Nosocomial cluster of Candida lipolytica fungemia in pediatric patients

Candida lipolytica has rarely been reported as a human pathogen. An apparen t outbreak of Candida lipolytica fungemia (n = 5 cases) occurred in a pedia tric ward over a 9-week period. The five patients infected were hospitalize d in three adjacent rooms and cared for by the same healthcare workers. The index patient had central venous catheter-related fungemia, whereas the se cond patient, who was in the adjacent single room, had transient fungemia. Three additional cases of fungemia occurred in patients with hematological disorders who shared the same I-oem; all three patients had central venous catheters and had been receiving oral fluconazole prophylaxis (50 mg/day fo r more than 3 weeks) at the time of infection. in vitro susceptibility test ing of the strains showed that the MIC of fluconazole for all the isolates was 32 mu g/ml. Random amplified polymorphic DNA analysis provided evidence of the clonal origin of the isolates, but the source of the outbreak was n or identified. All four patients with persistent fungemia were successfully treated via catheter removal or empiric amphotericin B treatment. This out break shows the potential for the nosocomial epidemic transmission of Candi da lipolytica.