Candida parapsilosis fungemia in neonates: genotyping results suggest healthcare workers hands as source, and review of published studies

Abstract

An outbreak of Candida parapsilosis fungemia involving 17 neonatal intensive care unit (NICU) patients was studied. There were 14 blood culture and nine colonizing isolates from other sites available. The hands of NICU healthcare workers (HCW) yielded eight isolates. Screening of the isolates by random amplified polymorphic DNA (RAPD) method showed only three profiles. Typing by restriction fragment length polymorphism (RFLP) revealed all blood isolates were RFLP subtype VII-1. Among the nine infant colonizing isolates, there were four different RFLP subtypes; four of the isolates were subtype VII-1. Seven of the eight isolates from HCW were RFLP subtype VII-1. The majority of infant colonizers were not found in the blood, suggesting a possible direct spread of the epidemic subtype VII-1 strain from HCW hands to infant blood. The source of the infant colonizing strains is unclear, but non-VII-1 strains may be largely of maternal origin and VII-1 strains from HCW. These findings reinforce prior studies that have implicated HCW hands as the source of nosocomial, including neonatal, fungemia.

Nosocomial Candiduria in Critically Ill Patients Admitted to Intensive Care Units in Qazvin, Iran

“…This may relate to the ability to adhere to skin, plastic, and multiply insolutions containing glucose. Interestingly, 60% of the C. parapsilosis isolated in our study were obtained from patients with diabetes mellitus (23,24). In addition, it is not all members of the C. parapsilosis family can be virulent, and between them, C. metapsilosis is an environmental organism, rarely isolated from clinical samples (23).…”

“…Due to the capacity of C. parapsilosis family for biofilm formation, they have emerged as main opportunistic and nosocomial pathogens (23,24). This may relate to the ability to adhere to skin, plastic, and multiply insolutions containing glucose.…”

Candidemia em unidade materno infantil de referência: aspectos clínico-epidemiológicos e fatores de risco em prematuros com peso inferior a 1.500 g

“…Por outro lado, no estudo de Ali et al 15 , os quais afirmam que a espécie de fungo mais encontrada em UTI Neonatal ainda é a C. albicans. O aumento na incidência de infecção por C. parapsilosis pode ser explicado pelo fato de sua transmissão ocorrer sem pré-colonização, podendo ser transmitida horizontalmente ou pelo contato com as mãos dos prestadores de cuidados de saúde 20,21 . Diferentemente de C. albicans que geralmente é precedida de colonização para desenvolver a doença invasiva.…”

Candidiasis invasoras en recién nacidos: diagnóstico, tratamiento y prevención

“…La principal fuente de adquisición de C. albicans es el canal del parto, a diferencia de C. parapsilosis que se asocia en mayor Infectología al Día medida a una transmisión horizontal 11 . Se han comunicado brotes de CI por C. parapsilosis en UCIN, secundarios a la transmisión por las manos del personal 12,13 .…”