Ashrafi Khozani Mahtab, Abastabar Mahdi, Moazeni Maryam, Rezai Mohammad Sadegh, Farhadi Roya, Yazdani Charati Jamshid, Mayahi Sabah, Haghani Iman, Ghazanfari Mona, Tavakoli Mahin, Javidnia Javad, Roilides Emmanuel, Hedayati Mohammad Taghi
From the Student Research Committee Center.
Department of Medical Mycology, School of Medicine.
Pediatr Infect Dis J. 2024 Dec 1;43(12):1194-1199. doi: 10.1097/INF.0000000000004495. Epub 2024 Aug 2.
Although the Candida species continue to be the most frequent colonizer of neonatal skin, a clear increase of colonization due to rare yeast-like fungi has been reported. In this study, we report an unusual high prevalence of Cryptococcus diffluens colonization in neonates admitted to the neonatal intensive care unit (NICU) over a 1-month period.
From January 2020 to June 2021, the study included all neonates who were admitted to the NICU of Bu Ali Sina Hospital at least 28 days old. Skin swabs from different anatomical areas were collected. Sampling was done 3 times/week. Each sample was inoculated into Sabouraud Dextrose Agar containing chloramphenicol and CHROMagar Candida, separately. The plates were incubated at 30 °C and 35 °C, respectively. Identification of the isolates was molecularly confirmed. In vitro antifungal susceptibility testing of the isolates was performed against different antifungal agents using the Clinical Laboratory Standards Institute protocol.
Among 1026 samples collected from 78 neonates, 213 yeast isolates were recovered, of which the Candida species were the most common (77.5%), followed by C. diffluens (16.9%). During the study, 55 isolated yeasts were collected from December 26, 2020, to January 26, 2021, of which 65.5% were C. diffluens , while Candida spp. constituted 100% and 98.3% of the isolates before and after this period, respectively. The most frequent sources of C. diffluens were genital regions (27.8%). Of 36 C. diffluens isolates, 13.9%, 22.2%, 52.8%, and 83.3% were non-wild type to fluconazole, amphotericin B, itraconazole and 5-flucytosine, respectively.
We reported for the first time an unusual high prevalence of C. diffluens colonization in neonates hospitalized in NICU. Our findings also showed the high minimum inhibitory concentration of amphotericin B and 5-flucytosine against C. diffluens .
尽管念珠菌属仍然是新生儿皮肤最常见的定植菌，但已有报道称罕见的酵母样真菌引起的定植明显增加。在本研究中，我们报告了在新生儿重症监护病房（NICU）住院1个月期间，新生儿中异常高的溶脂隐球菌定植率。
2020年1月至2021年6月，该研究纳入了所有入住布阿里·西纳医院NICU且年龄至少28天的新生儿。采集不同解剖部位的皮肤拭子。每周采样3次。每个样本分别接种到含有氯霉素的沙氏葡萄糖琼脂和科玛嘉念珠菌显色培养基中。平板分别在30℃和35℃下孵育。分离株的鉴定通过分子方法确认。使用临床实验室标准协会的方案对分离株进行针对不同抗真菌药物的体外抗真菌药敏试验。
在从78名新生儿采集的1026份样本中，共分离出213株酵母，其中念珠菌属最为常见（77.5%），其次是溶脂隐球菌（16.9%）。在研究期间，2020年12月26日至2021年1月26日收集了55株分离的酵母，其中65.5%是溶脂隐球菌，而在此期间之前和之后，念珠菌属分别占分离株的100%和98.3%。溶脂隐球菌最常见的来源是生殖器区域（27.8%）。在36株溶脂隐球菌分离株中，对氟康唑、两性霉素B、伊曲康唑和5-氟胞嘧啶的非野生型分别为13.9%、22.2%、52.8%和83.3%。
我们首次报告了在NICU住院的新生儿中溶脂隐球菌定植的异常高发生率。我们的研究结果还显示两性霉素B和5-氟胞嘧啶对溶脂隐球菌的最低抑菌浓度较高。
