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C. parapsilosis clone identified, linked to bloodstream infections
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Candida parapsilosis can spread clonally and, therefore, can rapidly cause a nosocomial outbreak from just one isolate, according to data presented at the 2014 European Congress of Clinical Microbiology and Infectious Diseases.
Yasemin Cag, MD, of Lutfi Kirdar Kartal Training and Research Hospital in Istanbul, and colleagues investigated an outbreak of C. parapsilosis in their hospital’s ICUs between July and October 2012. They sought to define the relationship between C. parapsilosis isolates and bloodstream infections. The mean age of the patients was 61 years.
Besides positive patient cultures, environmental cultures and cultures from health care workers’ hands also were studied. Researchers evaluated the hospital’s compliance with infection control measures and reinforced infection control education.
Thirteen cases of C. parapsilosis bloodstream infections were identified during the study period, three of which were related to central venous catheters. Besides the 13 isolates discovered from the cases during the study period, five isolates from previous cases between January 2011 and June 2012 were included in their analysis.
The mean candida score was 3. The mean length of stay in the ICU before infection developed was 33 days. All but one patient received wide-spectrum antibiotics within the last 2 weeks. Antifungal treatment resulted in microbiological cure for nine patients. Six patients died. Health care worker and environmental cultures were negative for C. parapsilosis.
Molecular typing showed 10 of the 13 outbreak isolates and four of the five previous isolates were from the same clone. All isolates were susceptible to the antifungals amphotericin B, flucytosine, fluconazole, voriconazole and caspofungin (Cancidas, Merck).
Researchers reported that the outbreak was controlled within the 11-week study period because of repeated education to increase infection control compliance in ICUs.
“C. parapsilosis can spread clonally and rapidly, causing a nosocomial outbreak. Even one isolate of C. parapsilosis in a unit can point the way of an outbreak. In that case, molecular typing helps to investigate suspected outbreaks in hospitals,” the researchers concluded.
For more information:
Cag Y. Abstract P1630. Presented at: European Congress of Clinical Microbiology and Infectious Diseases; May 10-13, 2014; Barcelona, Spain.