To evaluate the mechanism and risk factors associated with the nosocom
ial acquisition of Candida albicans, a 10-month prospective study was
conducted in a 24-bed bone marrow transplant unit and an 8-bed medical
intensive care unit of a university hospital. A total of 98 patients
had samples taken on admission and during hospitalization for culture.
Samples from hands of hospital personnel and environmental surfaces w
ere also cultured. C. albicans was isolated from 52 patients, and each
patient was matched with a control. Fourteen patients acquired C. alb
icans after admission to the study. Prior antibiotics and length of ti
me spent in the unit were more common in patients with new acquisition
of C. albicans than in controls (92% vs. 64% and 32.5 vs. 13.0 days,
respectively). Restriction enzyme analysis revealed 32 strain types; 4
were common to 30 patients and 10 environmental surfaces. Identical s
trains of C. albicans from patients who were geographically and tempor
ally associated suggests the exogenous nosocomial acquisition of C. al
bicans through indirect patient contact.