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. 1993 Nov;4(6):322-7.
doi: 10.1155/1993/495480.

Molecular epidemiology of Candida albicans colonization and fungemia in very low birthweight infants

J L Robinson  1 , A I Hartstein, R U Meuser, V H Morthland, M E Dragoon, W M Wenman
Affiliations

Molecular epidemiology of Candida albicans colonization and fungemia in very low birthweight infants

J L Robinson et al. Can J Infect Dis. 1993 Nov.

Abstract
in English, French

Objective: This study investigated the relationship between colonization and fungemia.

Design: 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.

Setting: Patients were from the neonatal intensive care unit of a tertiary care hospital.

Population studied: Twenty-nine very low birthweight infants.

Main results: 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.

Conclusions: 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.

Objectif:: Cette étude s’est penchée sur le rapport entre colonisation et fongémie.

Modèle:: Cette étude prospective a nécessité la mise en culture de prélèvements au niveau des narines, de la base de l’ombilic, du point d’entrée du cathéter ombilical et des liquides parentéraux. Des hémocultures ont été effectuées quand l’infection était soupçonnée. Tous les isolats Candida albicans ont été typés à l’aide d’une analyse de l’ADN par l’enzyme de restriction.

Contexte:: Patients de l’unité de soins intensifs pour prématurés d’un hôpital de soins tertiaires.

Population Étudiée:: Vingt-neuf nourrissons de très faible poids de naissance.

Principaux Résultats:: Chez onze bébés, on a décelé la présence de C albicans et cinq d’entre eux ont développé une fongémie, y compris cinq sur les sept chez qui le prélèvement avait été fait au point d’entrée du cathéter ombilical. Trois souches différentes de C albicans ont causé la fongémie. Certains des nourrissons étaient porteurs de plus d’une souche de C albicans.

Conclusions:: La colonisation préalable avec C albicans et en particulier, la colonisation au point d’entrée du cathéter vasculaire ombilical constitue un facteur de risque à l’égard du développement subséquent d’une fongémie à C albicans. Les isolats du sang et de la colonisation sont généralement identiques lors du typage de l’ADN.

Keywords: Candida albicans; Colonization; DNA typing; Fungemia; Molecular epidemiology; Neonates.

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Figures

Figure 1
Figure 1
Colonization with Candida albicans during umbilical catheterization. ○ Nares; ❑ Base of umbilical cord; • Umbilical catheter entry site
Figure 2
Figure 2
EcoR1 digests of DNA from Candida albicans analyzed by agarose gel electrophoresis. Size markers are indicated on the right (kilobase pairs). Lanes 1 to 7 contain DNA from patient 2. Six of these samples show the same pattern (designated pattern B) with predominant bands at 6.5, 3.8 and 2.6 kb, but the sample in lane 7 has an extra band at 4.2 kb (arrowhead) and has been designated pattern C. Lanes 8 to 10 contain DNA from patient 1. Predominant bands are at 6.5, 4.2 and 2.6 kb (designated pattern A)
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