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Use of Electrophoretic Karyotyping in the Evaluation of Candida Infections in a Neonatal Intensive-Care Unit

Published online by Cambridge University Press:  02 January 2015

Jose A. Vazquez ,
Dina Boikov ,
Sergei G. Boikov  and
Adnan S. Dajani
Jose A. Vazquez*
Affiliation:
Division of Infectious Diseases, Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan Veterans' Administration Medical Center, Allen Park, Michigan
Dina Boikov
Affiliation:
Division of Infectious Diseases, Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan Veterans' Administration Medical Center, Allen Park, Michigan
Sergei G. Boikov
Affiliation:
Department of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan Veterans' Administration Medical Center, Allen Park, Michigan
Adnan S. Dajani
Affiliation:
Department of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan Veterans' Administration Medical Center, Allen Park, Michigan
*
Division of Infectious Diseases, Harper Hospital Professional Bldg, 4160 John R, Suite 202, Detroit, MI 48201
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Abstract

Objective:

To evaluate a possible commonsource outbreak of Candida infections in the neonatal intensive-care unit. Systemic Candida infections increased from 6 to 11 cases (0.71 to 1.34 per 1,000 patient-days). In addition, Candida parapsilosis infections increased from 1 in 1992 to 10 in 1993.

Design and Setting:

Tertiary-care, teaching, pediatric institution with a 40-bed neonatal intensive-care unit (NICU). Clinical characteristics, associated conditions, and antimicrobial therapy were obtained from the medical records of all NICU patients with positive blood cultures for Candida during 1992 and 1993. Nineteen Candida isolates from 15 infants were studied retrospectively using contour-clamped homogeneous electric-field (CHEF) electrophoresis.

Results:

CHEF revealed eight karyotypes of C parapsilosis. Five isolates recovered from four patients shared one karyotype. The remaining isolates from seven infants all had distinctly different karyotypes.

Conclusions:

The evidence was insufficient to implicate a single source of infection, even though four patients in the same unit had identical strain types. However, identical strains of C parapsilosis were associated geographically, suggesting that nosocomial acquisition of C parapsilosis through indirect patient contact in the NICU was possible. The CHEF technique yields unique patterns that may be used to delineate clinical isolates and to study the molecular epidemiology of candidal infections.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 18 , Issue 1 , January 1997 , pp. 32 - 37
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1997

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