MOLECULAR TRACKING OF CANDIDA-ALBICANS IN A NEONATAL INTENSIVE-CARE UNIT - LONG-TERM COLONIZATIONS VERSUS CATHETER-RELATED INFECTIONS

Nosocomial neonatal candidiasis is a major problem in infants requirin g intensive therapy, The subjects of this retrospective study were nin e preterm infants admitted to the neonatal intensive care unit of the Hospital Central de Asturias between March 1993 and August 1994. The i nfants were infected with or colonized by Candida albicans, Five patie nts developed C. albicans bloodstream infections. A total of 36 isolat es (including isolates from catheters and parenteral nutrition) were e xamined for molecular relatedness by PCR fingerprinting and restrictio n fragment length polymorphism (RFLP) analysis, The core sequence of p hage M13 was used as a single primer In the PCR-based fingerprinting p rocedure, and RFLP analysis was performed with C. albicans-specific DN A probe 27A. Both techniques were evaluated with a panel of eight C. a lbicans reference strains, and each technique showed eight different p atterns, With the 36 isolates from neonates, each technique enabled us to identify by PCR and RFLP analysis seven and six different patterns , respectively, The combination of these two methods (composite DNA ty pe) identified eight different profiles, A strain with one of these pr ofiles was present in three patients and in their respective catheters , Patients infected with or colonized by this isolate-profile were clu stered in time, Among the other patients, each patient was infected ov er time and at multiple anatomic sites with a C. albicans strain with a distinct DNA type, We conclude that C. albicans was most commonly pr oducing long-term colonizations, although horizontal transmission prob ably due to catheters also occurred.