Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-09T07:12:32.477Z Has data issue: false hasContentIssue false
  • English
  • Français

Outbreak of Candida tropicalis Fungemia in a Neonatal Intensive Care Unit

Published online by Cambridge University Press:  21 June 2016

R. Finkelstein ,
G. Reinhertz ,
N. Hashman  and
D. Merzbach
R. Finkelstein*
Affiliation:
Departments of Internal Medicine and Infectious Diseases Unit, Rambam Medical Center, Israel Institute of Technology, Haifa, Israel
G. Reinhertz
Affiliation:
Epidemiology, Rambam Medical Center, Israel Institute of Technology, Haifa, Israel
N. Hashman
Affiliation:
Clinical Microbiology, Rambam Medical Center, Israel Institute of Technology, Haifa, Israel
D. Merzbach
Affiliation:
Clinical Microbiology, Rambam Medical Center, Israel Institute of Technology, Haifa, Israel
*
Department of Internal Medicine, Infectious Diseases Unit, Rambam Medical Center 31096, Haifa, Israel
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To describe an outbreak of Candida tropicalis fungemia in a neonatal intensive care unit (NICU), to evaluate the risk factors associated with this infection and the possible mode of nosocomial transmission.

Design:

Descriptive and case-control study

Patients and Methods:

Surveillance cultures were taken from hospitalized patients, personnel, and inanimate objects in the NICU. Six patients with C tropicalis fungemia (cases) were compared with C tropicalis culture-negative patients matched for duration of exposure to the NICU (controls).

Results:

During a five-month period, C tropicalis was isolated from 29 blood cultures of six premature infants. The same organism also was isolated from fingernail samples taken from the ward housekeeper, who had a mild onychomycosis, and an asymptomatic nurse. Other potential reservoirs of C tropicalis were not identified among all the other infants or in the hospital environment. The six patients with C tropicalis fungemia were more likely to have received a larger number of antibiotics (4.0 versus 1.8, R<0.001) and to have been subjected to a longer duration of total parenteral nutrition (TPN) therapy (8.5 versus 2.67 days, P= 0.004) than the controls.

Conclusions:

The risk of fungemia in this outbreak can be attributed to a larger number of antibiotics and a longer period of TPN administered to the patients. Analysis of events suggests that the outbreak may have been the result of cross-infection between staff and patients.

Type
Brief Report
Information
Infection Control & Hospital Epidemiology , Volume 14 , Issue 10 , October 1993 , pp. 587 - 590
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1993 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Solomon, SL, Khabbaz, RF, Parker, RH, et al. An outbreak of Candida parapsilosis bloodstream infections in patients receiving parenteral nutrition. J Infect Dis 1984;149:98–102.10.1093/infdis/149.1.98CrossRefGoogle ScholarPubMed
2. Bernie, JP, Odds, FC, Lee, W, Webster, C, Williams, JD. Outbreak of systemic Candida albicans in intensive care unit caused by cross-infection. BMJ 1985;290:746–748.10.1136/bmj.290.6470.746CrossRefGoogle Scholar
3. Vendry, WL, Tierney, AJ, Wenman, WM. Investigation of a cluster of systemic Candida albicans infections in a neonatal intensive care unit. J Infect Dis 1988;158:1375–1379.Google Scholar
4. Cooper, BH, Silva-Hutner, M. Yeast of medical importance. In: Lennette, EH, Balows, A, Housler, WJ Jr, Shadomy, HJ, eds. Manual of Clinical Microbiology. 4th ed. Washington, DC: American Society of Microbiology; 1985:526–541.Google Scholar
5. Nonparametric test for two independent samples (median test). In: Conover, WJ, ed. Practical Nonparametric Statistics. 2nd ed. New York, NY: John Wiley and Sons; 1980:171–178.Google Scholar
6. Jarvis, WR. The National Nosocomial Surveillance System, Hospital Infection Program, Centers for Disease Control and Prevention, Atlanta, Georgia. Nosocomial Fungal infections in the United States, National Nosocomial Infections Surveillance System (NNIS) January 1980-April 1990. In: Program and Abstracts of the Third International Conference on Nosocomial Infections, Atlanta, Georgia, July 31-August 3. 1990. Abstract 8.Google Scholar
7. Johnson, DE, Thompson, TR, Green, TP, Ferrieri, F! Systemic condidiasis in very-low-birth-weight infants (<1,500 grams). Pediatrics 1984;73:138–143.CrossRefGoogle Scholar
8. Phelps, M, Ayliffe, AT, Babb, JR. An outbreak of candidiasis in a special care baby unit: the uses of resistogram typing method. J Hosp Infect 1986;7:13–20.CrossRefGoogle Scholar
9. Planffe, JF, Brown, DG, Silva, J Jr, et al. Nosocomial outbreak of Candida parapsilosis fungemia related to intravenous infusions. Arch Intern Med 1977;137:1686–1689.Google Scholar
10. Weinstein, RA, Stamm, WE, Kramer, L, Corey, L. Pressure monitoring devices. JAMA 1976;236:936–938.CrossRefGoogle ScholarPubMed
11. Mc Cray, E, Rempell, N, Solomon, SL, et al. Outbreak of Candida parapsilosis endophthalmitis after cataract extraction and intraocular lens implantation. J Clin Microbiol 1986;24:625–628.10.1128/jcm.24.4.625-628.1986CrossRefGoogle ScholarPubMed
12. Eisenberg, HD, Tucci, V, Cintron, F, et al. Single-source outbreak of Candida tropicalis complicating coronary bypass. J Clin Microbiol 1989;27:2426–2428.CrossRefGoogle Scholar
13. Sobel, JD. Candida infections in the intensive care unit. Crit Care Clin 1988;4:325–344.10.1016/S0749-0704(18)30495-0CrossRefGoogle ScholarPubMed
14. Roberts, DT, Evans, EGV, Allen, BR. Mycology and epidemiology. In: Roberts, DT, Evans, EGV, Allen, BR, eds. Fungal Nail Infection. London, England: Gower Medical Publishing; 1990:49–59.Google Scholar
15. Haneke, E. Epidemiology and pathology of onychomycosis. In: Nolting, S, Korting, HC, eds. Onychomycosis. Local Antimycotic Treatment. Berlin, Germany: Springer-Verlag; 1990:1–11.Google Scholar