Recurring Events of Candida krusei Septicaemia: First Report from an ICU

Renu Gur,Pragnya Paramita Jena,Sharon Rainy Rongpharpi,Immaculata Xess,Vineeta Wadhwa,Shalini Dewan Duggal,Avinash Kumar,Mrignayani Pandey

doi:10.1155/2015/721424

Renu Gur, Pragnya Paramita Jena + Show 6 more

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https://doi.org/10.1155/2015/721424

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Abstract

Resurgence of nonalbicans Candida spp. was observed thrice at the same location in our hospital over a period of four years. In two of these outbreaks it was identified up to the molecular level as Candida krusei. This fungus was traced to some environmental source in all three episodes. Prompt infection control measures were initiated which helped to control the outbreak every time. To the best of our knowledge, this is the first series of recurring Candida krusei infections at the same site in a hospital with successful control of each episode.

Highlights

Candida is the fourth leading cause of blood stream infections in hospitalized patients, with an associated mortality of 40– 50% [1]
We present a report in which resurgence of nonalbicans Candida spp. was observed thrice at the same place over a period of four years after successful control each time
Sugar assimilation test and further speciation of the nonalbicans Candida were done for isolates in the second and third outbreaks

Summary

Introduction

Candida is the fourth leading cause of blood stream infections in hospitalized patients, with an associated mortality of 40– 50% [1]. Outbreaks of candidemia have been linked with contaminated milk bottles, parenteral nutrition, glycerine suppositories, contaminated intravenous fluids, syringe reutilization, health care worker (HCW) hand-colonization, and long term indwelling vascular devices [2]. It has been recognized as a difficult to treat fungal pathogen due to fluconazole resistance and decreased susceptibility to flucytosine and amphotericin B [2]. We present a report in which resurgence of nonalbicans Candida spp. was observed thrice at the same place over a period of four years after successful control each time. It was identified as the same strain of Candida krusei in the second and third outbreaks. In all the outbreaks the source could be traced and immediate control was achieved

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