ABSTRACT
Antecedentes. Las infecciones oportunistas son un problema cada vez más frecuente en los hospitales, y Candida parapsilosis se está convirtiendo en un importante patógeno nosocomial, sobre todo en las unidades de cuidados intensivos neonatales (UCIN) donde ha sido responsable de brotes de candidiasis invasoras. En recién nacidos, los factores de riesgo de infección por C. parapsilosis incluyen la prematuridad, bajo peso al nacer, la hospitalización prolongada, los catéteres venosos centrales permanentes, alimentación parenteral, las emulsiones grasas por vía intravenosa y la administración de antibióticos de amplio espectro. Para esclarecer el origen y evolución de estos brotes hospitalarios, pueden utilizarse métodos moleculares, que permiten estudiar las variaciones genéticas entre los aislamientos clínicos. Objetivos. El objetivo del presente estudio fue estudiar un brote de C. parapsilosis en la UCIN del Hospital das Clinicas, Facultad de Medicina de Botucatu, un hospital de asistencia terciaria de São Paulo, Brasil, usando una técnica de genotipificación molecular basada en el estudio de microsatélites. Métodos. Durante un período de 43 días en la UCIN, se diagnosticaron un total de 11 casos de fungemia por C. parapsilosis. Para confirmar el brote, todas las cepas se sometieron a análisis de tipificación molecular utilizando la técnica de microsatélites. Resultados. Se observó el mismo genotipo en 9 de las 11 cepas estudiadas, lo que permitió confirmar la presencia de un brote de C. parapsilosis en la UCIN del hospital. Conclusiones. El presente estudio revela que el análisis de marcadores de microsatélites puede ser de utilidad para los objetivos ya mencionados. Es de destacar la importancia de usar técnicas moleculares para la detección precoz de brotes hospitalarios y la introducción eficaz de medidas preventivas, en especial en las UCIN(AU)
Background. Opportunistic infections are an increasingly common problem in hospitals, and the yeast Candida parapsilosis has emerged as an important nosocomial pathogen, especially in neonatal intensive care units (NICUs) where it has been responsible for outbreak cases. Risk factors for C. parapsilosis infection in neonates include prematurity, very low birth weight, prolonged hospitalization, indwelling central venous catheters, hyperalimentation, intravenous fatty emulsions and broad spectrum antibiotic therapy. Molecular methods are widely used to elucidate these hospital outbreaks, establishing genetic variations among strains of yeast. Aims. The aim of this study was to detect an outbreak of C. parapsilosis in an NICU at the Hospital das Clinicas, Faculty of Medicine of Botucatu, a tertiary hospital located in São Paulo, Brazil, using the molecular genotyping by the microsatellite markers analysis. Methods. A total of 11 cases of fungemia caused by C. parapsilosis were identified during a period of 43 days in the NICU. To confirm the outbreak all strains were molecularly typed using the technique of microsatellites. Results. Out of the 11 yeast samples studied, nine showed the same genotypic profile using the technique of microsatellites. Conclusions. Our study shows that the technique of microsatellites can be useful for these purposes. In conclusion, we detected the presence of an outbreak of C. parapsilosis in the NICU of the hospital analyzed, emphasizing the importance of using molecular tools, for the early detection of hospital outbreaks, and for the introduction of effective preventive measures, especially in NICUs(AU)
Subject(s)
Humans , Male , Female , Infant, Newborn , Fungemia/complications , Fungemia/diagnosis , Critical Care/methods , Critical Care , Opportunistic Infections/complications , Opportunistic Infections/diagnosis , Fungemia/therapy , Critical Care/organization & administration , Critical Care/trends , Microsatellite Instability , Microsatellite Instability/radiation effects , Opportunistic Infections/microbiology , Molecular Biology/methodsABSTRACT
BACKGROUND: Opportunistic infections are an increasingly common problem in hospitals, and the yeast Candida parapsilosis has emerged as an important nosocomial pathogen, especially in neonatal intensive care units (NICUs) where it has been responsible for outbreak cases. Risk factors for C. parapsilosis infection in neonates include prematurity, very low birth weight, prolonged hospitalization, indwelling central venous catheters, hyperalimentation, intravenous fatty emulsions and broad spectrum antibiotic therapy. Molecular methods are widely used to elucidate these hospital outbreaks, establishing genetic variations among strains of yeast. AIMS: The aim of this study was to detect an outbreak of C. parapsilosis in an NICU at the "Hospital das Clinicas", Faculty of Medicine of Botucatu, a tertiary hospital located in São Paulo, Brazil, using the molecular genotyping by the microsatellite markers analysis. METHODS: A total of 11 cases of fungemia caused by C. parapsilosis were identified during a period of 43 days in the NICU. To confirm the outbreak all strains were molecularly typed using the technique of microsatellites. RESULTS: Out of the 11 yeast samples studied, nine showed the same genotypic profile using the technique of microsatellites. CONCLUSIONS: Our study shows that the technique of microsatellites can be useful for these purposes. In conclusion, we detected the presence of an outbreak of C. parapsilosis in the NICU of the hospital analyzed, emphasizing the importance of using molecular tools, for the early detection of hospital outbreaks, and for the introduction of effective preventive measures, especially in NICUs.
