Possible transmission of Candida albicans on an intensive care unit : intensive care unit

• Background: Nosocomial transmission of Candida spp. has not fully been explored and previous studies have shown conflicting results.Aim: To evaluate the possible nosocomial transmission of Candida spp. on an intensive care unit (ICU).Methods: We conducted a prospective study over 19 month, including all patients on our ICU with growth of Candida spp. from surveillance and directed cultures. Molecular typing, with rep-PCR (DiversiLab) was used to define genotype relationships between the C. albicans and C. glabrata isolates. Candida isolates obtained from blood cultures taken from patients in our county outside the ICU, were used as a reference. Temporal cluster analysis was performed to evaluate genotype distribution over time.Findings: Seventy-seven patients with 78 ICU stays, representing twelve per cent of all ICU stays, were found to harbour 180 isolates of Candida spp. Molecular typing revealed 27 C. albicans genotypes and ten of C. glabrata. Possible clustering, indicated by overlapping stays of patients with indistinguishable candida genotypes was observed on seven occasions with C. albicans and on two occasions with C. glabrata. Two C. albicans genotypes were found significantly more often in the ICU group compared to the reference group. Moreover, C. albicans genotypes isolated from more than one patient were significantly more often found in the ICU group. Temporal cluster analysis revealed a significantly increased number of pairs with indistinguishable genotypes at a 21-dayinterval, indicating clustering.Conclusion: This study indicates transmission of C. albicans between ICU patients based on genotyping and temporal cluster analysis.

Nyckelord

Candida

Molecular typing

Intensive care unit

nosocomial infections

Publikations- och innehållstyp

vet (ämneskategori)

ovr (ämneskategori)