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Genetic Relatedness Among Candida tropicalis Isolates From Sporadic Cases of Fungemia in Two University Hospitals in Korea

  • Jong Hee Shin (a1), Mi-Na Kim (a2), Dong Hyeon Shin (a3), Sook-In Jung (a3), Kwang Jin Kim (a1), Duck Cho (a1), Seung Jung Kee (a1), Myung Geun Shin (a1), Soon Pal Suh (a1) and Dong Wook Ryang (a1)...

Abstract

Objective:

To compare the epidemiology and genetic relatedness of Candida tropicalis isolates causing bloodstream infection (BSI) in two hospitals.

Setting:

Two tertiary-care hospitals in Korea.

Methods:

A retrospective molecular epidemiologic analysis using pulsed-field gel electrophoresis (PFGE) was performed with 49 C. tropicalis isolates from sporadic cases of BSI. The isolates were collected from 27 patients at Chonnam National University Hospital (CUH) during a 6-year period and 22 patients at Asan Medical Center (AMC) during a 2-year period.

Results:

Based on the PFGE patterns, the average similarity value (SAB) for the 27 isolates from CUH was 0.84 ± 0.08, which was significantly higher than that for the 22 isolates from AMC (0.78 ± 0.06; P < .001). Of the 49 strains from patients at the 2 hospitals, 9 isolates were placed into 3 subtypes with SAB values of 1.0, which indicated that they were identical. All 9 of these strains were isolated from CUH patients, and each type strain was isolated sporadically during a period ranging from 4 months to 3 years. On comparison of the clinical characteristics of the patients of the 2 hospitals, the CUH strains were isolated more frequently from non-neutropenic patients and patients with central venous catheter–related fungemia; cases from CUH had a better outcome than those from AMC (P < .05).

Conclusions:

These data show that the clinical and epidemiologic characteristics of C. tropicalis fungemia may differ markedly among hospitals and that some cases of C. tropicalis fungemia may be caused by endemic strains within a hospital.

Copyright

Corresponding author

Department of Laboratory Medicine, Chonnam National University Medical School, 8 Hakdong Dongku, Gwangju 501-757, South Korea

References

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1.Komshian, SV, Uwaydah, AK, Sobel, JD, Crane, LR. Fungemia caused by Candida species and Torulopsis glabrata in the hospitalized patient: frequency, characteristics, and evaluation of factors influencing outcome. Rev Infect Dis 1989;11:379390.
2.Wingard, JR. Importance of Candida species other than C. albicans as pathogens in oncology patients. Clin Infect Dis 1995;20:115125.
3.Pfaller, MA. Nosocomial candidiasis: emerging species, reservoirs, and modes of transmission. Clin Infect Dis 1996;22:S89S94.
4.Walsh, TJ, Merz, WG. Pathologic features in the human alimentary tract associated with invasiveness of Candida tropicalis. Am J Clin Pathol 1986;85:498502.
5.Pfaller, MA, Cabezudo, I, Koontz, F, Bale, M, Gingrich, R. Predictive value of surveillance cultures for systemic infection due to Candida species. Eur J Clin Microbiol 1987;6:628633.
6.Kontoyiannis, DP, Vaziri, I, Hanna, HA, et al.Risk factors for Candida tropicalis fungemia in patients with cancer. Clin Infect Dis 2001;33:16761681.
7.Goldani, LZ, Mario, PS. Candida tropicalis fungemia in a tertiary care hospital. J Infect 2003;46:155160.
8.Pfaller, MA, Lockhart, SR, Pujol, C, et al.Hospital specificity, region specificity, and fluconazole resistance of Candida albicans bloodstream isolates. J Clin Microbiol 1998;36:15181529.
9.Doebbeling, BN, Lehmann, PF, Hollis, RJ, et al.Comparison of pulsed-field gel electrophoresis with isoenzyme profiles as a typing system for Candida tropicalis. Clin Infect Dis 1993;16:377383.
10.Zhang, J, Hollis, RJ, Pfaller, MA. Variations in DNA subtype and antifungal susceptibility among clinical isolates of Candida tropicalis. Diagn Microbiol Infect Dis 1997;27:6367.
11.Hunter, PR, Gaston, MA. Numerical index of the discriminatory ability of typing systems: an application of Simpson's index of diversity. J Clin Microbiol 1988;26:24652466.
12.Richard, B, Thomson, JR, Miller, JM. Specimen collection, transport, and processing: bacteriology. In: Murray, PR, Baron, EJ, Jorgensen, JH, Pfaller, MA, Yolken, RH, eds. Manual of Clinical Microbiology, ed. 8. Washington, DC: American Society for Microbiology; 2003:286330.
13.Rex, JH, Bennett, JE, Sugar, AM, et al.A randomized trial comparing fluconazole with amphotericin B for the treatment of candidemia in patients without neutropenia. N Engl J Med 1994;331:13251330.
14.Doebbeling, BN, Hollis, RJ, Isenberg, HD, Wenzel, RP, Pfaller, MA. Restriction fragment analysis of a Candida tropicalis outbreak of sternal wound infections. J Clin Microbiol 1991;29:12681270.
15.Vazquez, JA, Beckley, A, Donabedian, S, Sobel, JD, Zervos, MJ. Comparison of restriction enzyme analysis versus pulsed-field gradient gel electrophoresis as a typing system for Torulopsis glabrata and Candida species other than C. albicans. J Clin Microbiol 1993;31:20212030.
16.Roilides, E, Farmaki, E, Evdoridou, J, et al.Candida tropicalis in a neonatal intensive care unit: epidemiologic and molecular analysis of an outbreak of infection with an uncommon neonatal pathogen. J Clin Microbiol 2003;41:735741.
17.Ferra, C, Doebbeling, BN, Hollis, RJ, Pfaller, MA, Lee, CK, Gingrich, RD. Candida tropicalis vertebral osteomyelitis: a late sequela of fungemia. Clin Infect Dis 1994;19:697703.
18.Walsh, TJ, Francesconi, A, Kasai, M, Chanock, SJ. PCR and single-strand conformational polymorphism for recognition of medically important opportunistic fungi. J Clin Microbiol 1995;33:32163220.
19.Joly, S, Pujol, C, Schroppel, K, Soll, DR. Development of two species-specific fingerprinting probes for broad computer-assisted epidemiological studies of Candida tropicalis. J Clin Microbiol 1996;34:30633071.
20.Pfaller, MA, Rhine-Chalberg, J, Barry, AL, Rex, JH. Strain variation and antifungal susceptibility among bloodstream isolates of Candida species from 21 different medical institutions. Clin Infect Dis 1995;21:15071509.
21.Khatib, R, Ayeni, O, Riederer, KM, Briski, LE, Wilson, FM. Strain relatedness in persistent and recurrent candiduria. J Urol 1998;159:20542056.
22.Sadhu, C, McEachern, MJ, Rustchenko-Bulgac, EP, Schmid, J, Soll, DR, Hicks, JB. Telomeric and dispersed repeat sequences in Candida yeasts and their use in strain identification. J Bacteriol 1991;173:842850.
23.Sobel, JD, Rex, JH. Invasive candidiasis: turning risk into a practical prevention policy? Clin Infect Dis 2001;33:187190.
24.Nguyen, MH, Peacock, JE JrTanner, DC, et al.Therapeutic approaches in patients with candidemia: evaluation in a multicenter, prospective, observational study. Arch Intern Med 1995;155:24292435.
25.Nucci, M, Silveira, Ml, Spector, N, et al.Risk factors for death among cancer patients with fungemia. Clin Infect Dis 1998;27:107111.
26.Levin, AS, Costa, SF, Mussi, NS, et al.Candida parapsilosis fungemia associated with implantable and semi-implantable central venous catheters and the hands of healthcare workers. Diagn Microbiol Infect Dis 1998;30:243249.
27.Shin, JH, Shin, DH, Song, JW, Kee, SJ, Suh, SP, Ryang, DW. Electrophoretic karyotype analysis of sequential Candida parapsilosis isolates from patients with persistent or recurrent fungemia. J Clin Microbiol 2001;39:12581263.
28.Shin, JH, Kee, SJ, Shin, MG, et al.Biofilm production by isolates of Candida species recovered from nonneutropenic patients: comparison of bloodstream isolates with isolates from other sources. J Clin Microbiol 2002;40:12441248.

Genetic Relatedness Among Candida tropicalis Isolates From Sporadic Cases of Fungemia in Two University Hospitals in Korea

  • Jong Hee Shin (a1), Mi-Na Kim (a2), Dong Hyeon Shin (a3), Sook-In Jung (a3), Kwang Jin Kim (a1), Duck Cho (a1), Seung Jung Kee (a1), Myung Geun Shin (a1), Soon Pal Suh (a1) and Dong Wook Ryang (a1)...

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