Pichia anomala fungaemia in immunocompromised children Fallbericht. Pichia anomala-Funga ¨mie bei immunkompromittierten Kindern M. BakIr, 1 N. C ¸ erikciog ˘ lu, 2 A. TIrtIr, 1 S. Berrak, 1 E. O ¨ zek 1 and C. Canpolat 1 Departments of 1 Pediatrics and 2 Clinical Microbiology, Marmara University School of Medicine, _ Istanbul, Turkey Summary Pichia anomala is an emerging yeast causing serious nosocomial infections in newborn and immunocompromised children. We describe nosocomial port catheter infection due to P. anomala in three children who were receiving cancer chemotherapy, bloodstream infection in a preterm infant and in an infant with severe combined immunodeficiency. All patients were treated with amphotericin B. All isolates were susceptible to amphotericin B and fluconazole. No recurrence was observed during follow-up in four of five patients. The common clinical feature in all of our patients was the presence of prior antimicrobial therapy. Zusammenfassung Pichia anomala gilt als opportunistischer Erreger nosokomialer Infektionen bei Neugeborenen und immunsupprimierten Kindern. Wir beschreiben nosokomiale Katheterinfektionen durch P. anomala bei drei Kindern mit Krebs, bei einer Fru ¨ hgeburt und bei einem immunsupprimierten Sa ¨ugling. Alle fu ¨ nf Patienten hatten vorab antibakterielle Therapie erhalten und wurden durch Amphotericin B erfolgreich behandelt. Alle Isolate waren empfindlich fu ¨ r Amphotericin B und Fluconazol. In der Nachbeobachtungszeit wurde an vier fu ¨ nf Patienten kein Rezidiv beobachtet. Key words: Pichia anomala, fungaemia, immunosuppression, children, nosocomial, amphotericin B. Schlu ¨ sselwo ¨ rter: Pichia anomala, Funga ¨mie, Immunsuppression, Kindern. Introduction Pichia anomala is the anamorph of the teleomorphic yeast Hansenula anomala (previously called Candida pelliculosa), which produces ascospores. 1,2 Although it is mainly found on plants, in soil and fruit juices there are studies defining P. anomala as transient flora of human skin, throat and gastrointestinal system. 3–6 This species is of low virulence and not a common pathogen of human beings. It may nevertheless lead to blood- stream infections in cases with several risk factors such as neutropenia, acquired immune deficiency syndrome, intravenous drug abuse, hyperalimentation and low birth weight. 1,3,5–15 In this study we report five patients with fungaemia due to P. anomala who had been hospitalized in pediatric wards. Patients and methods Fungal growth was detected in blood cultures of fungaemic patients with Becton-Dickinson 9120 blood culture system (Franklin Lakes, NJ, USA) and the isolates were identified with the use of bioMe ´rieux ID32 C assimilation set (Marcy l’Etoile, France) and confirmed by observing typical ascospores of P. ano- mala by performing ascospore production test on ascospore medium. 16 Susceptibility tests for fluconazole Correspondence: Professor Mustafa Bakır, Marmara University Hospital, Tophaneliog ˘ lu Cd. No. 13–15, Altunizade, U ¨ sku ¨ dar, _ Istanbul, Turkey. Tel.: +90 216 327 3757. Fax: +90 216 489 7916. E-mail: bakirm@superonline.com Accepted for publication 24 January 2003 Case report Ó 2004 Blackwell Publishing Ltd • Mycoses, 47, 231–235 231