title: Molecular investigation of a fungemia outbreak due to Candida parapsilosis in an intensive care unit.
abstract: We investigated a nosocomial cluster of four Candida parapsilosis fungemia episodes that occurred in a neurological intensive care unit over a two-week period. The four infected patients had received parenteral nutrition through central lines, and all four had catheter-related candidemia. All of the isolates were susceptible to all of the antifungals tested, including amphotericin B, fluconazole, voriconazole, and caspofungin. They had strictly related fingerprints, based on randomly amplified polymorphic DNA analysis. Additional DNA sequencing data revealed that they were same strain. Although no isolate of Candida parapsilosis was recovered from other clinical, surveillance, or environmental samples, nosocomial spread of this yeast ceased, following the reinforcement of infection-control measures. Candida parapsilosis may require an intravascular foreign body to cause fungemia, but this outbreak shows that it can be transmitted nosocomially and can cause epidemics.
authors.affiliation: Department of Clinical Microbiology and Infectious Diseases and Infection Control Committee, Gazi University, Tokyo, Japan.
authors.forename: Murat
authors.initials: M
authors.lastname: Dizbay
authors.forename: Ayse
authors.initials: A
authors.lastname: Kalkanci
authors.forename: Busra Ergut
authors.initials: BE
authors.lastname: Sezer
authors.forename: Firdevs
authors.initials: F
authors.lastname: Aktas
authors.forename: Sibel
authors.initials: S
authors.lastname: Aydogan
authors.forename: Isil
authors.initials: I
authors.lastname: Fidan
authors.forename: Semra
authors.initials: S
authors.lastname: Kustimur
authors.forename: Takashi
authors.initials: T
authors.lastname: Sugita
mesh_terms: D000368:Aged; D000935:Antifungal Agents / Q000494:pharmacology; D001938:Brazil; D002175:Candida / Q000145:classification / Q000187:drug effects / Q000235:genetics*; D002177:Candidiasis / Q000453:epidemiology / Q000382:microbiology*; D002404:Catheterization / Q000009:adverse effects; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D004271:DNA, Fungal / Q000032:analysis; D004196:Disease Outbreaks; D005260:Female; D016469:Fungemia / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D016533:Mycological Typing Techniques / Q000379:methods; D010288:Parenteral Nutrition / Q000295:instrumentation; D019105:Random Amplified Polymorphic DNA Technique; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000935:Antifungal Agents; D004271:DNA, Fungal