Candida tropicalis in a neonatal intensive care unit: Epidemiologic and molecular analysis of an outbreak of infection with an uncommon neonatal pathogen

Emmanuel Roilides, Evangelia Farmaki, Joanna Evdoridou, Andrea Francesconi, Miki Kasai, Joanna Filioti, Maria Tsivitanidou, Danai Sofianou, George Kremenopoulos, Thomas J. Walsh

Research output: Contribution to journalArticle

Abstract

From June to July 1998, two episodes of Candida tropicalis fungemia occurred in the Aristotle University neonatal intensive care unit (ICU). To investigate this uncommon event, a prospective study of fungal colonization and infection was conducted. From December 1998 to December 1999, surveillance cultures of the oral cavities and perinea of the 593 of the 781 neonates admitted to the neonatal ICU who were expected to stay for >7 days were performed. Potential environmental reservoirs and possible risk factors for acquisition of C. tropicalis were searched for. Molecular epidemiologic studies by two methods of restriction fragment length polymorphism analysis and two methods of random amplified polymorphic DNA analysis were performed. Seventy-two neonates were colonized by yeasts (12.1%), of which 30 were colonized by Candida albicans, 17 were colonized by C. tropicalis, and 5 were colonized by Candida parapsilosis. From December 1998 to December 1999, 10 cases of fungemia occurred; 6 were due to C. parapsilosis, 2 were due to C. tropicalis, 1 was due to Candida glabrata, and 1 was due to Trichosporon asahii (12.8/1,000 admissions). Fungemia occurred more frequently in colonized than in noncolonized neonates (P <0.0001). Genetic analysis of 11 colonization isolates and the two late blood isolates of C. tropicalis demonstrated two genotypes. One blood isolate and nine colonization isolates belonged to a single type. The fungemia/colonization ratio of C. parapsilosis (3/5) was greater than that of C. tropicalis (2/17, P = 0.05), other non-C. albicans Candida spp. (1/11, P = 0.02), or C. albicans (0/27, P = 0.05). Extensive environmental cultures revealed no common source of C. tropicalis or C. parapsilosis. There was neither prophylactic use of azoles nor other risk factors found for acquisition of C. tropicalis except for total parenteral nutrition. A substantial risk of colonization by non-C. albicans Candida spp. in the neonatal ICU may lead to a preponderance of C. tropicalis as a significant cause of neonatal fungemia.

Original languageEnglish (US)
Pages (from-to)735-741
Number of pages7
JournalJournal of Clinical Microbiology
Volume41
Issue number2
DOIs
StatePublished - Feb 1 2003
Externally publishedYes

Fingerprint

Candida tropicalis
Neonatal Intensive Care Units
Disease Outbreaks
Fungemia
Infection
Candida albicans
Trichosporon
Candida glabrata
Perineum
Azoles
Mycoses
Total Parenteral Nutrition
Candida
Restriction Fragment Length Polymorphisms
Mouth
Epidemiologic Studies
Yeasts
Genotype
Prospective Studies

ASJC Scopus subject areas

  • Microbiology (medical)
  • Microbiology

Cite this

Candida tropicalis in a neonatal intensive care unit : Epidemiologic and molecular analysis of an outbreak of infection with an uncommon neonatal pathogen. / Roilides, Emmanuel; Farmaki, Evangelia; Evdoridou, Joanna; Francesconi, Andrea; Kasai, Miki; Filioti, Joanna; Tsivitanidou, Maria; Sofianou, Danai; Kremenopoulos, George; Walsh, Thomas J.

In: Journal of Clinical Microbiology, Vol. 41, No. 2, 01.02.2003, p. 735-741.

Research output: Contribution to journalArticle

Roilides, E, Farmaki, E, Evdoridou, J, Francesconi, A, Kasai, M, Filioti, J, Tsivitanidou, M, Sofianou, D, Kremenopoulos, G & Walsh, TJ 2003, 'Candida tropicalis in a neonatal intensive care unit: Epidemiologic and molecular analysis of an outbreak of infection with an uncommon neonatal pathogen', Journal of Clinical Microbiology, vol. 41, no. 2, pp. 735-741. https://doi.org/10.1128/JCM.41.2.735-741.2003
Roilides, Emmanuel ; Farmaki, Evangelia ; Evdoridou, Joanna ; Francesconi, Andrea ; Kasai, Miki ; Filioti, Joanna ; Tsivitanidou, Maria ; Sofianou, Danai ; Kremenopoulos, George ; Walsh, Thomas J. / Candida tropicalis in a neonatal intensive care unit : Epidemiologic and molecular analysis of an outbreak of infection with an uncommon neonatal pathogen. In: Journal of Clinical Microbiology. 2003 ; Vol. 41, No. 2. pp. 735-741.
@article{c091c14574754354abd366fe504710d5,
title = "Candida tropicalis in a neonatal intensive care unit: Epidemiologic and molecular analysis of an outbreak of infection with an uncommon neonatal pathogen",
abstract = "From June to July 1998, two episodes of Candida tropicalis fungemia occurred in the Aristotle University neonatal intensive care unit (ICU). To investigate this uncommon event, a prospective study of fungal colonization and infection was conducted. From December 1998 to December 1999, surveillance cultures of the oral cavities and perinea of the 593 of the 781 neonates admitted to the neonatal ICU who were expected to stay for >7 days were performed. Potential environmental reservoirs and possible risk factors for acquisition of C. tropicalis were searched for. Molecular epidemiologic studies by two methods of restriction fragment length polymorphism analysis and two methods of random amplified polymorphic DNA analysis were performed. Seventy-two neonates were colonized by yeasts (12.1{\%}), of which 30 were colonized by Candida albicans, 17 were colonized by C. tropicalis, and 5 were colonized by Candida parapsilosis. From December 1998 to December 1999, 10 cases of fungemia occurred; 6 were due to C. parapsilosis, 2 were due to C. tropicalis, 1 was due to Candida glabrata, and 1 was due to Trichosporon asahii (12.8/1,000 admissions). Fungemia occurred more frequently in colonized than in noncolonized neonates (P <0.0001). Genetic analysis of 11 colonization isolates and the two late blood isolates of C. tropicalis demonstrated two genotypes. One blood isolate and nine colonization isolates belonged to a single type. The fungemia/colonization ratio of C. parapsilosis (3/5) was greater than that of C. tropicalis (2/17, P = 0.05), other non-C. albicans Candida spp. (1/11, P = 0.02), or C. albicans (0/27, P = 0.05). Extensive environmental cultures revealed no common source of C. tropicalis or C. parapsilosis. There was neither prophylactic use of azoles nor other risk factors found for acquisition of C. tropicalis except for total parenteral nutrition. A substantial risk of colonization by non-C. albicans Candida spp. in the neonatal ICU may lead to a preponderance of C. tropicalis as a significant cause of neonatal fungemia.",
author = "Emmanuel Roilides and Evangelia Farmaki and Joanna Evdoridou and Andrea Francesconi and Miki Kasai and Joanna Filioti and Maria Tsivitanidou and Danai Sofianou and George Kremenopoulos and Walsh, {Thomas J.}",
year = "2003",
month = "2",
day = "1",
doi = "10.1128/JCM.41.2.735-741.2003",
language = "English (US)",
volume = "41",
pages = "735--741",
journal = "Journal of Clinical Microbiology",
issn = "0095-1137",
publisher = "American Society for Microbiology",
number = "2",

}

TY - JOUR

T1 - Candida tropicalis in a neonatal intensive care unit

T2 - Epidemiologic and molecular analysis of an outbreak of infection with an uncommon neonatal pathogen

AU - Roilides, Emmanuel

AU - Farmaki, Evangelia

AU - Evdoridou, Joanna

AU - Francesconi, Andrea

AU - Kasai, Miki

AU - Filioti, Joanna

AU - Tsivitanidou, Maria

AU - Sofianou, Danai

AU - Kremenopoulos, George

AU - Walsh, Thomas J.

PY - 2003/2/1

Y1 - 2003/2/1

N2 - From June to July 1998, two episodes of Candida tropicalis fungemia occurred in the Aristotle University neonatal intensive care unit (ICU). To investigate this uncommon event, a prospective study of fungal colonization and infection was conducted. From December 1998 to December 1999, surveillance cultures of the oral cavities and perinea of the 593 of the 781 neonates admitted to the neonatal ICU who were expected to stay for >7 days were performed. Potential environmental reservoirs and possible risk factors for acquisition of C. tropicalis were searched for. Molecular epidemiologic studies by two methods of restriction fragment length polymorphism analysis and two methods of random amplified polymorphic DNA analysis were performed. Seventy-two neonates were colonized by yeasts (12.1%), of which 30 were colonized by Candida albicans, 17 were colonized by C. tropicalis, and 5 were colonized by Candida parapsilosis. From December 1998 to December 1999, 10 cases of fungemia occurred; 6 were due to C. parapsilosis, 2 were due to C. tropicalis, 1 was due to Candida glabrata, and 1 was due to Trichosporon asahii (12.8/1,000 admissions). Fungemia occurred more frequently in colonized than in noncolonized neonates (P <0.0001). Genetic analysis of 11 colonization isolates and the two late blood isolates of C. tropicalis demonstrated two genotypes. One blood isolate and nine colonization isolates belonged to a single type. The fungemia/colonization ratio of C. parapsilosis (3/5) was greater than that of C. tropicalis (2/17, P = 0.05), other non-C. albicans Candida spp. (1/11, P = 0.02), or C. albicans (0/27, P = 0.05). Extensive environmental cultures revealed no common source of C. tropicalis or C. parapsilosis. There was neither prophylactic use of azoles nor other risk factors found for acquisition of C. tropicalis except for total parenteral nutrition. A substantial risk of colonization by non-C. albicans Candida spp. in the neonatal ICU may lead to a preponderance of C. tropicalis as a significant cause of neonatal fungemia.

AB - From June to July 1998, two episodes of Candida tropicalis fungemia occurred in the Aristotle University neonatal intensive care unit (ICU). To investigate this uncommon event, a prospective study of fungal colonization and infection was conducted. From December 1998 to December 1999, surveillance cultures of the oral cavities and perinea of the 593 of the 781 neonates admitted to the neonatal ICU who were expected to stay for >7 days were performed. Potential environmental reservoirs and possible risk factors for acquisition of C. tropicalis were searched for. Molecular epidemiologic studies by two methods of restriction fragment length polymorphism analysis and two methods of random amplified polymorphic DNA analysis were performed. Seventy-two neonates were colonized by yeasts (12.1%), of which 30 were colonized by Candida albicans, 17 were colonized by C. tropicalis, and 5 were colonized by Candida parapsilosis. From December 1998 to December 1999, 10 cases of fungemia occurred; 6 were due to C. parapsilosis, 2 were due to C. tropicalis, 1 was due to Candida glabrata, and 1 was due to Trichosporon asahii (12.8/1,000 admissions). Fungemia occurred more frequently in colonized than in noncolonized neonates (P <0.0001). Genetic analysis of 11 colonization isolates and the two late blood isolates of C. tropicalis demonstrated two genotypes. One blood isolate and nine colonization isolates belonged to a single type. The fungemia/colonization ratio of C. parapsilosis (3/5) was greater than that of C. tropicalis (2/17, P = 0.05), other non-C. albicans Candida spp. (1/11, P = 0.02), or C. albicans (0/27, P = 0.05). Extensive environmental cultures revealed no common source of C. tropicalis or C. parapsilosis. There was neither prophylactic use of azoles nor other risk factors found for acquisition of C. tropicalis except for total parenteral nutrition. A substantial risk of colonization by non-C. albicans Candida spp. in the neonatal ICU may lead to a preponderance of C. tropicalis as a significant cause of neonatal fungemia.

UR - http://www.scopus.com/inward/record.url?scp=12244257511&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=12244257511&partnerID=8YFLogxK

U2 - 10.1128/JCM.41.2.735-741.2003

DO - 10.1128/JCM.41.2.735-741.2003

M3 - Article

C2 - 12574275

AN - SCOPUS:12244257511

VL - 41

SP - 735

EP - 741

JO - Journal of Clinical Microbiology

JF - Journal of Clinical Microbiology

SN - 0095-1137

IS - 2

ER -