Garzillo Carmine, Bagattini Maria, Bogdanović Lidija, Di Popolo Anna, Iula Vita Dora, Catania Maria Rosaria, Raimondi Francesco, Triassi Maria, Zarrilli Raffaele
Department of Public Health, University of Naples "Federico II", Via S. Pansini n.5, 80131, Naples, Italy.
Department of Molecular Medicine and Medical Biotechnologies, University of Naples "Federico II", Naples, Italy.
Ital J Pediatr. 2017 Jan 19;43(1):10. doi: 10.1186/s13052-017-0332-5.
Candida parapsilosis is increasingly responsible for invasive candidiasis in neonates. This study investigates phenotypic and genotypic features of C. parapsilosis microbial isolates and underlying clinical conditions associated with acquisition of C. parapsilosis in a neonatal intensive care unit (NICU) in Italy.
Identification of C. parapsilosis was performed by VITEK® 2 and MALDI TOF and confirmed by analysis of internal transcribed spacer ribosomal DNA sequences. Genotyping was performed by PCR fingerprinting. Antifungal susceptibility of strains was evaluated by microdilution. A case-control study was designed to identify risk factors for C. parapsilosis bloodstream infection.
During the study period (April 2009- April 2012), C. parapsilosis was responsible for 6 umbilical catheter and 11 central catheter-associated bloodstream infection in 17 neonates in the NICU. Molecular typing identified identical fingerprinting profile in all C. parapsilosis isolates from neonates. Fifteen of 17 C. parapsilosis isolates were susceptible to all antifungal drugs, two isolates were resistant to fluconazole and intermediate susceptible to itraconazole. Low birthweight, gestational age and time to exposure to assisted ventilation were risk factors for C. parapsilosis infection in neonates in the NICU at univariate and multivariate analysis.
C. parapsilosis bloodstream infections in the NICU were caused by a single epidemic clone. Low birthweight, gestational age and time to exposure to invasive devices, with predominance of assisted ventilation, were the clinical conditions associated with C. parapsilosis bloodstream infection in the NICU.
近平滑念珠菌在新生儿侵袭性念珠菌病中所占比例日益增加。本研究调查了意大利一家新生儿重症监护病房（NICU）中近平滑念珠菌微生物分离株的表型和基因型特征，以及与近平滑念珠菌感染相关的潜在临床情况。
通过VITEK® 2和基质辅助激光解吸电离飞行时间质谱（MALDI TOF）对近平滑念珠菌进行鉴定，并通过分析核糖体DNA内转录间隔区序列进行确认。采用聚合酶链反应（PCR）指纹图谱法进行基因分型。通过微量稀释法评估菌株的抗真菌药敏性。设计了一项病例对照研究以确定近平滑念珠菌血流感染的危险因素。
在研究期间（2009年4月至2012年4月），近平滑念珠菌导致NICU中17例新生儿发生6例脐导管相关和11例中心导管相关血流感染。分子分型显示，所有新生儿来源的近平滑念珠菌分离株具有相同的指纹图谱。17株近平滑念珠菌分离株中有15株对所有抗真菌药物敏感，2株对氟康唑耐药，对伊曲康唑中度敏感。单因素和多因素分析显示，低出生体重、胎龄和接受辅助通气的时间是NICU中新生儿近平滑念珠菌感染的危险因素。
NICU中的近平滑念珠菌血流感染由单一流行克隆引起。低出生体重、胎龄以及接触侵入性装置的时间（主要是辅助通气时间）是NICU中与近平滑念珠菌血流感染相关的临床情况。
