An outbreak of Candida spp. bloodstream infection in a tertiary care center in Bogotá, Colombia

Abstract

Several cases of Candida bloodstream infections were documented from June to October 2004 at a tertiary care center in Bogotá, Colombia. Since no cases of candidemia had occurred during the preceding four months, an outbreak was declared. As a result, a microbiological study, a revision of infection control practices and a casecontrol study were performed. In all, 18 cases of candidemia were ascertained. Parenteral nutrition (p=0.04), presence of a central line (p=0.03), and severity of illness (p=0.03) were associated with candidemia in bivariate analysis. Diverse Candida species were observed. Candida parapsilosis contamination was found in plastic containers used for transient intravenous (IV) medication storage at the bedside, plastic bags reused for the transportation of IV medicines and cotton used for disinfection of IV ports. Poor infection control practices were widely observed. The outbreak was controlled after elimination of plastic bags used for transportation, instauration of daily disinfection of IV medication containers, acquisition of sterile alcohol swabs for port disinfection and staff education. It was concluded that candidemia was associated with previously-described risk factors and that poor infectioncontrol practices were likely responsible for the outbreak.

Incidencia y prevalencia de candidemia en pacientes críticamente enfermos en Colombia

“…Los datos de incrementos observados durante periodos de tiempo en los hospitales podrían representar brotes en las instituciones; sin embargo, en ausencia de confirmación epidemiológica o molecular, no se puede establecer con certeza. En Colombia sí se han reportado brotes de candidemia en UCI neonatal 23 . Otro de los aspectos importantes en la candidemia ha sido el cambio epidemiológico a expensas de un aumento en los casos de C. no albicans.…”

Comparative Phenotypic Analysis of the Major Fungal Pathogens Candida parapsilosis and Candida albicans

“…C. parapsilosis , a major cause of infection in premature neonates [15], does not appear to have a sexual cycle [16], [17] and does not undergo white-opaque switching [18]. Unlike other Candida species, C. parapsilosis is often isolated from the hands of health care workers and has been responsible for causing outbreaks of infection [19], [20], [21], [22], [23], [24]. C. parapsilosis is responsible for approximately 20% of Candida infections particularly in infants less than 1 year old [25], [26].…”

Candida krusei fungemia in 7 neonates: Clonality tracked to an infusate

“…1 It is difficult to treat owing to intrinsic fluconazole resistance and variable susceptibility to flucytosine and amphotericin B. 2 We report an outbreak of C krusei fungemia in the neonatal Intensive care unit (ICU) of our hospital over a short period of 2 weeks.…”

“…2 A recent study considered the possibility of an outbreak when various samples from 3 patients grew C krusei that differed from one another, but all were related to C krusei isolated from the immediate environment. 3 Thus, potential environmental sources of infection must be screened when this isolate grows in culture from sterile sites.…”

“…However, the diagnosis is commonly missed, even if the Infectious Diseases Society of America and American Thoracic Society guidelines are followed. 2 Given that the clinical manifestations of Legionnaires' disease are nonspecific, laboratory tests are required for diagnosis. The most accurate test is culture on selective media, which is not widely available.…”