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[新生儿重症监护病房白色念珠菌暴发]

[Candida albicans outbreak in a neonatal intensive care unit].

作者信息

Tiraboschi Iris Nora, Carnovale Susana, Benetucci Ariana, Fernández Norma, Kurlat Isabel, Foccoli Monica, Lasala María Beatriz

机构信息

Hospital de Clínicas "José de San Martín" Universidad de Buenos Aires, Avda. Córdoba 2351, Piso 3(1120) Ciudad Autónoma de Buenos Aires, Argentina.

出版信息

Rev Iberoam Micol. 2007 Dec 31;24(4):263-7. doi: 10.1016/s1130-1406(07)70053-0.

Abstract

The appearance of Candida albicans in three patients made physicians investigate an outbreak. Outbreak description and microbiologic screening: Case 1 developed C. albicans in the placenta culture and in the blood culture carried out on the 8th day of birth. Four days after this candidemia, C. albicans was recovered in a catheter tip of a second neonate (case 2) and finally five days later other newborn (case 3) developed C. albicans in the hemoculture. After that, the hands of all caregivers as well as case 3's incubator, case 1's mother, and from all nine neonates in the unit were studied with swabs. A wet mount was done to all swabs and then they were cultured in Chromagar Candida and SDA. All C. albicans were studied by RAPD. RAPD study showed that C. albicans recovered from placenta and blood cultures of case 1, the catheter tip of case 2 and the blood culture of case 3, resulted to be identical and these yeasts were related to the C. albicans from the mouth of case 1 mother and the mouth of another colonized newborn. C. albicans was not found in the others swabs. The isolations of identical C. albicans allowed to suppose the horizontal transmission from the case 1, that had acquired it congenitally. Not only isolation of unusual Candida species would be an alert. Despite patients' personal factors to justify a fungal infection, the recovery of C. albicans in a short period of time should warn physicians about the possibility of a horizontal transmission.

摘要

三名患者出现白色念珠菌感染,促使医生对疫情爆发展开调查。疫情描述及微生物筛查:病例1在出生第8天的胎盘培养物和血培养物中出现白色念珠菌。该念珠菌血症发生4天后,在第二名新生儿(病例2)的导管尖端发现了白色念珠菌,最终在5天后,另一名新生儿(病例3)的血培养物中也出现了白色念珠菌。此后,用拭子对所有护理人员的手部以及病例3的保育箱、病例1的母亲以及该病房所有9名新生儿进行了检测。对所有拭子制作湿片,然后在科玛嘉念珠菌显色培养基和沙氏培养基上进行培养。所有白色念珠菌均通过随机扩增多态性DNA(RAPD)分析。RAPD分析表明,从病例1的胎盘和血培养物、病例2的导管尖端以及病例3的血培养物中分离出的白色念珠菌是相同的,这些酵母菌与病例1母亲口腔以及另一名定植新生儿口腔中的白色念珠菌有关。在其他拭子中未发现白色念珠菌。相同白色念珠菌的分离表明可能存在从先天性感染的病例1开始的水平传播。不仅不常见念珠菌种类的分离是一个警示信号。尽管患者存在个人因素可解释真菌感染,但在短时间内分离出白色念珠菌应提醒医生注意水平传播的可能性。

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