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Use of DNA fingerprinting and biotyping methods to study a Candida albicans outbreak in a neonatal intensive care
P Betremieux1, S Chevrier, G Quindos
1Pontchaillou Teaching Hospital, Rennes, France.
Insights
A Candida albicans outbreak in a neonatal intensive care unit (NICU) was traced to a healthy staff member. Genetic fingerprinting and morphotyping identified the source of the infant sepsis.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Neonatal Care
Background:
- Neonatal intensive care units (NICUs) are vulnerable settings for hospital-acquired infections.
- Candida albicans is a common cause of sepsis in premature infants, leading to significant morbidity and mortality.
- Identifying the source of Candida albicans outbreaks is crucial for effective infection control.
Purpose of the Study:
- To investigate the source of a Candida albicans sepsis outbreak among premature infants in a NICU.
- To evaluate the discriminatory power of various molecular and phenotypic techniques for strain typing.
- To implement targeted infection control measures based on outbreak investigation findings.
Main Methods:
- Collected Candida albicans isolates from blood cultures of infected infants, NICU environment, and personnel hands.
- Employed five techniques: serotype determination, genetic fingerprinting, morphotyping, resistotyping, and killer yeast typing.
- Utilized combined analysis of morphotyping and genetic fingerprinting for high discriminatory power.
Main Results:
- Seven premature infants developed Candida albicans sepsis over a 15-day period.
- Morphotyping and genetic fingerprinting were the most effective methods for differentiating strains.
- The outbreak strain was identified on the hands of a healthy healthcare worker, linking them to infant infections.
Conclusions:
- A single strain of Candida albicans, carried by a healthy staff member, was the source of the NICU outbreak.
- Integrated molecular and phenotypic typing methods are essential for accurate outbreak source identification.
- Enhanced hand hygiene protocols and staff screening are critical for preventing candidemia in NICUs.
Abstract:
During a 15-day period, 7 premature infants hospitalized in a neonatal intensive care unit presented with sepsis caused by Candida albicans. The local environment and hands of all 54 persons involved in the intensive care unit were examined for the presence of this organism. Five techniques were used in the analysis of the isolates recovered from blood cultures of the children, the hands of personnel and 10 control isolates. The methods used were serotype determination, genetic fingerprinting, morphotyping, resistotyping and killer yeast typing. Morphotyping and genetic fingerprinting proved to be the most discriminatory techniques, and only combined analysis of the results obtained with these various methods allowed the source of the outbreak to be identified. An isolate from the hands of a healthy staff member and isolates from infected children all belonged to the same strain.