title: Outbreak of Candida albicans fungaemia in a neonatal intensive care unit.
abstract: During a 4-month period, 9 premature infants hospitalized in a neonatal intensive care unit (NICU) developed Candida albicans fungaemia. All 9 infants received antifungal agents. Fluconazole was administered in 7 patients and successfully eradicated this organism in 6 with no adverse effects. For epidemiological investigation, 64 environmental specimens and hand-washings of all 54 staff members involved in the NICU were examined for the presence of this organism. No C. albicans could be identified from environmental sources, while the hand-washing of 1 nurse was C. albicans-positive. Two genotyping methods, including electrophoretic karyotyping using contour-clamped homogeneous electric field gel electrophoresis and polymerase chain reaction-based direct sequencing of rRNA gene, were used in the analysis of the isolates recovered from blood cultures of the infants, the hand-washing of the nurse and 7 control isolates. Both methods yielded comparable results and revealed that all 13 isolates from infected infants as well as the isolate from hand washing of the nurse were of the same genotype while the control isolates were distinct. These results suggest that the outbreak of C. albicans fungaemia was caused by a particular strain and possibly via cross-infection. In addition, we showed that fluconazole seemed to be safe and effective in treating C. albicans fungaemia in neonates, although the data were limited.
authors.affiliation: Division of Infectious Diseases, Chang Gung Childrens Hospital, Taoyuan, Taiwan, ROC.
authors.forename: Y C
authors.initials: YC
authors.lastname: Huang
authors.forename: T Y
authors.initials: TY
authors.lastname: Lin
authors.forename: H L
authors.initials: HL
authors.lastname: Peng
authors.forename: J H
authors.initials: JH
authors.lastname: Wu
authors.forename: H Y
authors.initials: HY
authors.lastname: Chang
authors.forename: H S
authors.initials: HS
authors.lastname: Leu
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D002177:Candidiasis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission; D004196:Disease Outbreaks; D018562:Disease Transmission, Infectious; D005260:Female; D016469:Fungemia / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D008297:Male; D012307:Risk Factors; D013624:Taiwan
chemical_list: D000935:Antifungal Agents