Nosocomial Candida albicans acquisition in a geriatric unit: epidemiology and evidence for person-to-person transmission

• Published in: The Journal of hospital infection 2001-01, Vol.47 (1), p.46-52
• Main Authors: Fanello, S., Bouchara, J.-P., Jousset, N., Delbos, V., LeFlohic, A.-M.
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Candida albicans; Candida albicans - genetics; Candidiasis - epidemiology; Candidiasis - microbiology; Candidiasis - prevention & control; Candidiasis - transmission; Carrier State - epidemiology; Carrier State - transmission; Community-Acquired Infections - epidemiology; Community-Acquired Infections - microbiology; Community-Acquired Infections - prevention & control; Community-Acquired Infections - transmission; Cross Infection - epidemiology; Cross Infection - microbiology; Cross Infection - prevention & control; Cross Infection - transmission; DNA, Fungal - analysis; DNA, Fungal - genetics; elderly patients; Electrophoresis, Gel, Pulsed-Field; Female; France - epidemiology; Genotype; Geriatrics; Hospital Units; hospital-acquired infection; Human mycoses; Humans; Incidence; Infection Control - methods; Infectious diseases; Male; Medical sciences; Middle Aged; Miscellaneous mycoses; Mycoses; Prevalence; Prospective Studies; pulsed field gel electrophoresis; Risk Factors
• ISSN: 0195-6701; 1532-2939
• DOI: 10.1053/jhin.2000.0849

This prospective study, which included 69 patients over a two-month period, was conducted to evaluate the incidence of community-acquired carriage and hospital-acquired yeasts in elderly patients hospitalized in a short stay care unit. Furthermore, possible person-to-person transmission was investigated by means of genotyping the Candida albicans isolates obtained from samples (throat swabs, urine and stools) systematically taken from the patients at different times during the hospitalization and from healthcare workers (throat swabs and handwashes) in the middle of the observation period. This study showed a high prevalence rate of 64% for community-acquired yeast carriage and a 40% incidence rate for hospital- acquired yeasts. Mycological analysis of the samples from the healthcare workers revealed eight of them to be colonized in the oral cavity. In addition, pulsed field gel electrophoresis and mitochondrial DNA analysis of the C. albicans isolates demonstrated person-to-person transmission. This study suggests that regular mycological sampling should be done as hospitalized elderly patients are frequently colonized by yeasts. Likewise, oropharyngeal swabs from healthcare workers may be helpful in this setting.