Cluster of Candida parapsilosis primary bloodstream infection in a neonatal intensive care unit

Cl, da Silva; Rm, dos Santos; Colombo, Arnaldo Lopes

doi:10.1590/s1413-86702001000100005

Cited by 19 publications

(11 citation statements)

References 35 publications

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“…In contrast to C. parapsilosis, which can cause clusters and common-source outbreaks (3,12,19,33), the potential of C. tropicalis for nosocomial transmission has not been well studied. During the 4-month early period of our prospective study, we encountered a cluster of two cases of fungemia and 17 cases of colonization.…”

Section: Discussionmentioning

confidence: 99%

“…There are several possible explanations for this pathogen shift away from C. albicans toward other species, including several diagnostic and therapeutic interventions, such as the increasing use of CVCs and NADP. For example, C. parapsilosis has been significantly associated with the use of NADP and the presence of CVCs (3,12). In addition, the extensive use of antifungal prophylaxis may have played an important role in this changing pattern of fungal pathogens isolated in some centers (8).…”

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confidence: 99%

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Candida tropicalis in a Neonatal Intensive Care Unit: Epidemiologic and Molecular Analysis of an Outbreak of Infection with an Uncommon Neonatal Pathogen

et al. 2003

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, two episodes of Candida tropicalis fungemia occurred in the Aristotle University neonatal intensive care unit (ICU). To investigate this uncommon event, a prospective study of fungal colonization and infection was conducted. From December 1998 to December 1999, surveillance cultures of the oral cavities and perinea of the 593 of the 781 neonates admitted to the neonatal ICU who were expected to stay for >7 days were performed. Potential environmental reservoirs and possible risk factors for acquisition of C. tropicalis were searched for. Molecular epidemiologic studies by two methods of restriction fragment length polymorphism analysis and two methods of random amplified polymorphic DNA analysis were performed. Seventy-two neonates were colonized by yeasts (12.1%), of which 30 were colonized by Candida albicans, 17 were colonized by C. tropicalis, and 5 were colonized by Candida parapsilosis. From December 1998 to December 1999, 10 cases of fungemia occurred; 6 were due to C. parapsilosis, 2 were due to C. tropicalis, 1 was due to Candida glabrata, and 1 was due to Trichosporon asahii (12.8/1,000 admissions). Fungemia occurred more frequently in colonized than in noncolonized neonates (P < 0.0001). Genetic analysis of 11 colonization isolates and the two late blood isolates of C. tropicalis demonstrated two genotypes. One blood isolate and nine colonization isolates belonged to a single type. The fungemia/colonization ratio of C. parapsilosis (3/5) was greater than that of C. tropicalis (2/17, P ‫؍‬ 0.05), other non-C. albicans Candida spp. (1/11, P ‫؍‬ 0.02), or C. albicans (0/27, P ‫؍‬ 0.05). Extensive environmental cultures revealed no common source of C. tropicalis or C. parapsilosis. There was neither prophylactic use of azoles nor other risk factors found for acquisition of C. tropicalis except for total parenteral nutrition. A substantial risk of colonization by non-C. albicans Candida spp. in the neonatal ICU may lead to a preponderance of C. tropicalis as a significant cause of neonatal fungemia.Candida spp. are common causes of nosocomial invasive infections in neonatal intensive care units (ICUs). Although Candida albicans has historically been the most frequently isolated species, infections caused by non-C. albicans Candida spp. have been diagnosed with increased frequency in recent years (14,17). In particular, Candida parapsilosis has become the predominant fungal pathogen in many neonatal ICUs (11,14,17). Moreover, recent studies have shown that C. parapsilosis is often a cause of clusters and common-source outbreaks (12, 29).In contrast, little is known about the roles of other non-C. albicans Candida spp. in neonatal ICUs (4). To our knowledge, Candida tropicalis fungemia in neonates has not been adequately described, and the significance of mucocutaneous colonization of neonates by this pathogen remains speculative.Two chronologically related unusual cases of C. tropicalis fungemia that occurred in the Aristotle University neonatal ICU prompted us to initiate a prospective study of fungal co...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Candida tropicalis in a Neonatal Intensive Care Unit: Epidemiologic and Molecular Analysis of an Outbreak of Infection with an Uncommon Neonatal Pathogen

et al. 2003

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“…13,14 In neonatal age, very low-birth-weight infants are the population at greatest risk for nosocomial infection caused by C. parapsilosis , especially when they present signs of gastrointestinal tract disease, compromised skin integrity, or long term endotracheal intubation. 2,9 Few data, however, exist on risk factors and outcome of candidemia caused by C. parapsilosis in pediatric patients.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology, Risk Factors and Outcome of Candida parapsilosis Bloodstream Infection in Children

Dotis

Prasad

Zaoutis

et al. 2012

Pediatric Infectious Disease Journal

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Background Candida parapsilosis constitutes a common Candida spp. isolated in children with candidemia. Few data exist on risk factors and outcome of candidemia caused by C. parapsilosis in pediatric patients. Methods We conducted a retrospective analysis of demographic data, clinical features, therapeutic procedures and outcomes associated with Candida bloodstream infections (BSIs) that occurred at the Children’s Hospital of Philadelphia between 1997–2009. Results Among 406 Candida BSIs, Candida albicans accounted for 198 (49%), C. parapsilosis for 99 (24%) and all other species for 109 (27%) episodes. There was no consistent change in proportion of C. parapsilosis BSIs during the study. C. parapsilosis BSI was more frequent than non-parapsilosis Candida spp. at age ≤2 years as compared with older patients [62% vs. 50%; OR=1.24, 95% CI=1.03–1.51, p=0.038]. Patients with C. parapsilosis were more likely to be mechanically ventilated within 48 hours of BSI (OR=1.38, 95% CI=1.01–1.85, p=0.047). Presence of a urinary catheter a week before infection was a protective factor for developing candidemia due to C. parapsilosis spp. (p=0.003). No significant differences were found between the two groups in presence of central intravascular catheters, co-morbidities and clinical or surgical procedures, previous administration of immunosuppressive or antifungal agents and mortality. Conclusions C. parapsilosis is the second most frequent cause of candidemia after C. albicans. While it is more frequent at the age of ≤2 years and is more likely associated with mechanical ventilation than other Candida spp., mortality does not significantly differ between those with and without C. parapsilosis candidemia.

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“…The yeast is capable of forming biofilm in gucosilated solutions and adhering to plastic materials, such as catheters used for parenteral nutrition. Over the last few years, outbreaks and clusters of cross-transmission, total parenteral nutrition solutions, intravascular devices, and medications have been related to C. parapsilosis fungemia (5,10,21). In addition, C. parapsilosis is an important pathogen of onychomycosis in fingernails (3,11).…”

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confidence: 99%

Candida isolates in tertiary hospitals in northeastern Brazil

Hinrichsen

Falcão²,

Vilella

et al. 2009

Braz. J. Microbiol.

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Candida is an opportunistic pathogen that affects high-risk patients who are either immunocompromised or critically ill and is associated with almost 80% of all nosocomial fungal infections, representing the major cause of fungemia with high mortality rates (40%). Candida albicans is the main cause of candidemia and among the non-albicans species C. parapsilosis, C. glabrata and C. tropicalis are the most frequent agents.

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Cluster of Candida parapsilosis primary bloodstream infection in a neonatal intensive care unit

Cited by 19 publications

References 35 publications

Candida tropicalis in a Neonatal Intensive Care Unit: Epidemiologic and Molecular Analysis of an Outbreak of Infection with an Uncommon Neonatal Pathogen

Candida tropicalis in a Neonatal Intensive Care Unit: Epidemiologic and Molecular Analysis of an Outbreak of Infection with an Uncommon Neonatal Pathogen

Epidemiology, Risk Factors and Outcome of Candida parapsilosis Bloodstream Infection in Children

Candida isolates in tertiary hospitals in northeastern Brazil

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