Hostname: page-component-6bf8c574d5-vmclg Total loading time: 0 Render date: 2025-02-22T20:51:34.289Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  02 January 2015

Jong Hee Shin ,
Mi-Na Kim ,
Dong Hyeon Shin ,
Sook-In Jung ,
Kwang Jin Kim ,
Duck Cho ,
Seung Jung Kee ,
Myung Geun Shin ,
Soon Pal Suh  and
Dong Wook Ryang
Jong Hee Shin*
Affiliation:
Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
Mi-Na Kim
Affiliation:
Department of Laboratory Medicine, University of Ulsan College of Medicineand Asan Medical Center, Seoul, Korea
Dong Hyeon Shin
Affiliation:
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
Sook-In Jung
Affiliation:
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
Kwang Jin Kim
Affiliation:
Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
Duck Cho
Affiliation:
Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
Seung Jung Kee
Affiliation:
Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
Myung Geun Shin
Affiliation:
Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
Soon Pal Suh
Affiliation:
Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
Dong Wook Ryang
Affiliation:
Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
*
Department of Laboratory Medicine, Chonnam National University Medical School, 8 Hakdong Dongku, Gwangju 501-757, South Korea
Get access Rights & Permissions [Opens in a new window]

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.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 8 , August 2004 , pp. 634 - 640
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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.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;11:379–390.CrossRefGoogle ScholarPubMed
2.Wingard, JR. Importance of Candida species other than C. albicans as pathogens in oncology patients. Clin Infect Dis 1995;20:115–125.CrossRefGoogle Scholar
3.Pfaller, MA. Nosocomial candidiasis: emerging species, reservoirs, and modes of transmission. Clin Infect Dis 1996;22:S89–S94.CrossRefGoogle ScholarPubMed
4.Walsh, TJ, Merz, WG. Pathologic features in the human alimentary tract associated with invasiveness of Candida tropicalis. Am J Clin Pathol 1986;85:498–502.CrossRefGoogle ScholarPubMed
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;6:628–633.CrossRefGoogle ScholarPubMed
6.Kontoyiannis, DP, Vaziri, I, Hanna, HA, et al.Risk factors for Candida tropicalis fungemia in patients with cancer. Clin Infect Dis 2001;33:1676–1681.CrossRefGoogle ScholarPubMed
7.Goldani, LZ, Mario, PS. Candida tropicalis fungemia in a tertiary care hospital. J Infect 2003;46:155–160.CrossRefGoogle ScholarPubMed
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;36:1518–1529.CrossRefGoogle ScholarPubMed
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;16:377–383.CrossRefGoogle ScholarPubMed
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;27:63–67.CrossRefGoogle ScholarPubMed
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;26:2465–2466.CrossRefGoogle ScholarPubMed
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; 2003:286–330.Google Scholar
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;331:1325–1330.CrossRefGoogle ScholarPubMed
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;29:1268–1270.CrossRefGoogle ScholarPubMed
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;31:2021–2030.CrossRefGoogle ScholarPubMed
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;41:735–741.CrossRefGoogle Scholar
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;19:697–703.CrossRefGoogle ScholarPubMed
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;33:3216–3220.CrossRefGoogle ScholarPubMed
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;34:3063–3071.CrossRefGoogle ScholarPubMed
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;21:1507–1509.CrossRefGoogle ScholarPubMed
21.Khatib, R, Ayeni, O, Riederer, KM, Briski, LE, Wilson, FM. Strain relatedness in persistent and recurrent candiduria. J Urol 1998;159:2054–2056.CrossRefGoogle ScholarPubMed
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;173:842–850.CrossRefGoogle ScholarPubMed
23.Sobel, JD, Rex, JH. Invasive candidiasis: turning risk into a practical prevention policy? Clin Infect Dis 2001;33:187–190.CrossRefGoogle ScholarPubMed
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;155:2429–2435.CrossRefGoogle Scholar
25.Nucci, M, Silveira, Ml, Spector, N, et al.Risk factors for death among cancer patients with fungemia. Clin Infect Dis 1998;27:107–111.CrossRefGoogle ScholarPubMed
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;30:243–249.CrossRefGoogle ScholarPubMed
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;39:1258–1263.CrossRefGoogle ScholarPubMed
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;40:1244–1248.CrossRefGoogle ScholarPubMed