Possible transmission of Candida albicans on an intensive care unit: genotype and temporal cluster analyses
Possible transmission of Candida albicans on an intensive care unit: genotype and temporal cluster analyses
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DOI：
10.1016/j.jhin.2013.06.002
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发表时间：
2013-09-01
影响因子：
6.9
通讯作者：
Matussek, A.
中科院分区：
文献类型：
--
作者：
Hammarskjold, F.;Mernelius, S.;Matussek, A.
背景：念珠菌属的医院传播。尚未得到充分探索，之前的研究显示了相互矛盾的结果。目的：评估念珠菌属可能的医院传播。方法：进行了一项为期 19 个月的前瞻性研究，研究对象包括我们 ICU 中出现念珠菌属生长的所有患者。来自监视和定向文化。使用基于重复序列的聚合酶链反应进行分子分型来定义白色念珠菌和光滑念珠菌分离株之间的基因型关系。使用从我县 ICU 外患者血培养中获得的念珠菌分离株作为参考。进行时间聚类分析以评估基因型随时间的分布。结果：78 次入住 ICU 的 77 名患者（占所有 ICU 入住人数的 12%）被发现携带 180 株念珠菌分离株。分子分型显示 27 种白色念珠菌基因型和 10 种光滑念珠菌基因型。具有无法区分的念珠菌基因型的患者的重叠停留表明了可能的聚集，在七次白色念珠菌和两次光滑念珠菌中观察到。与参考组相比，ICU 组中发现两种白色念珠菌基因型的频率明显更高。此外，从不止一名患者身上分离出白色念珠菌基因型的情况在 ICU 组中明显更常见。时间聚类分析显示，以 21 天为间隔，具有无法区分的基因型的配对数量显着增加，表明存在聚类。结论：本研究基于基因分型和时间聚类分析，表明 ICU 患者之间可能存在白色念珠菌传播。 (C) 2013 年医疗保健感染协会。由爱思唯尔有限公司出版。保留所有权利。
Background: Nosocomial transmission of Candida spp. has not been fully explored and previous studies have shown conflicting results.Aim: To evaluate the possible nosocomial transmission of Candida spp. on an intensive care unit (ICU).Methods: A prospective study was conducted for a period of 19 months, including all patients on our ICU with growth of Candida spp. from surveillance and directed cultures. Molecular typing with repetitive sequence-based polymerase chain reaction was used to define genotype relationships between the Candida albicans and Candida glabrata isolates. Candida isolates obtained from blood cultures taken from patients in our county outside the ICU were used as a reference. Temporal cluster analysis was performed to evaluate genotype distribution over time.Findings: Seventy-seven patients with 78 ICU stays, representing 12% of all ICU stays, were found to harbour 180 isolates of Candida spp. Molecular typing revealed 27 C. albicans genotypes and 10 of C. glabrata. Possible clustering, indicated by overlapping stays of patients with indistinguishable candida genotypes, was observed on seven occasions with C. albicans and on two occasions with C. glabrata. Two C. albicans genotypes were found significantly more often in the ICU group compared with the reference group. Moreover, C. albicans genotypes isolated from more than one patient were significantly more often found in the ICU group. Temporal cluster analysis revealed a significantly increased number of pairs with indistinguishable genotypes at a 21-day interval, indicating clustering.Conclusion: This study indicates possible transmission of C. albicans between ICU patients based on genotyping and temporal cluster analysis. (C) 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.