Investigation of an unrecognized large-scale outbreak of Candida parapsilosis sensu stricto fungaemia in a tertiary-care hospital in China.
Investigation of an unrecognized large-scale outbreak of Candida parapsilosis sensu stricto fungaemia in a tertiary-care hospital in China.
复制标题
对中国一家三级医院发生的未被识别的大规模近平滑假丝酵母菌血症疫情的调查。
DOI：
10.1038/srep27099
复制
发表时间：
2016-06-02
影响因子：
4.6
通讯作者：
Xu YC
中科院分区：
文献类型：
--
作者：
Wang H;Zhang L;Kudinha T;Kong F;Ma XJ;Chu YZ;Kang M;Sun ZY;Li RY;Liao K;Lu J;Zou GL;Xiao M;Fan X;Xu YC
对2013年中国医院侵袭性真菌监测网（CHIF-NET）项目酵母菌采集的数据分析显示，在一家参与医院（医院H）中，近平滑念珠菌复合群分离株（n = 98）的比例突然增加。在H医院提交给CHIF-NET参考实验室的443株酵母分离株中（2010-2014年），212株（47.9%）被鉴定为C.通过对26 S rRNA基因的内转录间隔区和D1/D2结构域进行测序分析，确定了狭义近平滑病的基因型。在212 C.对176株（83.0%）来自25例念珠菌血症患者的血液分离株和25株来自各种血管导管尖端培养物的分离株进行微卫星基因分型，并对152株分离株进行系统发育关系分析。在152株分离株中，共鉴定出45种基因型（T01 ~ T45），其中T15（n = 74，48.7%）和T16（n = 23，15.1%）为两种流行基因型（63.8%）。这两个主要的克隆人主要被限制在医院的三个不同的病房，他们分别持续了16-25个月和12-13个月。作为公共卫生控制的一部分，临床微生物实验室和感染控制人员之间缺乏适当的协调，导致未能及时发现疫情，从而导致C. H医院的狭义近平滑病。
A data analysis of yeast collections from the National China Hospital Invasive Fungal Surveillance Net (CHIF-NET) programme in 2013 revealed a sudden increase in the proportion of Candida parapsilosis complex isolates (n = 98) in one participating hospital (Hospital H). Out of 443 yeast isolates submitted to the CHIF-NET reference laboratory by Hospital H (2010–2014), 212 (47.9%) were identified as C. parapsilosis sensu stricto by sequencing analysis of the internal transcribed spacer region and D1/D2 domain of the 26S rRNA gene. Among the 212 C. parapsilosis sensu stricto isolates, 176 (83.0%) bloodstream-based isolates and 25 isolates from tip cultures of various vascular catheters from 25 patients with candidaemia, were subjected to microsatellite genotyping, and a phylogenetic relationship analysis was performed for 152 isolates. Among the 152 isolates, 45 genotypes (T01 to T45) were identified, and two prevalent genotypes (63.8%) were found: T15 (n = 74, 48.7%) and T16 (n = 23, 15.1%). These two main clones were confined mainly to three different wards of the hospital, and they persisted for 16–25 months and 12–13 months, respectively. The lack of proper coordination between the clinical microbiology laboratory and infection control staff as part of public health control resulted in the failure to timely identify an outbreak, which led to the wide and long-term dissemination of C. parapsilosis sensu stricto in Hospital H.