title: Candida parapsilosis candidaemia in a neonatal unit over 7 years: a case series study.
abstract: OBJECTIVE
  To evaluate Candida parapsilosis candidaemia in a neonatal unit over 7 years.
  
  
  METHODS
  Case series study.
  
  
  METHODS
  A 2000-bed tertiary-care university hospital at São Paulo, Brazil.
  
  
  METHODS
  Neonates hospitalised in a 63-bed neonatal unit.
  
  
  METHODS
  We evaluated the incidence of C parapsilosis fungemia in a neonatal unit from 2002 through 2008 and the main microbiological, clinical and epidemiological aspects of this disease in neonates. During the study period an outbreak occurred, an infection control programme was implemented, and isolates from blood and hand healthcare workers (HCWs) were submitted to molecular typing.
  
  
  RESULTS
  During 7 years, there were 36 cases of C parapsilosis fungaemia and annual incidence varied from 0 to 19.7 per 1000 admissions. Evaluating 31 neonates with fungemia, the mean age at diagnosis was 19 days. All children except for one were premature; all had received total parenteral nutrition and all but one had used central venous catheter. Three neonates had received antifungal treatment previously to the diagnosis. Thirty-day mortality was 45%. Only lower birthweight was associated with mortality. C parapsilosis species complex was isolated from hand cultures in eight (11%) of the HCWs (one isolate was identified as C orthopsilosis). By molecular typing no HCW isolate was similar to any of the blood isolates.
  
  
  CONCLUSIONS
  The incidence of C parapsilosis fungemia in a neonatal unit varied widely over 7 years. We observed in our series a higher death rate than that reported in European countries and the USA.
authors.affiliation: Department of Infectious Diseases and LIM 54, University of São Paulo, São Paulo, Brazil.
authors.forename: Lourdes das Neves
authors.initials: Ld
authors.lastname: Miranda
authors.forename: Eliete C A
authors.initials: EC
authors.lastname: Rodrigues
authors.forename: Silvia F
authors.initials: SF
authors.lastname: Costa
authors.forename: Inneke Marie
authors.initials: IM
authors.lastname: van der Heijden
authors.forename: Kátia C
authors.initials: KC
authors.lastname: Dantas
authors.forename: Renata D
authors.initials: RD
authors.lastname: Lobo
authors.forename: Mariusa
authors.initials: M
authors.lastname: Basso
authors.forename: Gláucia F
authors.initials: GF
authors.lastname: Varkulja
authors.forename: Vera Lúcia Jornada
authors.initials: VL
authors.lastname: Krebs
authors.forename: Maria Augusta Bento Cicaroni
authors.initials: MA
authors.lastname: Gibelli
authors.forename: Paulo R
authors.initials: PR
authors.lastname: Criado
authors.forename: Anna Sara
authors.initials: AS
authors.lastname: Levin