Abstract
This study investigated the relationship between colonization and fungemia. This was a prospective study involving surveillance cultures of the nares, base of umbilicus, point of entry of umbilical catheter and parenteral fluids. Blood cultures were done when sepsis was suspected. All Candida albicans isolates were typed using restriction enzyme analysis of DNA. Patients were from the neonatal intensive care unit of a tertiary care hospital. Twenty-nine very low birthweight infants. Eleven babies were colonized with C albicans and five of these babies developed fungemia, including five of seven who were colonized at the point of entry of the umbilical catheter. Three different strains of C albicans caused fungemia. In four of the five patients, initial catheter entry site isolates were identical to the subsequent blood isolates. Occasionally, infants were colonized with more than one strain of C albicans. Preceding colonization with C albicans and, in particular, colonization at the site of entry of umbilical vascular catheters are risk factors for subsequent development of C albicans fungemia. Fungemic and colonizing isolates are usually identical to one another by DNA typing.
Highlights
Epidemiologie moleculaire de Ia colonisation de Candida albicans et fongemie chez des nourrissons de tres petit poids de naissance
We report the results of a prospective study on colonization of very low birthweight (VLBW) infants by Calbicans in a neonatal intensive care unit
Colonization with C albicans and candidemia: None of the patients was colonized with C albicans at any site when cultured durtng the first fo u r days of umbilical catheterization
Summary
This study investigated the relationship between colonization and fungemia. DESIGN: This was a prospective study involving surveillance cultures ofthe nares, base ofumbilicus, point ofentry ofumbilical catheter and parenteral fluids. In four of the five patients, initial catheter entry site isolates were identical to the subsequent blood isolates. Colonization at the site of entry of umbilical vascular catheters are risk factors for subsequent development of C albicans fungemia. Key Wor d s: Candida albicans, Colonization, DNA typing, Fungemia, Molecular epiclemiology, Neonates. MoDELE: Cette etude prospective a necessite Ia mise en culture de prelevements au niveau des narines, de Ia base de l'ombilic, du point d'entree du catheter ombilical et des liquides parenteraux. Tous les isolats Candida albicans ont ete types a !'aide d'une analyse de l'ADN par !'enzyme de restriction. PRINciPAux R:EsULTATS: Chez ooze bebes, on a decele Ia presence de C albicans et cinq d'entre eux ont developpe une fongemie, y compris cinq sur les sept chez qui le prelevement avait ete fait au point d'entree du catheter ombilical.
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