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.

[Variations of the skin permeability in premature newborn infants. Value of the skin vasoconstriction test with neosynephrine]. / Variations de la perméabilité cutanée du nouveau-né prématuré. Intérêt d'un test de vasoconstriction cutanée par la Néosynéphrine.

BACKGROUND: The skin of preterm infants is defective as a barrier and does not function like that of mature until about 2 weeks of age. METHODS: Percutaneous drug absorption was studied by observing the blanching response to aqueous solutions of 10% Neosynephrin applied to a small area of skin on the internal surface of the thigh. The subjects, 10 preterm infants born at gestational ages 29 to 32 weeks (mean: 31 weeks 2 days), were tested when they were aged from day 0 to 7. The controls were 8 normal newborns aged 2 days. All preterm infants were tested a second time at the age 7 to 17 days (mean: 10 days). The blanching response was measured after 5 minutes, and graded on a scale of 0 to 4. RESULTS: The first test was positive grade 2 to 4 in all the preterm babies, while it was negative in the normal newborns. The second test was negative in 7 of the 10 preterm infants; in other 3, the grade was at least 50% lower. Infants nursed under radiant heaters were not different from the other infants. CONCLUSION: Skin permeability is increased in immature infants, but falls steadily until about the age of 10 days. The results of the Neosynephrin test could be useful in predicting the response to topically administered drug.