Skip to main content
Journal of Clinical Microbiology logoLink to Journal of Clinical Microbiology
. 1995 Dec;33(12):3278–3283. doi: 10.1128/jcm.33.12.3278-3283.1995

Contribution of molecular typing methods and antifungal susceptibility testing to the study of a candidemia cluster in a burn care unit.

E Bart-Delabesse 1, H van Deventer 1, W Goessens 1, J L Poirot 1, N Lioret 1, A van Belkum 1, F Dromer 1
PMCID: PMC228688  PMID: 8586717

Abstract

We investigated a cluster of cases of Candida septicemia diagnosed in four burn patients. Twenty clinical isolates of Candida albicans and two of Candida parapsilosis, plus eight isolates of C. albicans recovered from nurses' clothes, were analyzed by antifungal susceptibility testing and three genotyping methods (restriction fragment length polymorphism analysis with EcoRI and HinfI, arbitrarily primed PCR, and karyotyping). The high MICs of the azoles for all of the C. albicans isolates tested suggest either a natural resistance of the endogenous flora or the transmission of isolates with acquired resistance. The genotyping methods demonstrated the involvement of four different strains, cross-infections with one C. albicans strain and one C. parapsilosis strain, and identity between some of the strains from the patients and nurses. The origins of the strains remain unclear. Our results show that the use of a combination of at least two different methods such as those used in the present study is recommended for C. albicans typing.

Full Text

The Full Text of this article is available as a PDF (485.2 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anaissie E. J., Karyotakis N. C., Hachem R., Dignani M. C., Rex J. H., Paetznick V. Correlation between in vitro and in vivo activity of antifungal agents against Candida species. J Infect Dis. 1994 Aug;170(2):384–389. doi: 10.1093/infdis/170.2.384. [DOI] [PubMed] [Google Scholar]
  2. Bart-Delabesse E., Boiron P., Carlotti A., Dupont B. Candida albicans genotyping in studies with patients with AIDS developing resistance to fluconazole. J Clin Microbiol. 1993 Nov;31(11):2933–2937. doi: 10.1128/jcm.31.11.2933-2937.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Beck-Sagué C., Jarvis W. R. Secular trends in the epidemiology of nosocomial fungal infections in the United States, 1980-1990. National Nosocomial Infections Surveillance System. J Infect Dis. 1993 May;167(5):1247–1251. doi: 10.1093/infdis/167.5.1247. [DOI] [PubMed] [Google Scholar]
  4. Garcia-Hermoso D., Dromer F., Improvisi L., Provost F., Dupont B. Fluconazole concentrations in saliva from AIDS patients with oropharyngeal candidosis refractory to treatment with fluconazole. Antimicrob Agents Chemother. 1995 Mar;39(3):656–660. doi: 10.1128/AAC.39.3.656. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Goff D. A., Koletar S. L., Buesching W. J., Barnishan J., Fass R. J. Isolation of fluconazole-resistant Candida albicans from human immunodeficiency virus-negative patients never treated with azoles. Clin Infect Dis. 1995 Jan;20(1):77–83. doi: 10.1093/clinids/20.1.77. [DOI] [PubMed] [Google Scholar]
  6. Hunter P. R., Harrison G. A., Fraser C. A. Cross-infection and diversity of Candida albicans strain carriage in patients and nursing staff on an intensive care unit. J Med Vet Mycol. 1990;28(4):317–325. [PubMed] [Google Scholar]
  7. Kwon-Chung K. J., Edman J. C., Wickes B. L. Genetic association of mating types and virulence in Cryptococcus neoformans. Infect Immun. 1992 Feb;60(2):602–605. doi: 10.1128/iai.60.2.602-605.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Magee B. B., D'Souza T. M., Magee P. T. Strain and species identification by restriction fragment length polymorphisms in the ribosomal DNA repeat of Candida species. J Bacteriol. 1987 Apr;169(4):1639–1643. doi: 10.1128/jb.169.4.1639-1643.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Meunier F., Aoun M., Bitar N. Candidemia in immunocompromised patients. Clin Infect Dis. 1992 Mar;14 (Suppl 1):S120–S125. doi: 10.1093/clinids/14.supplement_1.s120. [DOI] [PubMed] [Google Scholar]
  10. Pearce M. A., Howell S. A. Restriction fragment length polymorphism analysis of azole-resistant and azole-susceptible Candida albicans strains. J Clin Microbiol. 1991 Jul;29(7):1364–1367. doi: 10.1128/jcm.29.7.1364-1367.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Pfaller M. A. Epidemiology and control of fungal infections. Clin Infect Dis. 1994 Aug;19 (Suppl 1):S8–13. doi: 10.1093/clinids/19.supplement_1.s8. [DOI] [PubMed] [Google Scholar]
  12. Rex J. H., Pfaller M. A., Rinaldi M. G., Polak A., Galgiani J. N. Antifungal susceptibility testing. Clin Microbiol Rev. 1993 Oct;6(4):367–381. doi: 10.1128/cmr.6.4.367. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Romano F., Ribera G., Giuliano M. A study of a hospital cluster of systemic candidosis using DNA typing methods. Epidemiol Infect. 1994 Apr;112(2):393–398. doi: 10.1017/s0950268800057800. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. States B., Segal S. Levels of gamma-glutamyltranspeptidase in cultured skin fibroblasts from cystinotics and normals. Life Sci. 1980 Nov 24;27(21):1985–1990. doi: 10.1016/0024-3205(80)90419-1. [DOI] [PubMed] [Google Scholar]
  15. Strausbaugh L. J., Sewell D. L., Ward T. T., Pfaller M. A., Heitzman T., Tjoelker R. High frequency of yeast carriage on hands of hospital personnel. J Clin Microbiol. 1994 Sep;32(9):2299–2300. doi: 10.1128/jcm.32.9.2299-2300.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Vazquez J. A., Beckley A., Donabedian S., Sobel J. D., Zervos M. J. Comparison of restriction enzyme analysis versus pulsed-field gradient gel electrophoresis as a typing system for Torulopsis glabrata and Candida species other than C. albicans. J Clin Microbiol. 1993 Aug;31(8):2021–2030. doi: 10.1128/jcm.31.8.2021-2030.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Vazquez J. A., Beckley A., Sobel J. D., Zervos M. J. Comparison of restriction enzyme analysis and pulsed-field gradient gel electrophoresis as typing systems for Candida albicans. J Clin Microbiol. 1991 May;29(5):962–967. doi: 10.1128/jcm.29.5.962-967.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Vazquez J. A., Sanchez V., Dmuchowski C., Dembry L. M., Sobel J. D., Zervos M. J. Nosocomial acquisition of Candida albicans: an epidemiologic study. J Infect Dis. 1993 Jul;168(1):195–201. doi: 10.1093/infdis/168.1.195. [DOI] [PubMed] [Google Scholar]
  19. Voss A., Hollis R. J., Pfaller M. A., Wenzel R. P., Doebbeling B. N. Investigation of the sequence of colonization and candidemia in nonneutropenic patients. J Clin Microbiol. 1994 Apr;32(4):975–980. doi: 10.1128/jcm.32.4.975-980.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Voss A., Pfaller M. A., Hollis R. J., Rhine-Chalberg J., Doebbeling B. N. Investigation of Candida albicans transmission in a surgical intensive care unit cluster by using genomic DNA typing methods. J Clin Microbiol. 1995 Mar;33(3):576–580. doi: 10.1128/jcm.33.3.576-580.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Weems J. J., Jr, Chamberland M. E., Ward J., Willy M., Padhye A. A., Solomon S. L. Candida parapsilosis fungemia associated with parenteral nutrition and contaminated blood pressure transducers. J Clin Microbiol. 1987 Jun;25(6):1029–1032. doi: 10.1128/jcm.25.6.1029-1032.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Wickes B., Staudinger J., Magee B. B., Kwon-Chung K. J., Magee P. T., Scherer S. Physical and genetic mapping of Candida albicans: several genes previously assigned to chromosome 1 map to chromosome R, the rDNA-containing linkage group. Infect Immun. 1991 Jul;59(7):2480–2484. doi: 10.1128/iai.59.7.2480-2484.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. van Belkum A., Kluytmans J., van Leeuwen W., Bax R., Quint W., Peters E., Fluit A., Vandenbroucke-Grauls C., van den Brule A., Koeleman H. Multicenter evaluation of arbitrarily primed PCR for typing of Staphylococcus aureus strains. J Clin Microbiol. 1995 Jun;33(6):1537–1547. doi: 10.1128/jcm.33.6.1537-1547.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. van Belkum A., Melchers W., de Pauw B. E., Scherer S., Quint W., Meis J. F. Genotypic characterization of sequential Candida albicans isolates from fluconazole-treated neutropenic patients. J Infect Dis. 1994 May;169(5):1062–1070. doi: 10.1093/infdis/169.5.1062. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Microbiology are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES