title: Outbreak of fungemia caused by Candida parapsilosis in a neonatal intensive care unit: molecular investigation through microsatellite analysis.
abstract: BACKGROUND
  Opportunistic infections are an increasingly common problem in hospitals, and the yeast Candida parapsilosis has emerged as an important nosocomial pathogen, especially in neonatal intensive care units (NICUs) where it has been responsible for outbreak cases. Risk factors for C. parapsilosis infection in neonates include prematurity, very low birth weight, prolonged hospitalization, indwelling central venous catheters, hyperalimentation, intravenous fatty emulsions and broad spectrum antibiotic therapy. Molecular methods are widely used to elucidate these hospital outbreaks, establishing genetic variations among strains of yeast.
  
  
  OBJECTIVE
  The aim of this study was to detect an outbreak of C. parapsilosis in an NICU at the "Hospital das Clinicas", Faculty of Medicine of Botucatu, a tertiary hospital located in São Paulo, Brazil, using the molecular genotyping by the microsatellite markers analysis.
  
  
  METHODS
  A total of 11 cases of fungemia caused by C. parapsilosis were identified during a period of 43 days in the NICU. To confirm the outbreak all strains were molecularly typed using the technique of microsatellites.
  
  
  RESULTS
  Out of the 11 yeast samples studied, nine showed the same genotypic profile using the technique of microsatellites.
  
  
  CONCLUSIONS
  Our study shows that the technique of microsatellites can be useful for these purposes. In conclusion, we detected the presence of an outbreak of C. parapsilosis in the NICU of the hospital analyzed, emphasizing the importance of using molecular tools, for the early detection of hospital outbreaks, and for the introduction of effective preventive measures, especially in NICUs.
authors.affiliation: Department of Microbiology, Institute of Biomedical Sciences II, University of São Paulo, Av. Prof. Lineu Prestes, 1374, CEP 05508-900, São Paulo, Brazil. lu_ruiz74@hotmail.com
authors.forename: Luciana
authors.initials: L
authors.lastname: da Silva Ruiz
authors.forename: Augusto Cezar
authors.initials: AC
authors.lastname: Montelli
authors.forename: Maria de Fátima
authors.initials: Mde F
authors.lastname: Sugizaki
authors.forename: Eriques Gonçalves
authors.initials: EG
authors.lastname: Da Silva
authors.forename: Georgea Carla Matuura
authors.initials: GC
authors.lastname: De Batista
authors.forename: Débora
authors.initials: D
authors.lastname: Moreira
authors.forename: Claudete Rodrigues
authors.initials: CR
authors.lastname: Paula
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002175:Candida / Q000235:genetics / Q000302:isolation & purification*; D058387:Candidemia / Q000453:epidemiology / Q000382:microbiology*; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D004271:DNA, Fungal / Q000235:genetics* / Q000302:isolation & purification; D004196:Disease Outbreaks; D005260:Female; D005838:Genotype; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D018895:Microsatellite Repeats; D016533:Mycological Typing Techniques; D009894:Opportunistic Infections / Q000453:epidemiology / Q000382:microbiology*; D012307:Risk Factors
chemical_list: D004271:DNA, Fungal