DNA Analysis in the Study of the Epidemiology of Nosocomial Candidiasis

Abstract

Pathogenic Candida species are ubiquitous organisms usually confined to human and animal reservoirs, but they can be recovered from soil, food, and the hospital environment. They are normal inhabitants of the female genital tract and the gastrointestinal tract, including the oropharynx, rectum, and perineum. Candida species are increasingly important nosocomial pathogens in immunocompromised patients, as well as in intensive care and postoperative patients. The changing patterns and the increasing incidence of disseminated Candida infection has been demonstrated in large autopsy series1 and is related to the modem aggressive treatment of malignancy and intensive supportive care of hospitalized patients. Current therapeutic regimens have resulted in greater numbers of cancer patients achieving and maintaining remission despite more prolonged periods of neu-tropenia. Greater success in the treatment of bacterial and viral infections has resulted in longer patient survival and hence an increased susceptibility of developing severe Candida infections. Candida species are now the fourth most commonly recovered organism from blood cultures of hospitalized patients with a crude mortality for Candida albicans fungemia of approximately 80% to 85%.