Epidemiology of yeast colonization in the intensive care unit

In order to investigate the epidemiology of colonization and possible trans mission of yeasts among patients and healthcare workers in adult intensive care units (ICUs), 194 patients were followed for a mean of 9 +/- 11 days a nd 63 healthcare workers were followed for a mean of 132 +/- 52 days. Among the patients, 142 (73%) were colonized by yeast, with Candida albicans bei ng the species most commonly recovered. Most patients (65%) were already co lonized with yeast upon admission to the intensive care unit; only 17% beca me colonized after admission. Persistent colonization occurred in 51 (55%) of 92 patients who had more than three cultures performed; in 75% of them, colonization persisted with the same strain of Candida albicans or Candida glabrata, Bacterial infection in the month preceding entry into the ICU was the only risk factor significantly associated with yeast colonization. Amo ng the healthcare workers, yeasts were isolated from 42 (67%). Candida albi cans was most frequently recovered from the oropharynx (19% of occasions), and Candida parapsilosis was most frequently found on hands (8% of occasion s). Persistent colonization of the oropharynx occurred in only six healthca re workers, and none had persistence of yeasts on hands. In this non-outbre ak setting, 5 (4%) of 123 patient/healthcare worker interactions that were linked epidemiologically yielded the same strain of Candida albicans, provi ding evidence for possible cross-transmission. No similar link was found be tween healthcare worker-patient interactions and colonization with Candida glabrata or Candida parapsilosis.