Molecular investigation of a fungemia outbreak due to Candida parapsilosis in an intensive care unit

We investigated a nosocomial cluster of four Candida parapsilosis fungemia episodes that occurred in a neurological intensive care unit over a two-week period. The four infected patients had received parenteral nutrition through central lines, and all four had catheter-related candidemia. All of the...

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Bibliographic Details
Published in:The Brazilian journal of infectious diseases 2008-10, Vol.12 (5), p.395-399
Main Authors: Dizbay, Murat, Kalkanci, Ayse, Sezer, Busra Ergut, Aktas, Firdevs, Aydogan, Sibel, Fidan, Isil, Kustimur, Semra, Sugita, Takashi
Format: Article
Language:English
Subjects:
Aged
Antifungal Agents - pharmacology
Brazil
Candida - classification
Candida - drug effects
Candida - genetics
Candida parapsilosis
Candidemia
Candidiasis
Candidiasis - epidemiology
Candidiasis - microbiology
Catheterization - adverse effects
Control
Critically ill
Cross Infection - epidemiology
Cross Infection - microbiology
Demographic aspects
Disease Outbreaks
DNA sequencing
DNA, Fungal - analysis
Female
Fungemia - epidemiology
Fungemia - microbiology
Genetic aspects
Health aspects
Humans
Infection control
INFECTIOUS DISEASES
intensive care unit
Intensive Care Units
Male
Mycological Typing Techniques - methods
nosocomial outbreak
Nucleotide sequencing
Parenteral Nutrition - instrumentation
Random Amplified Polymorphic DNA Technique
RAPD
Retrospective Studies
Risk Factors
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Summary:We investigated a nosocomial cluster of four Candida parapsilosis fungemia episodes that occurred in a neurological intensive care unit over a two-week period. The four infected patients had received parenteral nutrition through central lines, and all four had catheter-related candidemia. All of the isolates were susceptible to all of the antifungals tested, including amphotericin B, fluconazole, voriconazole, and caspofungin. They had strictly related fingerprints, based on randomly amplified polymorphic DNA analysis. Additional DNA sequencing data revealed that they were same strain. Although no isolate of Candida parapsilosis was recovered from other clinical, surveillance, or environmental samples, nosocomial spread of this yeast ceased, following the reinforcement of infection-control measures. Candida parapsilosis may require an intravascular foreign body to cause fungemia, but this outbreak shows that it can be transmitted nosocomially and can cause epidemics.
ISSN:1413-8670
1678-4391
1678-4391
DOI:10.1590/s1413-86702008000500010