[Candida albicans outbreak in a neonatal intensive care unit]

The appearance of Candida albicans in three patients made physicians investigate an outbreak. Outbreak description and microbiologic screening: Case 1 developed C. albicans in the placenta culture and in the blood culture carried out on the 8th day of birth. Four days after this candidemia, C. albicans was recovered in a catheter tip of a second neonate (case 2) and finally five days later other newborn (case 3) developed C. albicans in the hemoculture. After that, the hands of all caregivers as well as case 3's incubator, case 1's mother, and from all nine neonates in the unit were studied with swabs. A wet mount was done to all swabs and then they were cultured in Chromagar Candida and SDA. All C. albicans were studied by RAPD. RAPD study showed that C. albicans recovered from placenta and blood cultures of case 1, the catheter tip of case 2 and the blood culture of case 3, resulted to be identical and these yeasts were related to the C. albicans from the mouth of case 1 mother and the mouth of another colonized newborn. C. albicans was not found in the others swabs. The isolations of identical C. albicans allowed to suppose the horizontal transmission from the case 1, that had acquired it congenitally. Not only isolation of unusual Candida species would be an alert. Despite patients' personal factors to justify a fungal infection, the recovery of C. albicans in a short period of time should warn physicians about the possibility of a horizontal transmission.