title: Skin Colonization by Malassezia spp. in hospitalized neonates and infants in a tertiary care centre in North India.
abstract: Malassezia, a skin colonizer, is associated with multiple skin disorders in adults, and cephalic pustulosis and folliculitis in children. It can cause fungemia in infants and neonates. The time and pattern of colonization, risk factors associated with colonization and causing fungemia in children, are not well understood. The prospective cohort study was conducted to determine the rate of Malassezia species colonization and associated factors in hospitalized neonates and infants. Consecutive 50 neonates and infants admitted in neonatal and pediatric intensive care units were studied. The skin swabs were collected on the day of admission and every fifth day, thereafter, till the patient was discharged or died. Putative risk factors for the colonization of Malassezia species were recorded. Isolates were identified by phenotypic methods and sequencing of the D1 and D2 region of rDNA. Neonates were not colonized at the time of entry in neonatal ICU or at birth. Nineteen (38 %) neonates were colonized with Malassezia species during their hospital stay. Among the infants, three (6 %) came to ICU with Malassezia colonization and 26 (52 %) acquired Malassezia during ICU stay. Mechanical ventilation, duration of hospital stay, central venous catheterization, and antifungal therapy were the significantly associated factors for colonization. Malassezia furfur was the most common species isolated from the skin of infants and neonates. Colonization by Malassezia species in infants and neonates in a hospital is not uncommon and can be a potential source of nosocomial infection.
authors.affiliation: Mycology Division, Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
authors.forename: Prerna
authors.initials: P
authors.lastname: Gupta
authors.forename: Arunaloke
authors.initials: A
authors.lastname: Chakrabarti
authors.forename: Sunit
authors.initials: S
authors.lastname: Singhi
authors.forename: Praveen
authors.initials: P
authors.lastname: Kumar
authors.forename: Prasanna
authors.initials: P
authors.lastname: Honnavar
authors.forename: Shivaprakash M
authors.initials: SM
authors.lastname: Rudramurthy
mesh_terms: D015331:Cohort Studies; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology; D004271:DNA, Fungal / Q000737:chemistry / Q000235:genetics; D004275:DNA, Ribosomal / Q000737:chemistry / Q000235:genetics; D003881:Dermatomycoses / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D008290:Malassezia / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D008297:Male; D008969:Molecular Sequence Data; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D017422:Sequence Analysis, DNA; D012867:Skin / Q000382:microbiology*; D062606:Tertiary Care Centers
chemical_list: D004271:DNA, Fungal; D004275:DNA, Ribosomal