Abstract
BackgroundThe nosocomial acquisition of Candida albicans is a growing concern in intensive care units (ICUs) and understanding the route of contamination is relevant for infection control guidelines.MethodsTo analyze whether there is a specific ecology for any given hospital, we genotyped C. albicans isolates of the ICU of Versailles hospital (Hospital A) and compared the results with those previously obtained in another ICU in Henri Mondor hospital (Hospital B) using three polymorphic microsatellite markers (PMM).ResultsAmong 36 patients with at least one positive culture for C. albicans, 26 had a specific multilocus genotype, two shared a common multilocus genotype, and 8 had the most common multilocus genotype found in the general population. The time interval between periods of hospitalization between patients with common genotypes differed by 13 to 78 days, thus supporting a lack of direct contamination. To confirm this hypothesis, the multilocus genotypic distributions of the three PMM were compared between the two hospitals. No statistically significant difference was observed. Multiple correspondences analysis did not indicate the association of a multilocus genotypic distribution with any given hospital.ConclusionThe present epidemiological study supports the conclusions that each patient harbours his/her own isolate, and that nosocomial transmission is not common in any given ICU. This study also supports the usefulness and practicability of PMM for studying the epidemiology of C. albicans.
Highlights
The nosocomial acquisition of Candida albicans is a growing concern in intensive care units (ICUs) and understanding the route of contamination is relevant for infection control guidelines
C. albicans is still predominant in ICUs, accounting for 55% of yeast bloodstream infections [2,3]
Polymorphic microsatellite markers (PMM) have a high discriminatory power and a high throughput when fluorogenic primers and an automated sequencer are used for analysis[5,6]
Summary
The nosocomial acquisition of Candida albicans is a growing concern in intensive care units (ICUs) and understanding the route of contamination is relevant for infection control guidelines. Candida infections are a growing concern in patients hospitalized in intensive care units (ICUs) [1]. C. albicans is still predominant in ICUs, accounting for 55% of yeast bloodstream infections [2,3]. Most of these infections are nosocomial, which raises the issue of their prevention. Understanding the route of contamination is of utmost importance in order to implement adequate preventive guidelines. Genotyping is an approach that can be used to detect cross-contamination.
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