title: Investigation of a cluster of Candida albicans invasive Candidiasis in a neonatal intensive care unit by pulsed-field gel electrophoresis.
abstract: Nosocomial invasive candidiasis (IC) has emerged as a major problem in neonatal intensive care units (NICUs). We investigated herein the temporal clustering of six cases of neonatal IC due to Candida albicans in an NICU. Eighteen isolates obtained from the six neonates and two isolates from two health care workers (HCWs) working at the same unit and suffering from fingers' onychomycosis were genotyped by electrophoretic karyotyping (EK) and restriction endonuclease analysis of genomic DNA by using Sfi I (PFGE-Sfi I). PFGE-Sfi I was more effective in discriminating between temporally related isolates. It showed that (i) both HCWs had specific strains excluding them as a source of infections in neonates. (ii) Isolates collected from three neonates were identical providing evidence of their clonal origin and the occurrence of a horizontal transmission of C. albicans in the unit. (iii) The three remaining neonates had specific strains confirming that the IC cases were coincidental. (iv) Microevolution occurred in one catheter-related candidemia case. Our results illustrate the relevance of the molecular approach to investigate suspected outbreaks in hospital surveys and the effectiveness of PFGE-Sfi I for typing of epidemiologically related C. albicans isolates.
authors.affiliation: UR02SP13 Research Unit, Ministry of Public Health, Tunisia. abdeljeliljihene@yahoo.fr
authors.forename: Jihene
authors.initials: J
authors.lastname: Ben Abdeljelil
authors.forename: Fatma
authors.initials: F
authors.lastname: Saghrouni
authors.forename: Imene
authors.initials: I
authors.lastname: Khammari
authors.forename: Soukeina
authors.initials: S
authors.lastname: Gheith
authors.forename: Akila
authors.initials: A
authors.lastname: Fathallah
authors.forename: Moncef
authors.initials: M
authors.lastname: Ben Said
authors.forename: Jalel
authors.initials: J
authors.lastname: Boukadida
mesh_terms: D002176:Candida albicans / Q000235:genetics / Q000302:isolation & purification*; D002177:Candidiasis / Q000453:epidemiology* / Q000382:microbiology; D016000:Cluster Analysis; D004271:DNA, Fungal; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D014416:Tunisia / Q000453:epidemiology
chemical_list: D004271:DNA, Fungal