title: Nosocomial outbreak of Candida parapsilosis fungemia related to intravenous infusions.
abstract: Candida parapsilosis is rarely isolated from blood cultures. Our hospital surveillance detected an increased rate of isolation of C parapsilosis during a four month period. Fourteen postoperative patients receiving intravenous (IV) hyperalimentation and eight burn patients receiving IV albumin were involved. Hectic fever, the major clinical manifestation, was seen in 61% of cases. Therapy in the postoperative patients consisted merely of discontinuing IV catheters and hyperalimentation, while amphotericin B was needed in five of eight burn patients to control persistent fungemia. Epidemiologic analysis identified a source of the organism in the IV-additive preparation room where C parapsilosis was found contaminating a vacuum system. Organisms apparently refluxed into IV bottles when aliquots were removed to accommodate additives. Of 103 patients who received fluids prepared with the contaminated system, 21% became infected with C parapsilosis. Infection surveillance was instrumental in detection and control of the outbreak. Routine guideline should be established to insure the sterility of IV fluids containing additives.
mesh_terms: D000328:Adult; D000368:Aged; D002056:Burns / Q000628:therapy; D002175:Candida / Q000302:isolation & purification; D002177:Candidiasis / Q000382:microbiology / Q000635:transmission*; D003428:Cross Infection / Q000382:microbiology / Q000635:transmission*; D004196:Disease Outbreaks; D006801:Humans; D008824:Michigan; D008875:Middle Aged; D010288:Parenteral Nutrition / Q000009:adverse effects*; D010289:Parenteral Nutrition, Total / Q000009:adverse effects* / Q000295:instrumentation; D011182:Postoperative Care; D011183:Postoperative Complications / Q000382:microbiology; D018805:Sepsis / Q000382:microbiology / Q000635:transmission*; D014946:Wound Infection / Q000382:microbiology