Rodero L, Hochenfellner F, Demkura H, Pereda R, Córdoba S, Canteros C, Rial M J, Davel G
Departamento de Micología, Instituto Nacional de Enfermedades Infecciosas ANLIS Dr Carlos G. Malbrán, Av. Velez Sarsfield 563, 1281 Buenos Aires, Argentina.
Rev Argent Microbiol. 2000 Oct-Dec;32(4):179-84.
Candida spp. colonization in neonates occurs due to vertical or horizontal transmission. Preliminary studies determined that Candida albicans is the principal agent of these infections. In order to establish nosocomial transmission, 26 Candida albicans strains isolated from patients with candidosis hospitalized during a 18-month period in 2 neonatal intensive care units (NICU) from a pediatric hospital were studied. Fourteen isolates from patients and health care workers, involved in possible outbreaks of an intensive care unit (UCI) and a NICU from another pediatric hospital were also studied. All Candida albicans strains were genotyped by Southern blot hybridization with 27A. Isolates for outbreak confirmation were also hybridized with another specific Candida albicans probe, Ca3. Hybridization patterns demonstrated horizontal transmission in all the units studied. In a NICU, transmission among 4 patients during a 10-month period could be established and in the other NICU, 3 cases of transmission among 2 patients each were demonstrated in periods of 2 to 20 days. The outbreak studies showed the same strain isolated from 2 nurses and from one patient at the NICU and at the ICU identical strains were found in 3 patients. In this study, hybridization with Ca3 in addition to 27A probe did not increase discrimination power among isolates. Genotypic analysis allows, not only, determination of transmission and persistence of strains during prolonged periods or in sporadic outbreaks, but also facilitates necessary epidemiological decisions for optimizing nosocomial fungal infection control measures.
新生儿念珠菌属定植是由垂直或水平传播引起的。初步研究确定白色念珠菌是这些感染的主要病原体。为了确定医院内传播情况，对一家儿科医院的2个新生儿重症监护病房（NICU）在18个月期间住院的念珠菌病患者分离出的26株白色念珠菌菌株进行了研究。还对另一家儿科医院的重症监护病房（UCI）和一个NICU中可能爆发感染的患者及医护人员分离出的14株菌株进行了研究。所有白色念珠菌菌株均通过与27A进行Southern印迹杂交进行基因分型。用于爆发确认的分离株也与另一种白色念珠菌特异性探针Ca3进行杂交。杂交模式表明在所研究的所有病房中均存在水平传播。在一个NICU中，可确定在10个月期间4名患者之间发生了传播，在另一个NICU中，在2至20天的时间段内分别证明了2名患者之间发生了3起传播病例。爆发研究显示，在NICU从2名护士和1名患者中分离出相同菌株，在ICU从3名患者中发现了相同菌株。在本研究中，除27A探针外，与Ca3杂交并未增加分离株之间的鉴别能力。基因分型分析不仅可以确定菌株在长时间或散发性爆发期间的传播和持续存在情况，还有助于做出必要的流行病学决策，以优化医院内真菌感染控制措施。
