title: Molecular epidemiology of Candida albicans colonization and fungemia in very low birthweight infants.
abstract: OBJECTIVE
  This study investigated the relationship between colonization and fungemia.
  
  
  METHODS
  This was a prospective study involving surveillance cultures of the nares, base of umbilicus, point of entry of umbilical catheter and parenteral fluids. Blood cultures were done when sepsis was suspected. All Candida albicans isolates were typed using restriction enzyme analysis of DNA.
  
  
  METHODS
  Patients were from the neonatal intensive care unit of a tertiary care hospital.
  
  
  METHODS
  Twenty-nine very low birthweight infants.
  
  
  RESULTS
  Eleven babies were colonized with C albicans and five of these babies developed fungemia, including five of seven who were colonized at the point of entry of the umbilical catheter. Three different strains of C albicans caused fungemia. In four of the five patients, initial catheter entry site isolates were identical to the subsequent blood isolates. Occasionally, infants were colonized with more than one strain of C albicans.
  
  
  CONCLUSIONS
  Preceding colonization with C albicans and, in particular, colonization at the site of entry of umbilical vascular catheters are risk factors for subsequent development of C albicans fungemia. Fungemic and colonizing isolates are usually identical to one another by DNA typing.
authors.affiliation: Division of Infectious Diseases, Department of Pediatrics, University of Alberta, Edmonton, Alberta; and Departments of Medicine and Hospital Infection Control, Oregon Health Sciences University, Portland, Oregon.
authors.forename: J L
authors.initials: JL
authors.lastname: Robinson
authors.forename: A I
authors.initials: AI
authors.lastname: Hartstein
authors.forename: R U
authors.initials: RU
authors.lastname: Meuser
authors.forename: V H
authors.initials: VH
authors.lastname: Morthland
authors.forename: M E
authors.initials: ME
authors.lastname: Dragoon
authors.forename: W M
authors.initials: WM
authors.lastname: Wenman