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Volume 26, Number 4—April 2020
Dispatch

Outbreak of Dirkmeia churashimaensis Fungemia in a Neonatal Intensive Care Unit, India

Anuradha ChowdharyComments to Author , Kothapalli Sharada, Pradeep Kumar Singh, Dalip Kumar Bhagwani, Nitin Kumar, Theun de Groot, and Jacques F. Meis
Author affiliations: Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India (A. Chowdhary, P.K. Singh); Hindu Rao Hospital, Delhi (K. Sharada, D.K. Bhagwani); Wellcome Trust Sanger Institute, Hinxton, UK (N. Kumar); Canisius-Wilhelmina Hospital (CWZ), Nijmegen, the Netherlands (T. de Groot, J.F. Meis); Centre of Expertise in Mycology Radboudumc/CWZ, Nijmegen (J.F. Meis)

Main Article

Table 1

Clinical details of patients with Dirkmeia churashimaensis fungemia in a neonatal intensive care unit, India*

Pt no. Isolate 
ID GA, wk/sex DOB; delivery method Birthweight, g Date blood sample collected Day of positive blood test† Risk factors Antifungal therapy‡ NICU stay, d; outcome
1
 VPCI 2456/P/16§
 31/M
 2016 Jun 25; LSCS
 1,400
 2016 Jun 25
 6
 PT, VLBW, IUGR, thrombocytopenia, CVC, severe asphyxia, sepsis, mechanical ventilation
 FLU, 10 d; VAN and MER, 7 d
 15; survived
2
 VPCI 2478/P/16
 29/M
 2016 Jul 7; LSCS
 1,100
 2016 Jul 8
2
 PT, VLBW, IUGR, sepsis, thrombocytopenia
 FLU, 14 d;
VAN and MER, 10 d
 12; survived
3
 VPCI 2510/P/16
 29/F
 2016 Jul 19; VD
 1,000
 2016 Jul 19
4
 PT, VLBW, sepsis, thrombocytopenia
 FLU, 14 d;
VAN and MER, 14 d
 18; survived
4
 VPCI 2515/P/16§
 27/F
 2016 Aug 30; VD
 1,000
 2016 Aug 31
4
 PT, VLBW, IUGR, thrombocytopenia, maternal history of preeclampsia, antepartum hemorrhage
 FLU, 14 d;
AMI and CIP, 12 d
 16; survived
5
 VPCI 2601/P/16
 32/F
 2016 Sep 24; LSCS
 1,200
 2016 Sep 24
3
 PT, VLBW, persistent hypoglycemia, severe asphyxia, sepsis, CVC, mechanical ventilation
 FLU, 10 d;
VAN and MER, 12 d
 6; died
6
 VPCI 2634/P/16
 27/M
 2016 Oct 17; VD
 750
 2016 Oct 17
5
 Extremely PT, ELBW, severe asphyxia, CVC, sepsis, mechanical ventilation
 FLU, 10 d
 8; died
7
 VPCI 2699/P/16§
 30/M
 2016 Nov 9; VD
 800
 2016 Nov 9
2
 PT, ELBW, sepsis, persistent hypoglycemia, severe asphyxia, CVC, mechanical ventilation
 FLU, 10 d;
VAN and MER, 10 d
 11; died
8
 VPCI 2759/P/16
 33/M
 2016 Nov 26; LSCS
 1,200
 2016 Nov 28
 3
 PT, VLBW, severe asphyxia, CVC,
thrombocytopenia, persistent hypoglycemia, mechanical ventilation
 FLU, 14 d;
VAN and MER, 10 d
 10; survived
9
 VPCI 2801/P/16§
 27/M
 2016 Dec 14; VD
 1,100
 2016 Dec 14
 4
 PT, VLBW, severe asphyxia, thrombocytopenia, sepsis, CVC, mechanical ventilation
 FLU, 18 d;
VAN and MER, 12 d
 24; survived
10
 VPCI 2845/P/16
 27/F
 2016 Dec 28; LSCS
 1,200
 2016 Dec 28
 6
 PT, VLBW, thrombocytopenia, mechanical ventilation, sepsis, persistent hypoglycemia, CVC
 FLU, 10 d;
VAN and MER, 8 d
 8; died
11
 VPCI 2224/P/17§
 30/M
 2017 Jan 3; LSCS
 1,350
 2017 Jan 3
 4
 PT, VLBW, sepsis, persistent hypoglycemia, CVC
 FLU, 10 d;
VAN and MER, 10 d
 14; survived
12 VPCI 2271/P/17§ 29/F 2017 Jan 18; VD 1,000 2017 Jan 19 4 PT, VLBW, thrombocytopenia, mechanical ventilation, CVC, sepsis, persistent hypoglycemia FLU, 10 d;
VAN and MER, 12 d 9; died

*AMI, amoxicillin; CIP, ciprofloxacin; CVC, central venous catheter; DOB, date of birth; ELBW, extremely low birthweight (<1,000 g); FLU, fluconazole; GA, gestational age; ID, identification; IUGR, intrauterine growth restriction; LSCS, lower segment cesarean section; MER, meropenem; PT, preterm; Pt., patient; VAN, vancomycin; VPCI, Vallabhbhai Patel Chest Institute (Delhi, India); VD, vaginal delivery; VLBW, very low birthweight (<1,500 g).
†Indicates days after birth.
‡All patients were given a 1-time loading dose of 12 mg/kg bodyweight of FLU and then 6 mg/kg bodyweight.
§Isolates selected for whole-genome sequencing.

Main Article

Page created: March 17, 2020
Page updated: March 17, 2020
Page reviewed: March 17, 2020
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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