1/7. Horizontal transmission of Candida parapsilosis candidemia in a neonatal intensive care unit.This report describes the nosocomial acquisition of Candida parapsilosis candidemia by one of the six premature newborns housed in the same room of a neonatal intensive care unit at the Ospedale Santa Chiara, Pisa, italy. The infant had progeria, a disorder characterized by retarded physical development and progressive senile degeneration. The infant, who was not found to harbor C. parapsilosis at the time of his admission to the intensive care unit, had exhibited symptomatic conjunctivitis before the onset of a severe bloodstream infection. In order to evaluate the source of infection and the route of transmission, two independent molecular typing methods were used to determine the genetic relatedness among the isolates recovered from the newborn, the inanimate hospital environment, hospital personnel, topically and intravenously administered medicaments, and indwelling catheters. Among the isolates collected, only those recovered from the hands of two nurses attending the newborns and from both the conjunctiva and the blood of the infected infant were genetically indistinguishable. Since C. parapsilosis was never recovered from indwelling catheters or from any of the drugs administered to the newborn, we concluded that (i) horizontal transmission of C. parapsilosis occurred through direct interaction between nurses and the newborn and (ii) the conjunctiva was the site through which C. parapsilosis entered the bloodstream. This finding highlights the possibility that a previous C. parapsilosis colonization and/or infection of other body sites may be a predisposing condition for subsequent C. parapsilosis hematogenous dissemination in severely ill newborns.- - - - - - - - - - ranking = 1keywords = candidemia (Clic here for more details about this article) |
2/7. Late onset Candida parapsilosis endocarditis after surviving nosocomial candidemia in an infant with structural heart disease.The incidence of nosocomial candidemia is increasing. Late onset endocarditis after surviving nosocomial fungemia is described in adults. We report a case of late onset Candida parapsilosis endocarditis of a structurally abnormal aortic valve in an infant surviving nosocomial candidemia.- - - - - - - - - - ranking = 1.2keywords = candidemia (Clic here for more details about this article) |
3/7. survival of candida sepsis in extracorporeal membrane oxygenation.OBJECTIVE: To report the survival of fungal sepsis in extracorporeal membrane oxygenation. DESIGN: Single case report. SETTING: Tertiary referral children's hospital pediatric intensive care unit. patients: A single case report of an infant with congenital heart disease who developed candida sepsis while supported postoperatively with extracorporeal membrane oxygenation. RESULTS: This infant survived a prolonged episode of candidemia after repair of congenital heart disease, which required extracorporeal membrane oxygenation support. The patient has no identified sequelae at 6-month follow-up and continues on long-term fluconazole therapy for candida endocarditis. CONCLUSIONS: candidemia, particularly candida albicans species, may not be a contraindication for extracorporeal membrane oxygenation support. With antifungal therapy and adequate inotropic use to counter the effects of septicemia, survival can be maintained until the patient adequately recovers, allowing decannulation, removal of all catheters, and eventual bloodstream sterility.- - - - - - - - - - ranking = 0.2keywords = candidemia (Clic here for more details about this article) |
4/7. A case of recurrent episodes of Candida parapsilosis fungemia.Candida species is the fourth most commonly isolated organism in blood stream infections in the hospital setting. patients with candidemia frequently succumb to this infection. For those that survive an initial candidemia, an increasing number of cases of breakthrough or recurrent candidemias have been reported in the literature. We report three episodes of C. parapsilosis fungemia in a cancer patient. Molecular testing was performed and confirmed that all these episodes occurring within an eight-month period were caused by the same organism. The incidence of recurrent candidemia is likely to increase in the near future. Studies and therapeutic interventions for patients at risk for recurrent candidemias are warranted.- - - - - - - - - - ranking = 1keywords = candidemia (Clic here for more details about this article) |
5/7. Nosocomial candidemia: risk factors and attributable mortality.Over the past decade, the incidence of hospital-acquired bloodstream infections caused by Candida species has risen and the species associated with such infections have changed. The incidence of candidemia is dramatically higher in high-risk, critical-care units than in other parts of the hospital. Certain underlying physical conditions including acute leukemia, leukopenia, burns, gastrointestinal disease, and premature birth predispose patients to nosocomial candidemia. Independent risk factors include prior treatment with multiple antibiotics, prior Hickman catheterization, isolation of Candida species from sites other than the blood, and prior hemodialysis. In this article some of the challenges posed by the management of nosocomial candidemia are presented in three case studies. In addition, the results of several investigations of nosocomial candidemia at the University of iowa hospitals and Clinics are reviewed.- - - - - - - - - - ranking = 1.6keywords = candidemia (Clic here for more details about this article) |
6/7. Failure of therapy with fluconazole for candidal endophthalmitis.The incidence of candidemia and its complications, such as endophthalmitis, has measurably increased in recent years. However, the optimal method of treatment of hematogenous candidal infection remains a controversial issue. Traditional therapy with amphotericin b is associated with well-known adverse reactions. Many clinicians therefore prefer to use fluconazole, which is administered orally and is relatively less toxic. We recently observed a patient with candidal sepsis in whom blinding endophthalmitis developed despite aggressive and lengthy therapy with fluconazole. This grave clinical outcome and the data derived from experimental models of ocular candidal infection suggest that empirical usage of fluconazole may not be warranted in cases of disseminated candidiasis potentially complicated by endophthalmitis.- - - - - - - - - - ranking = 0.2keywords = candidemia (Clic here for more details about this article) |
7/7. Contribution of molecular typing methods and antifungal susceptibility testing to the study of a candidemia cluster in a burn care unit.We investigated a cluster of cases of Candida septicemia diagnosed in four burn patients. Twenty clinical isolates of candida albicans and two of Candida parapsilosis, plus eight isolates of C. albicans recovered from nurses' clothes, were analyzed by antifungal susceptibility testing and three genotyping methods (restriction fragment length polymorphism analysis with EcoRI and HinfI, arbitrarily primed PCR, and karyotyping). The high MICs of the azoles for all of the C. albicans isolates tested suggest either a natural resistance of the endogenous flora or the transmission of isolates with acquired resistance. The genotyping methods demonstrated the involvement of four different strains, cross-infections with one C. albicans strain and one C. parapsilosis strain, and identity between some of the strains from the patients and nurses. The origins of the strains remain unclear. Our results show that the use of a combination of at least two different methods such as those used in the present study is recommended for C. albicans typing.- - - - - - - - - - ranking = 0.8keywords = candidemia (Clic here for more details about this article) |