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An outbreak of Candida parapsilosis prosthetic valve endocarditis following cardiac surgery

B L Johnston1, W F Schlech, T J Marrie

  • 1Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.

The Journal of Hospital Infection
|October 1, 1994
PubMed

Insights

A Candida parapsilosis outbreak caused prosthetic valve endocarditis in five patients, all of whom died. The cardiac bypass equipment may have been the source, highlighting the need for infection prevention.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Public Health

Background:

  • Nosocomial infections pose a significant threat in healthcare settings.
  • Prosthetic cardiac valve endocarditis (PVE) is a serious complication with high mortality.
  • Candida parapsilosis has emerged as an opportunistic pathogen in healthcare-associated infections.

Purpose of the Study:

  • To investigate a cluster of Candida parapsilosis prosthetic valve endocarditis cases.
  • To identify the source and risk factors associated with the PVE outbreak.
  • To emphasize the critical need for prevention strategies against nosocomial PVE.

Main Methods:

  • Retrospective cohort study design.
  • Analysis of patient data including pre-, intra-, and postoperative factors.
  • Environmental investigations to identify potential sources of contamination.

Main Results:

  • Five out of 34 patients (15%) developed PVE caused by Candida parapsilosis.
  • No significant differences in risk factors were identified between infected and uninfected patients.
  • Intraoperative contamination via cardiac bypass equipment was suspected but not definitively proven.

Conclusions:

  • The outbreak of Candida parapsilosis PVE had a uniformly fatal outcome.
  • Effective prevention of nosocomial infections, particularly PVE, is crucial.
  • Further investigation into environmental contamination sources in cardiac surgery is warranted.

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