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Year : 2016  |  Volume : 34  |  Issue : 2  |  Page : 202-207

Candida albicans outbreak associated with total parenteral nutrition in the neonatal unit

1 Department of Medical Microbiology, School of Medicine, Yuzuncu Yil University, Van, Turkey
2 Department of Medical Microbiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
3 Division of Molecular Microbiology, Faculty of Medicine, Inonu University, Malatya, Turkey
4 Department of Medical Microbiology, Patnos State Hospital, Agri, Turkey
5 Department of Pediatrics, Division of Neonatology, School of Medicine, Yuzuncu Yil University, Van, Turkey
6 Department of Microbiology, Lokman Hekim Hospital, Van, Turkey

Correspondence Address:
H Guducuoglu
Department of Medical Microbiology, School of Medicine, Yuzuncu Yil University, Van
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0255-0857.180303

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Background: The most frequently isolated fungi in patients using TPN belongs to the Candida genus. Various infections including venous catheter infections, fungemia, endocarditis and ophthalmitis may be encountered. Objective: Upon growth of Candida in the blood cultures from the pediatric (neonatal) unit of our hospital, a surveillance was performed in this unit and involving the health care workers. Clonal relationships of the isolates were investigated with molecular tests. Methods: Blood samples obtained from the patients in pediatric neonatal unit were studied with automatized blood culture [BacT/Alert (Bio Mιrioux, France)]. Yeast isolates from environmental surveillance cultures (TPN solutions, hands of healthcare personnel, ιtagθre, etc) and patients were identified as C. albicans with conventional methods and ID 32 C and ATB TM Fungus 3 (Biomerieux, France) kits. Clonal similarity was determined by using AP-PCR as initial method and we have also typified all strains by the method of REP-PCR (diversilab system,bioMιrieux). Finally; Pulsed Field Gel Electrophoresis (PFGE) was used for confirmation. Results: C. albicans was isolated in blood cultures of seven patients. Similar antifungal susceptibility patterns were observed in all isolates. AP-PCR and REP-PCR showed that the C. albicans isolates grown in the TPN solution and from the patients' blood cultures were clonally same strains. PFGE analysis further confirmed this clonality. Conclusion: According to results of the molecular methods, we thought that a C. albicans outbreak had occurred in the neonatal pediatric unit, due to contamination of TPN solution.


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2004 - Indian Journal of Medical Microbiology
Published by Wolters Kluwer - Medknow

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