Fungaemia caused by Hansenula anomala—an outbreak in a cancer hospital

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Abstract
Summary. Yeasts belonging to the genus Hansenula are rarely encountered as the cause of infection in clinical practice. A wide spectrum of infections caused by these fungi can be seen, ranging from asymptomatic fungaemia to severe disease. We describe an outbreak of 24 cases of infection due to H. anomala in an oncological hospital in Rio de Janeiro, Brazil. The median age of the patients was 11 years of whom 54.2% were female; 91.7% of the Hansenula fungaemia occurred in the haematology unit. The most frequent primary disease diagnosis was leukaemia (62.5%), and all of those infected had had a central venous catheter or peripheral venous catheter and had been treated previously with broad‐spectrum antibiotics. Numerous other risk factors were observed in our cases: previous use of steroids, chemotherapy, radiation therapy and neutropenia (data not shown). No deaths could be attributed to Hansenula. Zusammenfassung. Hefen der Gattung Hansenula werden selten als Mykoseerreger beobachtet. Wir berichten über den Ausbruch von 24 H. anomala‐Infektionen in einem onkologischen Krankenhaus in Rio de Janeiro, Brasilien. Das durchschnittliche Alter der Patienten war 11 Jahre. 92% der Hansenula‐Fungämie‐Fälle traten in der Hämatologie‐Einheit auf. Bei den meisten Patienten (63%) war Leukämie die Grundkrankheit, und alle Infizierten hatten einen zentralvenösen oder periphervenösen Verweilkatheter und wurden mit Breitspektrumantibiotika behandelt. Weitere Prädispositionsfaktoren waren Steroidbehandlung, antileukämische Chemotherapie, Strahlentherapie und Neutropenie. Hansenula‐bedingte Todesfälle wurden nicht beobachtet.