Journal article
National Epidemiology of Mycoses Survey: A Multicenter Study of Strain Variation and Antifungal Susceptibility Among Isolates of Candida Species
Diagnostic microbiology and infectious disease, Vol.31(1), pp.289-296
1998
DOI: 10.1016/S0732-8893(97)00245-9
PMID: 9597389
Abstract
The National Epidemiology of Mycoses Survey (NEMIS) involves six academic centers studying fungal infections in surgical and neonatal intensive care unit (ICU) patients. We studied variation in species and strain distribution and antifungal susceptibility of 408 isolates of
Candida spp.
Candida spp. were isolated from blood, other normally sterile site cultures, abscesses, wounds, catheters, and tissue biopsies of 141 patients hospitalized in the surgical (107 patients) and neonatal (34 patients) ICUs of medical centers located in Oregon, Iowa, California, Texas, Georgia, and New York. Isolates were also obtained from selected colonized patients (16 patients) and the hands of health care workers (27 individuals). DNA typing was performed using pulsed field gel electrophoresis, and antifungal susceptibility to amphotericin B, 5-fluorocytosine, fluconazole, and itraconazole was determined using National Committee for Clinical Laboratory Standards (NCCLS) methods. Important variation in susceptibility to itraconazole and fluconazole was noted: MICs of itraconazole ranged from 0.25 μg/mL (MIC
90) in Texas to 2.0 μg/mL (MIC
90) in New York. Similarly, the MIC
90 for fluconazole was higher for isolates from New York (64 μg/mL) compared to the other sites (8–16 μg/mL). In general, DNA typing revealed patient-unique strains; however, there were 13 instances of possible cross-infection noted in 5 of the medical centers. Notably, 9 of the 13 clusters involved species of
Candida other than
C. albicans. Potential transmission from patient-to-patient
(C. albicans, C. glabrata, C. tropicalis, C. parapsilosis) and health care worker-to-patient
(C. albicans, C. parapsilosis, C. krusei) was noted in both surgical ICU and neonatal ICU settings. These data provide further insight into the epidemiology of nosocomial candidiasis in the ICU setting.
Details
- Title: Subtitle
- National Epidemiology of Mycoses Survey: A Multicenter Study of Strain Variation and Antifungal Susceptibility Among Isolates of Candida Species
- Creators
- M.A Pfaller - University of Iowa College of Medicine, Iowa City, Iowa, USA (MAP, SAM, AH, MSR-F, TW)S.A Messer - University of Iowa College of Medicine, Iowa City, Iowa, USA (MAP, SAM, AH, MSR-F, TW)A Houston - University of Iowa College of Medicine, Iowa City, Iowa, USA (MAP, SAM, AH, MSR-F, TW)M.S Rangel-Frausto - University of Iowa College of Medicine, Iowa City, Iowa, USA (MAP, SAM, AH, MSR-F, TW)T Wiblin - University of Iowa College of Medicine, Iowa City, Iowa, USA (MAP, SAM, AH, MSR-F, TW)H.M Blumberg - Emory University School of Medicine, Atlanta, Georgia, USA (HMB, WJ)J.E Edwards - University of California School of Medicine, Los Angeles, California, USA (JEE)W Jarvis - Emory University School of Medicine, Atlanta, Georgia, USA (HMB, WJ)M.A Martin - Oregon Health Sciences University, Portland, Oregon, USA (MAM)H.C Neu - Columbia University, New York, New York, USA (HCN, LS)L Saiman - Columbia University, New York, New York, USA (HCN, LS)J.E Patterson - University of Texas Health Science Center, San Antonio, Texas, USA (JEP, JCD, CMR, MGR)J.C Dibb - University of Texas Health Science Center, San Antonio, Texas, USA (JEP, JCD, CMR, MGR)C.M Roldan - University of Texas Health Science Center, San Antonio, Texas, USA (JEP, JCD, CMR, MGR)M.G Rinaldi - University of Texas Health Science Center, San Antonio, Texas, USA (JEP, JCD, CMR, MGR)R.P Wenzel - Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia (RPW), USA
- Resource Type
- Journal article
- Publication Details
- Diagnostic microbiology and infectious disease, Vol.31(1), pp.289-296
- DOI
- 10.1016/S0732-8893(97)00245-9
- PMID
- 9597389
- NLM abbreviation
- Diagn Microbiol Infect Dis
- ISSN
- 0732-8893
- eISSN
- 1879-0070
- Publisher
- Elsevier Inc
- Language
- English
- Date published
- 1998
- Academic Unit
- Epidemiology; Pathology; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984094652202771
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