Cliff P R, Sandoe J A T, Heritage J, Barton R C
Mycology Reference Centre, The General Infirmary at Leeds, Leeds, UK.
J Hosp Infect. 2008 May;69(1):24-32. doi: 10.1016/j.jhin.2008.02.006. Epub 2008 Apr 8.
A prospective study was performed to determine the prevalence of candidal colonisation on the general intensive care unit at a large teaching hospital. Colonisation with Candida spp. was found to be common, occurring in 79% of patients on the unit. C. albicans was the commonest species, colonising 64% of patients, followed by C. glabrata (18%) and C. parapsilosis (14%). Most of the members of staff tested carried Candida spp. at some point, although carriage appeared to be transient. C. parapsilosis was the most commonly isolated species from staff hands, whereas C. albicans was the most commonly isolated species from the mouth. The molecular epidemiology of C. albicans was investigated using Ca3 typing and multilocus sequence typing (MLST). MLST proved to be a reproducible typing method and a useful tool for the investigation of the molecular epidemiology of C. albicans. The results of the molecular typing provided evidence for the presence of an endemic strain on the unit, which was isolated repeatedly from patients and staff. This finding suggests horizontal transmission of C. albicans on the unit though it may also reflect the relative frequency of C. albicans strain types colonising patients on admission. This study has important implications for the epidemiology of systemic candidal infections.
进行了一项前瞻性研究，以确定一家大型教学医院普通重症监护病房念珠菌定植的患病率。发现念珠菌属定植很常见，该病房79%的患者发生了定植。白色念珠菌是最常见的菌种，定植于64%的患者，其次是光滑念珠菌（18%）和近平滑念珠菌（14%）。大多数接受检测的工作人员在某个时间点携带念珠菌属，尽管携带似乎是短暂的。近平滑念珠菌是从工作人员手部最常分离出的菌种，而白色念珠菌是从口腔最常分离出的菌种。使用Ca3分型和多位点序列分型（MLST）对白色念珠菌的分子流行病学进行了研究。MLST被证明是一种可重复的分型方法，也是研究白色念珠菌分子流行病学的有用工具。分子分型结果为该病房存在一种地方菌株提供了证据，该菌株多次从患者和工作人员中分离出来。这一发现表明白色念珠菌在该病房存在水平传播，尽管它也可能反映了入院时定植于患者的白色念珠菌菌株类型的相对频率。这项研究对系统性念珠菌感染的流行病学具有重要意义。
