Horizontal transmission of Candida parapsilosis candidemia in a neonatal intensive care unit.
This report describes the nosocomial acquisition of Candida parapsilosis candidemia by one of the six premature newborns housed in the same room of a neonatal intensive care unit at the Ospedale Santa Chiara, Pisa, Italy. The infant had progeria, a disorder characterized by retarded physical development and progressive senile degeneration. The infant, who was not found to harbor C. parapsilosis at the time of his admission to the intensive care unit, had exhibited symptomatic conjunctivitis before the onset of a severe bloodstream infection. In order to evaluate the source of infection and the route of transmission, two independent molecular typing methods were used to determine the genetic relatedness among the isolates recovered from the newborn, the inanimate hospital environment, hospital personnel, topically and intravenously administered medicaments, and indwelling catheters. Among the isolates collected, only those recovered from the hands of two nurses attending the newborns and from both the conjunctiva and the blood of the infected infant were genetically indistinguishable. Since C. parapsilosis was never recovered from indwelling catheters or from any of the drugs administered to the newborn, we concluded that (i) horizontal transmission of C. parapsilosis occurred through direct interaction between nurses and the newborn and (ii) the conjunctiva was the site through which C. parapsilosis entered the bloodstream. This finding highlights the possibility that a previous C. parapsilosis colonization and/or infection of other body sites may be a predisposing condition for subsequent C. parapsilosis hematogenous dissemination in severely ill newborns.
Lupetti
Antonella
A
Dipartimento di Patologia Sperimentale, Biotecnologie Mediche, Infettivologia ed Epidemiologia, Università degli Studi di Pisa, Pisa, Italy.
Tavanti
Arianna
A
Davini
Paola
P
Ghelardi
Emilia
E
Corsini
Valerio
V
Merusi
Ilaria
I
Boldrini
Antonio
A
Campa
Mario
M
Senesi
Sonia
S
D002175:Candida / Q000235:genetics / Q000302:isolation & purification; D002177:Candidiasis / Q000150:complications / Q000382:microbiology / Q000635:transmission*; D003228:Conjunctiva / Q000382:microbiology; D003428:Cross Infection / Q000150:complications / Q000382:microbiology / Q000635:transmission*; D016172:DNA Fingerprinting; D004271:DNA, Fungal / Q000235:genetics / Q000302:isolation & purification; D004783:Environmental Microbiology; D016469:Fungemia / Q000150:complications / Q000382:microbiology / Q000635:transmission*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D017757:Infectious Disease Transmission, Professional-to-Patient; D007363:Intensive Care Units, Neonatal; D007558:Italy; D007621:Karyotyping; D008297:Male; D009741:Nursing Staff, Hospital; D011371:Progeria / Q000150:complications; D019105:Random Amplified Polymorphic DNA Technique; D012867:Skin / Q000382:microbiology
D004271:DNA, Fungal