This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints and Permissions Copyright Information Books from ASM Press MicrobeWorld Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Clark, T. A. Articles by Hajjeh, R. A. Search for Related Content PubMed PubMed Citation Articles by Clark, T. A. Articles by Hajjeh, R. A.

 Previous Article  |  Next Article 

Journal of Clinical Microbiology, October 2004, p. 4468-4472, Vol. 42, No. 10
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.10.4468-4472.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Epidemiologic and Molecular Characterization of an Outbreak of Candida parapsilosis Bloodstream Infections in a Community Hospital

Epidemic Intelligence Service, Epidemiology Program Office, Division of Applied Public Health Training,¹ Mycotic Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia,² Mississippi State Department of Health,³ University of Mississippi Medical Center, Jackson, Mississippi⁴

Received 29 April 2004/ Returned for modification 6 June 2004/ Accepted 22 June 2004

Candida parapsilosis is an important cause of bloodstream infections in the health care setting. We investigated a large C. parapsilosis outbreak occurring in a community hospital and conducted a case-control study to determine the risk factors for infection. We identified 22 cases of bloodstream infection with C. parapsilosis: 15 confirmed and 7 possible. The factors associated with an increased risk of infection included hospitalization in the intensive care unit (adjusted odds ratio, 16.4; 95% confidence interval, 1.8 to 148.1) and receipt of total parenteral nutrition (adjusted odds ratio, 9.2; 95% confidence interval, 0.9 to 98.1). Samples for surveillance cultures were obtained from health care worker hands, central venous catheter insertion sites, and medical devices. Twenty-six percent of the health care workers surveyed demonstrated hand colonization with C. parapsilosis, and one hand isolate was highly related to all case-patient isolates by tests with the DNA probe Cp3-13. Outbreak strain isolates also demonstrated reduced susceptibilities to fluconazole and voriconazole. This largest known reported outbreak of C. parapsilosis bloodstream infections in adults resulted from an interplay of host, environment, and pathogen factors. Recommendations for control measures focused on improving hand hygiene compliance.

This article has been cited by other articles:

• Lockhart, S. R., Messer, S. A., Pfaller, M. A., Diekema, D. J. (2008). Geographic Distribution and Antifungal Susceptibility of the Newly Described Species Candida orthopsilosis and Candida metapsilosis in Comparison to the Closely Related Species Candida parapsilosis. J. Clin. Microbiol. 46: 2659-2664 [Abstract] [Full Text]  
• Ding, C., Butler, G. (2007). Development of a Gene Knockout System in Candida parapsilosis Reveals a Conserved Role for BCR1 in Biofilm Formation. Eukaryot Cell 6: 1310-1319 [Abstract] [Full Text]  
• Pfaller, M. A., Diekema, D. J. (2007). Epidemiology of Invasive Candidiasis: a Persistent Public Health Problem. Clin. Microbiol. Rev. 20: 133-163 [Abstract] [Full Text]  
• Colombo, A. L., Nucci, M., Park, B. J., Nouer, S. A., Arthington-Skaggs, B., da Matta, D. A., Warnock, D., Morgan, J., for the Brazilian Network Candidemia Study, (2006). Epidemiology of candidemia in Brazil: a nationwide sentinel surveillance of candidemia in eleven medical centers.. J. Clin. Microbiol. 44: 2816-2823 [Abstract] [Full Text]  
• Almirante, B., Rodriguez, D., Cuenca-Estrella, M., Almela, M., Sanchez, F., Ayats, J., Alonso-Tarres, C., Rodriguez-Tudela, J. L., Pahissa, A., the Barcelona Candidemia Project Study Group, (2006). Epidemiology, Risk Factors, and Prognosis of Candida parapsilosis Bloodstream Infections: Case-Control Population-Based Surveillance Study of Patients in Barcelona, Spain, from 2002 to 2003.. J. Clin. Microbiol. 44: 1681-1685 [Abstract] [Full Text]  
• Lasker, B. A., Butler, G., Lott, T. J. (2006). Molecular Genotyping of Candida parapsilosis Group I Clinical Isolates by Analysis of Polymorphic Microsatellite Markers.. J. Clin. Microbiol. 44: 750-759 [Abstract] [Full Text]  
• Sarvikivi, E., Lyytikainen, O., Soll, D. R., Pujol, C., Pfaller, M. A., Richardson, M., Koukila-Kahkola, P., Luukkainen, P., Saxen, H. (2005). Emergence of Fluconazole Resistance in a Candida parapsilosis Strain That Caused Infections in a Neonatal Intensive Care Unit. J. Clin. Microbiol. 43: 2729-2735 [Abstract] [Full Text]