NOSOCOMIAL OUTBREAK OF CANDIDA-ALBICANS STERNAL WOUND INFECTIONS FOLLOWING CARDIAC-SURGERY TRACED TO A SCRUB NURSE

From August 1988 through October 1989, 15 patients at 1 hospital devel oped Candida albicans sternal wound infections after cardiac surgery, An investigation found that case-patients were more likely than cardia c surgery patients without sternal wound infections to have surgeries lasting >165 min (11/15 vs, 20/45; odds ratio [OR], 5.0; 95% confidenc e interval [CI], 1.5-16.3) or exposure to first scrub nurse A (15/15 v s. 22/45; OR, infinity; 95% CI, 2.5, infinity), Molecular typing of 5 case-patient C. albicans isolates revealed a common strain, Nurse A ha d a history of recurrent vaginal infections responding to topical anti fungal agents; however, cultures of multiple samples from nurse A, beg inning 3 weeks after the last infected patient's surgery, failed to yi eld C. albicans. Following her voluntary transfer from cardiac surgery , no additional infections of case-patients were detected, This study demonstrates the utility of combining epidemiologic methods and molecu lar typing in investigating C. albicans infection clusters and suggest s that a common exogenous source can be responsible for C. albicans su rgical wound infections.