Candida Pelliculosa Fungemia Cases in Pediatric Intensive Care Unit

Candida pelliculosa (teleomorph: Wickerhamomyces anomalus) is an opportunistic pathogen that rarely causes fungemia. Here we present two cases with C. pelliculosa fungemia in the pediatric intensive care unit. The fungemia developed as a result of horizontal transmission from a patient who was transferred from another hospital with the same condition. Strains isolated from blood cultures of the two patients were identified as Candida pelliculosa with API ID 32C (bioMerieux France) commercial kit. All strains were resistant to the same antibiotic and random amplified polymorphic DNA analysis type. E-test antifungal MIC levels were found in the order of 0.125 ug/mL, 24 ug/mL, 0.50 ug/mL, and 0.64 ug/mL for caspofungin, fluconazole, voriconazole, and amphotericin-B, respectively. Environmental samples for C. pelliculosa were negative. After measures to control the infection were implemented in the unit, the outbreak ended. In the case of hindering precautions, it should be taken into account that hospital-acquired infections can develop even from rarely encountered non-albicans Candida strains.