EVIDENCE OF NOSOCOMIAL SPREAD OF CANDIDA-ALBICANS CAUSING BLOOD-STREAM INFECTION IN A NEONATAL INTENSIVE-CARE UNIT

Candida albicans is an increasingly important bloodstream pathogen. We investigated a cluster of bloodstream infections in the neonatal inte nsive care unit (NICU) to determine whether nosocomial transmission oc curred. Subjects included any patient in the NICU who developed clinic ally significant bloodstream infection with C. albicans from January 1 984 to December 1987 (N = 7). Isolates were typed by restriction fragm ent length polymorphism analysis using a C. albicans-specific DNA prob e (27A). Four of the neonates were infected from June to August 1984 ( 1.4 infections per 100 admissions) (the epidemic period) versus none i n the period from January to May 1984, and three in the period from Se ptember 1984 to December 1987 (0.12 infections per 100 admissions) (P = .002). Three of the four patients in the epidemic period were infect ed with identical strains, readily distinguished from epidemiologicall y unrelated strains from the NICU. We conclude that nosocomial transmi ssion of C. albicans occurred and that neonates in intensive care unit s may represent one group at increased risk.