Abstract
BackgroundCandida parapsilosis is increasingly responsible for invasive candidiasis in neonates. This study investigates phenotypic and genotypic features of C. parapsilosis microbial isolates and underlying clinical conditions associated with acquisition of C. parapsilosis in a neonatal intensive care unit (NICU) in Italy.MethodsIdentification of C. parapsilosis was performed by VITEK® 2 and MALDI TOF and confirmed by analysis of internal transcribed spacer ribosomal DNA sequences. Genotyping was performed by PCR fingerprinting. Antifungal susceptibility of strains was evaluated by microdilution. A case-control study was designed to identify risk factors for C. parapsilosis bloodstream infection.ResultsDuring the study period (April 2009- April 2012), C. parapsilosis was responsible for 6 umbilical catheter and 11 central catheter-associated bloodstream infection in 17 neonates in the NICU. Molecular typing identified identical fingerprinting profile in all C. parapsilosis isolates from neonates. Fifteen of 17 C. parapsilosis isolates were susceptible to all antifungal drugs, two isolates were resistant to fluconazole and intermediate susceptible to itraconazole. Low birthweight, gestational age and time to exposure to assisted ventilation were risk factors for C. parapsilosis infection in neonates in the NICU at univariate and multivariate analysis.ConclusionC. parapsilosis bloodstream infections in the NICU were caused by a single epidemic clone. Low birthweight, gestational age and time to exposure to invasive devices, with predominance of assisted ventilation, were the clinical conditions associated with C. parapsilosis bloodstream infection in the NICU.
Highlights
Candida parapsilosis is increasingly responsible for invasive candidiasis in neonates
C. parapsilosis bloodstream infections in the neonatal intensive care unit (NICU) were caused by a single epidemic clone
Gestational age and time to exposure to invasive devices, with predominance of assisted ventilation, were the clinical conditions associated with C. parapsilosis bloodstream infection in the NICU
Summary
Candida parapsilosis is increasingly responsible for invasive candidiasis in neonates. This study investigates phenotypic and genotypic features of C. parapsilosis microbial isolates and underlying clinical conditions associated with acquisition of C. parapsilosis in a neonatal intensive care unit (NICU) in Italy. Healthcare-associated infections (HAI) are frequent complications occurring during hospitalization of neonates in intensive care units, resulting in increased morbidity and mortality, prolonged lengths of stay, and increased medical costs [1, 2]. Candida spp. are among the most frequent pathogens responsible for HAIs in NICUs, followed by gram positive or gram negative bacteria according to different clinical setting [1,2,3,4,5,6,7,8,9].
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