Uniform distribution of three Candida albicans microsatellite markers in two French ICU populations supports a lack of nosocomial cross-contamination.
BACKGROUND
The nosocomial acquisition of Candida albicans is a growing concern in intensive care units (ICUs) and understanding the route of contamination is relevant for infection control guidelines.


METHODS
To analyze whether there is a specific ecology for any given hospital, we genotyped C. albicans isolates of the ICU of Versailles hospital (Hospital A) and compared the results with those previously obtained in another ICU in Henri Mondor hospital (Hospital B) using three polymorphic microsatellite markers (PMM).


RESULTS
Among 36 patients with at least one positive culture for C. albicans, 26 had a specific multilocus genotype, two shared a common multilocus genotype, and 8 had the most common multilocus genotype found in the general population. The time interval between periods of hospitalization between patients with common genotypes differed by 13 to 78 days, thus supporting a lack of direct contamination. To confirm this hypothesis, the multilocus genotypic distributions of the three PMM were compared between the two hospitals. No statistically significant difference was observed. Multiple correspondences analysis did not indicate the association of a multilocus genotypic distribution with any given hospital.


CONCLUSIONS
The present epidemiological study supports the conclusions that each patient harbours his/her own isolate, and that nosocomial transmission is not common in any given ICU. This study also supports the usefulness and practicability of PMM for studying the epidemiology of C. albicans.
Eloy
Odile
O
Laboratoire de Parasitologie, Hôpital André Mignot, Le Chesnay, France. oeloy@ch-versailles.fr <oeloy@ch-versailles.fr>
Marque
Stéphanie
S
Botterel
Françoise
F
Stephan
François
F
Costa
Jean-Marc
JM
Lasserre
Virginie
V
Bretagne
Stéphane
S
D000368:Aged; D000369:Aged, 80 and over; D002176:Candida albicans / Q000145:classification / Q000235:genetics*; D002177:Candidiasis / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D018895:Microsatellite Repeats; D008875:Middle Aged; D011110:Polymorphism, Genetic