van Asbeck Eveline C, Huang Yhu-Chering, Markham Angela N, Clemons Karl V, Stevens David A
Division of Infectious Diseases, Santa Clara Valley Medical Center, California Institute for Medical Research, 751 South Bascom Avenue, San Jose, CA 95128, USA.
Mycopathologia. 2007 Dec;164(6):287-93. doi: 10.1007/s11046-007-9054-3. Epub 2007 Sep 15.
An outbreak of Candida parapsilosis fungemia involving 17 neonatal intensive care unit (NICU) patients was studied. There were 14 blood culture and nine colonizing isolates from other sites available. The hands of NICU healthcare workers (HCW) yielded eight isolates. Screening of the isolates by random amplified polymorphic DNA (RAPD) method showed only three profiles. Typing by restriction fragment length polymorphism (RFLP) revealed all blood isolates were RFLP subtype VII-1. Among the nine infant colonizing isolates, there were four different RFLP subtypes; four of the isolates were subtype VII-1. Seven of the eight isolates from HCW were RFLP subtype VII-1. The majority of infant colonizers were not found in the blood, suggesting a possible direct spread of the epidemic subtype VII-1 strain from HCW hands to infant blood. The source of the infant colonizing strains is unclear, but non-VII-1 strains may be largely of maternal origin and VII-1 strains from HCW. These findings reinforce prior studies that have implicated HCW hands as the source of nosocomial, including neonatal, fungemia.
对一起涉及17名新生儿重症监护病房（NICU）患者的近平滑念珠菌血症暴发进行了研究。共有14份血培养分离株以及来自其他部位的9份定植分离株。NICU医护人员（HCW）的手部检出8株分离株。采用随机扩增多态性DNA（RAPD）方法对分离株进行筛查，仅显示出3种图谱。通过限制性片段长度多态性（RFLP）分型发现，所有血培养分离株均为RFLP VII-1亚型。在9份婴儿定植分离株中，有4种不同的RFLP亚型；其中4株为VII-1亚型。8份来自HCW的分离株中有7株为RFLP VII-1亚型。大多数婴儿定植菌未在血液中检出，提示流行的VII-1亚型菌株可能从HCW的手部直接传播至婴儿血液。婴儿定植菌株的来源尚不清楚，但非VII-1菌株可能主要源自母体，而VII-1菌株来自HCW。这些发现强化了先前的研究，即HCW的手部被认为是包括新生儿真菌血症在内的医院感染的源头。
