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Skin Colonization by Malassezia in Neonates and Infants

Published online by Cambridge University Press:  02 January 2015

H. Ruth Ashbee ,
Astrid K. Leck ,
John W. L. Puntis ,
Wendy J. Parsons  and
E. Glyn V. Evans
H. Ruth Ashbee*
Affiliation:
Mycology Reference Center, Leeds General Infirmary, Leeds, United Kingdom
Astrid K. Leck
Affiliation:
Mycology Reference Center, Leeds General Infirmary, Leeds, United Kingdom
John W. L. Puntis
Affiliation:
Peter Congdon Neonatal Unit, Leeds General Infirmary, Leeds, United Kingdom
Wendy J. Parsons
Affiliation:
Research and Development Support Unit, Leeds General Infirmary, Leeds, United Kingdom
E. Glyn V. Evans
Affiliation:
Mycology Reference Center, Leeds General Infirmary, Leeds, United Kingdom
*
Mycology Reference Center, Division of Microbiology, University of Leeds, Leeds, LS2 9JT, UK
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Abstract

Objective:

To identify the timing, pattern, and determinants of colonization of neonates by Malassezia.

Design:

Prospective observational study.

Setting:

A neonatal medical and surgical unit consisting of 10 special care, 10 high-dependency, 10 intensive care, and 10 surgical cots.

Participants:

All neonates (≤ 28 days of age) or infants (> 28 days of age) admitted to the unit during the 20-week period from October 1995 to March 1996.

Methods:

All infants or neonates were swabbed on the day of admission and every third day thereafter and risk factors were collected for every day on the unit.

Results:

During the study period, 245 neonates and 42 infants were sampled for their entire duration of stay on the unit. Of these, 41 infants (97.6%) were colonized with Malassezia on admission to the unit and thereafter, as assessed by subsequent samples. Within the neonate population, 78 (31.8%) became colonized, but none were colonized immediately after birth. Univariate analysis showed that many factors appeared to be significantly associated with colonization in the neonates, including use of ventilation, presence of central venous catheters, use of parenteral nutrition, and use of antibacterial or antifungal drugs. However, when the data were analyzed by multivariate logistic regression to control for confounding variables, only gestational age and length of stay on the unit were found to be significantly associated with colonization.

Conclusion:

Colonization of infants is not as unusual as previously thought and many infants have established a cutaneous Malassezia commensal flora by the age of 3 to 6 months. Factors that predispose to colonization in neonates may not be the same as those that predispose to infection.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 23 , Issue 4 , April 2002 , pp. 212 - 216
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2002

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References

1.Long, JG, Keyserling, HL. Catheter-related infection in infants due to an unusual lipophilic yeast: Malassezia furfur. Pediatrics 1985;76:896–900.CrossRefGoogle Scholar
2.Redline, RW, Redline, SS, Boxerbaum, B, Dahms, BB. Systemic M. furfur infections in patients receiving intralipid therapy. Hum Pathol 1985; 16:815–822.CrossRefGoogle Scholar
3.Dankner, WH, Spector, SA, Fiere, RJ, Davis, CE. Malassezia fungaemia in neonates and adults: complication of hyperalimentation. Rev Infect Dis 1987;9:743–753.CrossRefGoogle ScholarPubMed
4.Shek, YH, Tucker, MC, Viciana, ML, Manz, HJ, Connor, DH. Malassezia furfur, disseminated infection in premature infants. Am J Clin Pathol 1989;92:595–603.Google Scholar
5.Chang, HJ, Miller, HL, Watkins, N, et al. An epidemic of Malassezia pachydermatis in an intensive care nursery associated with colonization of health care workers' pet dogs. N Engl J Med 1998;338:706–711.Google Scholar
6.Roberts, SOB. Pityrosporum orbiculare: incidence and distribution on clinically normal skin. Br J Dermatol 1969;81:264–269.Google Scholar
7.Abraham, Z, Berderly, A, Lefler, E. Pityrosporum orbiculare in children. Mycoses 1987;30:581–583.Google Scholar
8.Abtonen, P, Lehtonen, O-P, Kero, P, Tunnela, P, Havu, V. Malassezia furfur colonization of neonates in an intensive care unit. Mycoses 1990;33:543–547.Google Scholar
9.Bergbrant, I-M, Broberg, A. Pityrosporum ovale culture from the forehead of healthy children. Acta Derm Venereol 1994;74:260–261.Google Scholar
10.Faergemann, J, Fredriksson, T. Age incidence of Pityrosporum orbiculare on human skin. cta Derm Venereol 1980;60:531–533.CrossRefGoogle ScholarPubMed
11.Leeming, JP, Sutton, TM, Fleming, PJ. Neonatal skin as a reservoir of Malassezia species. Pediatr Infect Dis J 1995;14:719–720.Google Scholar
12.Shattuck, KE, Cochran, CK, Zabransky, RJ, Pasarell, L, Davis, JC, Malloy, MH. Colonization and infection associated with Malassezia and Candida species in a neonatal unit. J Hosp Infect 1996;34:123–129.CrossRefGoogle Scholar
13.Silva, V, Di Tilia, C, Fischman, O. Skin colonization by Malassezia furfur in healthy children up to 15 years old. Mycopathologia 1996;132:143–145.Google Scholar
14.Leeming, JP, Notman, FH. Improved methods for isolation and enumeration of Malassezia furfur from human skin. J Clin Microbiol 1987;25:2017–2019.Google Scholar
15.Kite, P, Millar, M. Diagnosis of neonatal bacteraemia using combinations of tests. Midwifery 1988:4:123–129.Google Scholar
16.Leck, AK. Epidemiology of Candida species in Neonates. Leeds, United Kingdom: University of Leeds; 1998.Google Scholar
17.Leeming, JP, Notman, FH, Holland, KT. The distribution and ecology of Malassezia furfur and cutaneous bacteria on human skin. Journal of Applied Bacteriology 1989;67:47–52.Google Scholar
18.Bell, LM, Alpert, G, Slight, PH, Campos, JM. Malassezia furfur skin colonization in infancy. Infect Control Hosp Epidemiol 1988;9:151–153.CrossRefGoogle ScholarPubMed
19.Powell, DA, Hayes, J, Durrell, DE, Miller, M, Marcon, MJ. Malassezia furfur skin colonization of infants hospitalised in intensive care units. J Pediatr 1987;111:217–220.CrossRefGoogle ScholarPubMed
20.Oh, CK, Kwon, KS, Lee, CW, Cho, SH, Jang, HS, Park, JH. The distribution of Malassezia yeasts on the skin of neonates and infants. Korean Journal of Medical Mycology 1999;4:27–32.Google Scholar
21.Guillot, J, Gueho, E. The diversity of Malassezia yeasts confirmed by rRNA sequence and nuclear DNA comparisons. Antonie Van Leeuwenhoek 1995;67:297–314.Google Scholar
22.Gueho, E, Midgley, G, Guillot, J. The genus Malassezia with description of four new species. Antonie Van Leeuwenhoek 1996;69:337–355.Google Scholar