Oral colonization: a possible source for candidemia in low-weight neonates.
OBJECTIVE
To check the oral colonization in neonates at high-risk and to associate these cases with candidemia.


METHODS
This study was conducted in the NICU. For six months, 125 high-risk neonates were investigated for oral colonization and septicemia by yeasts. From this total, 19 neonates had yeasts on the oral mucosae and 12 neonates developed fungemia. All of the 12 neonates with fungemia were included in the amount of 19 who have presented oral colonization by yeasts.


RESULTS
There was a species concordance between the yeasts of the oral mucosae and the blood in 6 neonates (50%) among the 12 neonates with oral colonization and septicemia at the same time. The yeasts isolated in these 6 cases regarding the species concordance were Candida albicans (5 cases, 83.4%) and Candida parapsilosis (1 case, 16.6%). All of the cases involving an association were confirmed by PFGE. All of the strains of yeasts involved in oral colonization and also blood presented the same karyotype. A total of 66.6% of the patients with strains in agreement progressed to death.


CONCLUSIONS
The results indicate the relevance of monitoring the oral microbiota, as a possible source of fungal infection, and assisting to develop appropriate therapeutic strategy.
Department of Microbiology, Institute of Biomedical Sciences II, University of São Paulo (USP), avenue Profesor Lineu Prestes, 1374, CEP 05508-900, São Paulo, Brazil.
G C M
GC
Batista
College of Medicine, University of São Paulo, São Paulo, Brazil.
V L J
VL
Krebs
Department of Microbiology, Institute of Biomedical Sciences II, University of São Paulo (USP), avenue Profesor Lineu Prestes, 1374, CEP 05508-900, São Paulo, Brazil.
L S
LS
Ruiz
Department of Pharmacy, Health Sciences, Universidade Estadual do Centro-Oeste (UNICENTRO), Guarapuava, Paraná, Brazil.
M E
ME
Auler
Division of Infections and Tropical Diseases, Federal University of Mato Grosso, Mato Grosso, MT, Brazil.
R C
RC
Hahn
Department of Microbiology, Institute of Biomedical Sciences II, University of São Paulo (USP), avenue Profesor Lineu Prestes, 1374, CEP 05508-900, São Paulo, Brazil. Electronic address: crpmicol@uol.com.br.
C R
CR
Paula
D001938:Brazil / Q000453:epidemiology; D002175:Candida / Q000254:growth & development* / Q000302:isolation & purification; D058387:Candidemia / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D009061:Mouth Mucosa / Q000382:microbiology*; D016533:Mycological Typing Techniques; D010843:Pichia / Q000254:growth & development / Q000302:isolation & purification; D018805:Sepsis / Q000453:epidemiology / Q000382:microbiology; D014250:Trichosporon / Q000254:growth & development / Q000302:isolation & purification
Candida; Candidemia; Colonisation orale; Neonates; Nouveau-nés; Oral colonization