to those for subjects assigned composite ASFS >24. Malassezia restricta and M. globosa were found to be the predominant Malassezia species present in both groups. Importantly, we found no evidence of M. furfur in either group, indicating that M. furfur can be eliminated as the causal organism for dandruff. Both groups also showed the presence of non-Malassezia fungi. This method, particularly when it is used in combination with existing fungal ITS databases, is expected to be useful in the diagnosis of multiple other fungal infections.Recently, members of the genus Malassezia have become viewed as opportunistic yeasts of increasing importance (1, 2, 31, 35, 42). They are lipophilic or lipid-dependent yeasts, and at least some belong to the normal cutaneous microflora. Some Malassezia species may act as pathogens when exposed to certain changes in the skin microclimate. For decades the genus Malassezia remained limited to two species, namely, the lipiddependent Malassezia furfur and the lipophilic M. pachydermatis. In 1995, 28S rRNA gene sequences revealed seven distinct genetic entities (25), which are now accepted as species (M. furfur, M. obtusa, M. globosa, M. slooffiae, M. sympodialis, M. pachydermatis, and M. restricta) (22). Malassezia species are exceptionally difficult to cultivate, so additional species may be discovered as DNA-based differentiation techniques are refined and applied to multiple ecosystems.While several of the seven described Malassezia species have been associated with human infection, the pathological role of each species is not fully understood. For example, M. furfur infections have been observed in hospitalized neonates with very low birth weights receiving intravenous lipid emulsions (5,7,15,23,41,46). M. globosa, which corresponds to the original description of Pityrosporum orbiculare and correlates to the former serovar B of M. furfur (14), ...

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An Epidemic ofMalassezia pachydermatisin an Intensive Care Nursery Associated with Colonization of Health Care Workers' Pet Dogs

Abstract: In this outbreak, it is likely that M. pachydermatis was introduced into the intensive care nursery on health care workers' hands after being colonized from pet dogs at home. The organism persisted in the nursery through patient-to-patient transmission.

Cited by 261 publications

References 13 publications

Malassezia Species Associated With Dermatitis in Dogs and Their Antifungal Susceptibility

Malassezia Species Associated With Dermatitis in Dogs and Their Antifungal Susceptibility

Identification and Typing of Malassezia Species by Amplified Fragment Length Polymorphism and Sequence Analyses of the Internal Transcribed Spacer and Large-Subunit Regions of Ribosomal DNA

Fast, Noninvasive Method for Molecular Detection and Differentiation of Malassezia Yeast Species on Human Skin and Application of the Method to Dandruff Microbiology

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