Journal of Microbiology

The Microbiological Society of Korea (한국미생물학회)
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Molecular Epidemiological Analysis of Bloodstream Isolates of Candida albicans from a University Hospital over a Five-Year Period

  • Shin Jong Hee (Department of Laboratory Medicine, Chonnam National University Medical School) ;
  • Og Yu Gyung (Department of Laboratory Medicine, Chonnam National University Medical School) ;
  • Cho Duck (Department of Laboratory Medicine, Chonnam National University Medical School) ;
  • Kee Seung Jung (Department of Laboratory Medicine, Chonnam National University Medical School) ;
  • Shin Myung Geun (Department of Laboratory Medicine, Chonnam National University Medical School) ;
  • Suh Soon Pal (Department of Laboratory Medicine, Chonnam National University Medical School) ;
  • Ryang Dong Wook (Department of Laboratory Medicine, Chonnam National University Medical School)
  • Published : 2005.12.01
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Abstract

We assessed the genetic relations and epidemiological links among bloodstream isolates of Candida albicans, which were obtained from a university hospital over a period of five years. The 54 bloodstream isolates from the 38 patients yielded 14 different karyotypes, 29 different patterns after digestion with SfiI (REAG-S), and 31 different patterns after digestion with BssHII (REAG-B) when analyzed using three different pulsed-field gel electrophoresis (PFGE) typing methods. In 11 patients with serial blood stream isolates, all strains from each patient had the same PFGE pattern. The dendrograms for all of the strains revealed that the distribution of similarity values ranged from 0.70 to 1.0 in the REAG-S patterns, and from 0.35 to 1.0 in the REAG-B patterns. Overall, the combination of the three different PFGE methods identified 31 distinct types, reflecting the results obtained using the REAG-B alone different. different Five PFGE types were shared among 22 isolates from 12 patients. These types of strains were more frequently associated with central venous catheter-related fungemia than the other 26 type strains $(92\%\;versus\;31\%;\;P<0.005)$. Of five PFGE types, four isolates were determined to be epidemiologically related: each of these types was primarily from two or three patients who had been hospitalized concurrently within the same intensive care unit. Our results suggest that the REAG-B constitutes perhaps the most useful PFGE method for investigating C. albicans candidemia and also shows that a relatively high proportion of C. albicans candidemia may be associated with exogenous acquisition of clonal strains.

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References

  1. Abi-Said, D., E. Anaissie, O. Uzun, I. Raad, H. Pinzcowski, and S. Vartivarian. 1997. The epidemiology of hematogenous candidiasis caused by different Candida species. Clin. Infect. Dis. 24, 1122-1128 https://doi.org/10.1086/513663
  2. Banerjee, S., T. Emori, D. Culver, R. Gaynes, W. Jarvis, T. Horan, J. Edwards, J. Tolson, T. Henderson, and W. Martone. 1991. Secular trends in nosocomial primary bloodstream infections in the United States, 1980-1989. National Nosocomial Infections Surveillance System. Am. J. Med. 91, 86S-89S
  3. Edmond, M.B., S.E. Wallace, D.K. McClish, M.A. Pfaller, R.N. Jones, and R.P. Wenzel. 1999. Nosocomial bloodstream infections in United States hospitals: a three-year analysis. Clin. Infect. Dis. 29, 239-244 https://doi.org/10.1086/520192
  4. Ellepola, A.N. and C.J. Morrison. 2005. Laboratory diagnosis of invasive candidiasis. J. Microbiol. 43, 65-84
  5. Hunter P.R. and M.A. Gaston. 1988. Numerical index of the discriminatory ability of typing systems: an application of Simpson's index of diversity. J. Clin. Microbiol. 26, 2465-2466
  6. Marco, F., S.R. Lockhart, M.A. Pfaller, C. Pujol, M.S. Rangel-Frausto, T. Wiblin, H.M. Blumberg, J.E. Edwards, W. Jarvis, L. Saiman, J.E. Patterson, M.G. Rinaldi, R.P. Wenzel, The Nemis Study Group, and D. R. Soll. 1999. Elucidating the origins of nosocomial infections with Candida albicans by DNA fingerprinting with the complex probe Ca3. J. Clin. Microbiol. 37, 2817-2828
  7. National Committee for Clinical Laboratory Standards. 1997. Reference method for broth dilution antifungal susceptibility testing of yeasts. Approved standard M27-A. National Committee for Clinical Laboratory Standards, Wayne, Pennsylvania
  8. Pfaller, M.A. 1994. Epidemiology and control of fungal infections. Clin. Infect. Dis. 19 (Suppl.), S8-13 https://doi.org/10.1093/clinids/19.Supplement_1.S8
  9. Pfaller, M.A., J. Rhine-Chalberg, A.L. Barry, and J.H. Rex. 1995. Strain variation and antifungal susceptibility among blood-stream isolates of Candida species from 21 different medical institutions. Clin. Infect. Dis. 21, 1507-1509 https://doi.org/10.1093/clinids/21.6.1507
  10. Pfaller, M.A. 1995. Epidemiology of candidiasis. J. Hosp. Infect. 30 (Suppl.), 329-338 https://doi.org/10.1016/0195-6701(95)90036-5
  11. Pfaller, M.A. 1996. Nosocomial candidiasis: emerging species, reservoirs, and modes of transmission. Clin. Infect. Dis. 22 (Suppl.), 589-594
  12. Raad, I. 1998. Intravascular-catheter-related infections. Lancet. 351, 893-898 https://doi.org/10.1016/S0140-6736(97)10006-X
  13. Rex, J.H. 1996. Editorial response: catheter and candidemia. Clin. Infect. Dis. 22, 467-470 https://doi.org/10.1093/clinids/22.3.467
  14. Rho J., J.H. Shin, J.W. Song, M.R. Park, S.J. Kee, S.J. Jang, Y.K. Park, S.P. Suh, and D.W. Ryang. 2004. Molecular investigation of two consecutive nosocomial clusters of Candida tropicalis candiduria using pulsed-field gel electrophoresis. J. Microbiol. 42, 80-86
  15. Richard, B., J.R. Thomson, and J.M. Miller. 2003. Specimen collection, transport, and processing: bacteriology, p. 286-330. In P.R. Murray, E.J. Baron, J.H. Jorgensen, M.A. Pfaller, and R.H. Yolken (ed.), Manual of Clinical Microbiology, 8th ed. American Society for Microbiology, Washington, D.C
  16. Ruiz-Diez, B., V. Martinez, M. Alvarez, J.L. Rodriguez-Tudela, and J.V. Martinez-Suarez. 1997. Molecular tracking of Candida albicans in a neonatal intensive care unit: long-term colonizations versus catheter-related infections. J. Clin. Microbiol. 35, 3032-3036
  17. Shin, J.H., D.H. Shin, J.W. Song, S.J. Kee, S.P. Suh, and D.W. Ryang. 2001. Electrophoretic karyotype analysis of sequential Candida parapsilosis isolates from patients with persistent or recurrent fungemia. J. Clin. Microbiol. 39, 1258-1263 https://doi.org/10.1128/JCM.39.4.1258-1263.2001
  18. Shin, J.H., S.J. Kee, M.G. Shin, S.H. Kim, D.H. Shin, S.K. Lee, S.P. Suh, and D.W. Ryang. 2002. Biofilm production by isolates of Candida species recovered from nonneutropenic patients: comparison of bloodstream isolates with isolates from other sources. J. Clin. Microbiol. 40, 1244-1248 https://doi.org/10.1128/JCM.40.4.1244-1248.2002
  19. Shin, J.H., M.N. Kim, D.H. Shin, S.I. Jung, K.J. Kim, D. Cho, S.J. Kee, M.G. Shin, S.P. Suh, and D.W. Ryang. 2004. Genetic relations among Candida tropicalis isolates from sporadic cases of fungemia in two university hospitals in Korea. Infect. Control. Hosp. Epidemiol. 25, 634-640 https://doi.org/10.1086/502453
  20. Shin, J.H., M.R. Park, J.W. Song, D.H. Shin, S.I. Jung, D.H. Shin, S.K. Lee, M.G. Shin, S.P. Suh, and D.W. Ryang. 2004. Microevolution of Candida albicans strains during catheter-related candidemia. J. Clin. Microbiol. 42, 4025-4031 https://doi.org/10.1128/JCM.42.9.4025-4031.2004
  21. Soll, D.R., S.R. Lockhart, and C. Pujol. 2003. Laboratory procedures for the epidemiological analysis of microorganisms, p. 139-161. In P.R. Murray, E.J. Baron, J.H. Jorgensen, M.A. Pfaller, and R.H. Yolken (ed.), Manual of Clinical Microbiology, 8th ed. American Society for Microbiology, Washington, D.C
  22. Voss, A., R.J. Hollis, M.A. Pfaller, R.P. Wenzel, and B.N. Doebbeling. 1994. Investigation of the sequence of colonization and candidemia in nonneutropenic patients. J. Clin. Microbiol. 32, 975-980
  23. Voss, A., M.A. Pfaller, R.J. Hollis, J. Rhine-Chalberg, and B.N. Doebbeling. 1995. Investigation of Candida albicans transmission in a surgical intensive care unit cluster by using genomic DNA typing methods. J. Clin. Microbiol. 33, 576-580
  24. Waggoner-Fountain, L.A., M.W. Walker, R.J. Hollis, M.A. Pfaller, J.E. 2nd Ferguson, R.P. Wenzel, and L.G. Donowitz. 1996. Vertical and horizontal transmission of unique Candida species to premature newborns. Clin. Infect. Dis. 22. 803-808 https://doi.org/10.1093/clinids/22.5.803
  25. Wenzel, R.P. 1995. Nosocomial candidemia: risk factors and attributable mortality. Clin. Infect. Dis. 20, 1531-1534 https://doi.org/10.1093/clinids/20.6.1531