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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
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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 

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