title: Candida colonisation as a source for candidaemia.
abstract: Candida spp. are important healthcare-associated pathogens. Identifying the source of infection is important for prevention and control strategies. The objective of this study was to evaluate candida colonisation sites as potential sources for candidaemia. Sixty-three consecutive patients with a positive blood culture for candida were included. Surveillance cultures were collected from urine, rectum, oropharynx, skin, intravascular catheter tip and skin around catheter. Molecular typing was performed when the same species of candida was isolated from blood and surveillance sites of a patient. C. albicans was associated with 42% of candidaemias, C. parapsilosis 33%, C. tropicalis 16% and C. guilliermondii, C. krusei, C. glabrata, C. holmii and C. metapsilosis were all 2% each. Six of 10 C. parapsilosis catheter tip isolates were indistinguishable from corresponding blood isolates (all in neonates). C. albicans isolates from blood were indistinguishable from corresponding gastrointestinal tract isolates in 13 of 26 patients and from catheter tip isolates in two patients. In conclusion, the results suggest that gastrointestinal colonisation is the probable source of C. albicans candidaemia and C. parapsilosis is exogenous.
authors.affiliation: Department of Infectious Diseases and LIM 54, University of São Paulo, São Paulo, Brazil.
authors.forename: L N
authors.initials: LN
authors.lastname: Miranda
authors.forename: I M
authors.initials: IM
authors.lastname: van der Heijden
authors.forename: S F
authors.initials: SF
authors.lastname: Costa
authors.forename: A P I
authors.initials: AP
authors.lastname: Sousa
authors.forename: R A
authors.initials: RA
authors.lastname: Sienra
authors.forename: S
authors.initials: S
authors.lastname: Gobara
authors.forename: C R
authors.initials: CR
authors.lastname: Santos
authors.forename: R D
authors.initials: RD
authors.lastname: Lobo
authors.forename: V P
authors.initials: VP
authors.lastname: Pessoa
authors.forename: A S
authors.initials: AS
authors.lastname: Levin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002175:Candida / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D002177:Candidiasis / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D016172:DNA Fingerprinting; D004271:DNA, Fungal / Q000235:genetics; D005260:Female; D016469:Fungemia / Q000209:etiology* / Q000382:microbiology*; D041981:Gastrointestinal Tract / Q000382:microbiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D016533:Mycological Typing Techniques; D055815:Young Adult
chemical_list: D004271:DNA, Fungal