Malassezia furfur-related colonization and infection of central venous catheters. A prospective study in a pediatric intensive care unit.

Objective: To determine the incidence of Malassezia furfur-related colonization and infection of central venous catheters.

Design: Prospective clinical study.

Setting: A paediatric intensive care unit at a University Hospital.

Patients: 66 newborns with central venous catheters for parenteral nutrition including lipid emulsions (Intralipid).

Methods: When a central venous catheter was removed, it was rinsed with 1 ml of physiological saline, transported at ambient temperature to the clinical laboratory and cultured on Dixon's medium. The tip of the central venous catheter was used for a bacteriological study using Maki's technique. In case of suspected sepsis, blood cultures were obtained using an Isolator tube. RESULTS. 74 central venous catheters were included: mean duration of use of a central venous catheters and infusions of lipid emulsion (Intralipid) were 19.3 +/- 10 days and 8.6 +/- 8 days respectively. Only 2 central venous catheters (2.7%) were colonized by Malassezia furfur: (Mf) one in an asymptomatic newborn, and the other in an infected newborn with signs of sepsis, who most probably died at 4 months of age from refractory hypoxia due to pulmonary hypoplasia, but not from Mf sepsis.

Conclusions: The incidence of Malassezia furfur-related colonization of central venous catheters appears to be low but not negligible, which warrants the use of specific culture techniques.