NOSOCOMIAL CANDIDA-GLABRATA COLONIZATION - AN EPIDEMIOLOGIC-STUDY

Candida glabrata has emerged as an important nosocomial pathogen, yet little is known about its epidemiology. We prospectively followed 98 p atients admitted to a medical intensive care unit and the bone marrow transplant unit of a university hospital. Samples from environmental s urfaces and the hands of hospital personnel were also cultured. Patien ts with newly acquired C. glabrata strains were compared to controls w ho were culture negative for C. glabrata. C. glabrata was recovered fr om multiple sites from 24 patients and three environmental surfaces. S ixteen patients (17%) acquired C. glabrata after admission to the stud y units. Significant risk factors for the nosocomial acquisition of C. glabrata were prolonged duration of hospitalization in the unit and p rior antimicrobial use. Strain delineation by restriction enzyme analy sis revealed 28 different strains of C. glabrata; three strain types w ere common to nine patients. The environmental isolates were of the sa me strain type and common to five patients (four patients with newly a cquired strains). These results suggest the possibility of exogenous n osocomial acquisition of C. glabrata, including the possible acquisiti on from the hospital environment, Transmission may be by indirect cont act since identical strains of C. glabrata were recovered from patient s who were geographically and temporally associated.