Infective endocarditis of a bicuspid aortic valve caused by hansenula anomala

Nohinek, B.; Zee-Cheng, Chi-Sung; Barnes, William G.; Dall, Lawrence; Gibbs, Harry

doi:10.1016/0002-9343(87)90400-1

Cited by 44 publications

(14 citation statements)

References 4 publications

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“…In the latter two reports, the correct identification was only obtainable through the use of sequencing data, as in our case. This suggests that Pichia fabianii could have been commonly misidentified in the past, most probably as Pichia anomala [5,14]. Pichia fabianii is not yet included in databases of the most widely used diagnostic kits (API 20C AUX, ID 32C and Vitek-2) and, therefore, both species are difficult to distinguish based on physiological characteristics in routine practice.…”

Section: Discussionmentioning

confidence: 99%

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A case of endocarditis caused by the yeastPichia fabianiiwith biofilm production and developedin vitroresistance to azoles in the course of antifungal treatment

et al. 2008

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Pichia fabianii, a yeast rarely causing human infections, was isolated from the blood of a patient with aortic valve endocarditis. The isolates were initially identified biochemically as Candida pelliculosa, but based on direct sequencing of the ITS2 region of rRNA, they were subsequently reidentified as P. fabianii. Antifungal therapy with fluconazole and later with voriconazole led to the development of resistant variants which had high MIC values to both antifungals. Strong biofilm formation by this yeast could also have played a role in the development of its resistance and allowed for its persistence on the infected valve during antifungal therapy. To our knowledge, this is the first published case of endocarditis and the fourth human infection caused by this yeast species.

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Section: Discussionmentioning

confidence: 99%

“…Up to now, we have found only three reports of Pichia fabianii human infections in the literature. However, because of the possible misidentification of Pichia fabianii, other cases of endocarditis caused by this species may have occurred in the past (e.g., [5]). …”

Section: Introductionmentioning

confidence: 99%

A case of endocarditis caused by the yeastPichia fabianiiwith biofilm production and developedin vitroresistance to azoles in the course of antifungal treatment

et al. 2008

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“…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).…”

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confidence: 99%

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

Chakrabarti¹,

Singh²,

Narang³

et al. 2001

J Clin Microbiol

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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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“…It has occasionally been reported as a causative agent of fungaemia in both immunocompetent and immunocompromised patients, including those with AIDS [10][11][12][13][14][15][16][17][18][19][20] . W. anomalus has also been reported as a causative agent of nosocomial cerebral ventriculitis in low-birth-weight neonates, endocarditis in an intravenous drug abuser and urinary tract infection in a renal transplant recipient 18,[21][22][23] . Particularly, in the pediatric population W. anomalus is known to be responsible for serious nosocomial bloodstream infections of immunocompromised mostly as outbreaks in pediatric intensive care units 8 .…”

Section: Discussionmentioning

confidence: 99%

Wickerhamomyces anomalus blood stream infection in a term newborn with pneumonia

2017

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The incidence of invasive candidiasis is high in neonates admitted to neonatal intensive care unit and is associated with significant morbidity and mortality rates. Candida albicans is the most common fungal agent pathogenic to neonates but invasive fungal infections caused by uncommon fungi have increased in recent years. Wickerhamomyces anomalus is a very rare pathogen causing blood stream infection in neonates, which has reportedly caused only few cases in the literature.Here we report a case of blood stream infection caused by a fungal agent Wickerhamomyces anomalus in a term male infant.

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Infective endocarditis of a bicuspid aortic valve caused by hansenula anomala

Cited by 44 publications

References 4 publications

A case of endocarditis caused by the yeastPichia fabianiiwith biofilm production and developedin vitroresistance to azoles in the course of antifungal treatment

A case of endocarditis caused by the yeastPichia fabianiiwith biofilm production and developedin vitroresistance to azoles in the course of antifungal treatment

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

Wickerhamomyces anomalus blood stream infection in a term newborn with pneumonia

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