High colonization by Candida parapsilosis sensu stricto on hands and surfaces in an adult intensive care unit

Silva, Eliane Martins da; Mansano, Elaine Sciuniti Benites; Mendonca, Patricia; Olegário, Rafael; Tobaldini-Valério, Flávia; Fiorini, Adriana; Svidzinski, Terezinha Inez Estivalet

doi:10.1016/j.mycmed.2020.101110

Cited by 14 publications

(6 citation statements)

References 27 publications

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“…Candida parapsilosis is the most common Candida species isolated from healthcare workers' hands and ICU surfaces [27,28]. The emergence of FRCP strains on these sources is a major threat to critically ill patients who are often empirically treated with FLC for candidemia [18].…”

Section: Discussionmentioning

confidence: 99%

A Brazilian Inter-Hospital Candidemia Outbreak Caused by Fluconazole-Resistant Candida parapsilosis in the COVID-19 Era

Thomaz

Negro

Ribeiro

et al. 2022

JoF

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Horizontal transmission of fluconazole-resistant Candida parapsilosis (FRCP) through healthcare workers’ hands has contributed to the occurrence of candidemia outbreaks worldwide. Since the first COVID-19 case in Brazil was detected in early 2020, hospitals have reinforced hand hygiene and disinfection practices to minimize SARS-CoV-2 contamination. However, a Brazilian cardiology center, which shares ICU patients with a cancer center under a FRCP outbreak since 2019, reported an increased FRCP candidemia incidence in May 2020. Therefore, the purpose of this study was to investigate an inter-hospital candidemia outbreak caused by FRCP isolates during the first year of the COVID-19 pandemic in Brazil. C. parapsilosis bloodstream isolates obtained from the cancer (n = 35) and cardiology (n = 30) centers in 2020 were submitted to microsatellite genotyping and fluconazole susceptibility testing. The ERG11 gene of all isolates from the cardiology center was sequenced and compared to the corresponding sequences of the FRCP genotype responsible for the cancer center outbreak in 2019. Unprecedentedly, most of the FRCP isolates from the cardiology center presented the same genetic profile and Erg11-Y132F mutation detected in the strain that has been causing the persistent outbreak in the cancer center, highlighting the uninterrupted horizontal transmission of clonal isolates in our hospitals during the COVID-19 pandemic.

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Section: Discussionmentioning

confidence: 99%

A Brazilian Inter-Hospital Candidemia Outbreak Caused by Fluconazole-Resistant Candida parapsilosis in the COVID-19 Era

Thomaz

Negro

Ribeiro

et al. 2022

JoF

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“…Similar to the literature, it was the most often isolated fungus among non-albicans Candida in HAIs in our investigation. Studies have shown that C. parapsilosis colonizes the hands of hospital staff and surfaces in hospitals [ 44 , 45 ]. HAIs caused by C. parapsilosis have been documented as a consequence of cross-contamination with healthcare workers’ hands [ 46 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the implementation of WHO infection prevention and control core components in Turkish health care facilities: results from a WHO infection prevention and control assessment framework (IPCAF)—based survey

Azak

Sertçelik

Ersöz

et al. 2023

Antimicrob Resist Infect Control

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Background The core components (CCs) of infection prevention and control (IPC) from World Health Organization (WHO) are crucial for the safety and quality of health care. Our objective was to examine the level of implementation of WHO infection prevention and control core components (IPC CC) in a developing country. We also aimed to evaluate health care-associated infections (HAIs) and antimicrobial resistance (AMR) in intensive care units (ICUs) in association with implemented IPC CCs. Methods Members of the Turkish Infectious Diseases and Clinical Microbiology Specialization Association (EKMUD) were invited to the study via e-mail. Volunteer members of any healt care facilities (HCFs) participated in the study. The investigating doctor of each HCF filled out a questionnaire to collect data on IPC implementations, including the Infection Prevention and Control Assessment Framework (IPCAF) and HAIs/AMR in ICUs in 2021. Results A total of 68 HCFs from seven regions in Türkiye and the Turkish Republic of Northern Cyprus participated while 85% of these were tertiary care hospitals. Fifty (73.5%) HCFs had advanced IPC level, whereas 16 (23.5%) of the 68 hospitals had intermediate IPC levels. The hospitals’ median (IQR) IPCAF score was 668.8 (125.0) points. Workload, staffing and occupancy (CC7; median 70 points) and multimodal strategies (CC5; median 75 points) had the lowest scores. The limited number of nurses were the most important problems. Hospitals with a bed capacity of > 1000 beds had higher rates of HAIs. Certified IPC specialists, frequent feedback, and enough nurses reduced HAIs. The most common HAIs were central line-associated blood stream infections. Most HAIs were caused by gram negative bacteria, which have a high AMR. Conclusions Most HCFs had an advanced level of IPC implementation, for which staffing was an important driver. To further improve care quality and ensure everyone has access to safe care, it is a key element to have enough staff, the availability of certified IPC specialists, and frequent feedback. Although there is a significant decrease in HAI rates compared to previous years, HAI rates are still high and AMR is an important problem. Increasing nurses and reducing workload can prevent HAIs and AMR. Nationwide “Antibiotic Stewardship Programme” should be initiated.

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“…C. parapsilosis is known to exist in hospital water environments, such as in sinks and in milk preparation rooms, which could also be sources of infection during the course of hospital care [ 24 , 25 , 26 ]. Additionally, C. parapsilosis cases have been described previously where the hands of HCWs turned out to be the predominant mode of transmission [ 27 , 28 , 29 , 30 ]. Therefore, we investigated mainly the water environment and hands of HCWs.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Biofilms Formed by C. parapsilosis Causing an Outbreak in a Neonatal Intensive Care Unit

Miyake

Gotoh

Iwahashi

et al. 2022

JoF

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Background: We dealt with the occurrence of an outbreak of Candida parapsilosis in a neonatal intensive care unit (NICU) in September 2020. There have been several reports of C. parapsilosis outbreaks in NICUs. In this study we describe our investigation into both the transmission route and the biofilm of C. parapsilosis. Methods: C. parapsilosis strains were detected in three inpatients and in two environmental cultures in our NICU. One environmental culture was isolated from the incubator used by a fungemia patient, and another was isolated from the humidifier of an incubator that had been used by a nonfungemia patient. To prove their identities, we tested them by micro satellite analysis. We used two methods, dry weight measurements and observation by electron microscopy, to confirm biofilm. Results: Microsatellite analysis showed the five C. parapsilosis cultures were of the same strain. Dry weight measurements and electron microscopy showed C. parapsilosis formed biofilms that amounted to clumps of fungal cells. Conclusions: We concluded that the outbreak happened due to horizontal transfer through the humidifier of the incubator and that the C. parapsilosis had produced biofilm, which promoted an invasive and infectious outbreak. Additionally, biofilm is closely associated with pathogenicity.

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High colonization by Candida parapsilosis sensu stricto on hands and surfaces in an adult intensive care unit

Cited by 14 publications

References 27 publications

A Brazilian Inter-Hospital Candidemia Outbreak Caused by Fluconazole-Resistant Candida parapsilosis in the COVID-19 Era

A Brazilian Inter-Hospital Candidemia Outbreak Caused by Fluconazole-Resistant Candida parapsilosis in the COVID-19 Era

Evaluation of the implementation of WHO infection prevention and control core components in Turkish health care facilities: results from a WHO infection prevention and control assessment framework (IPCAF)—based survey

Characteristics of Biofilms Formed by C. parapsilosis Causing an Outbreak in a Neonatal Intensive Care Unit

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