Journal
JOURNAL OF CLINICAL MICROBIOLOGY
Volume 56, Issue 7, Pages -Publisher
AMER SOC MICROBIOLOGY
DOI: 10.1128/JCM.00574-18
Keywords
Candida albicans; Candida parapsilosis; candidemia; cluster; genotyping; catheter-related infection
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Funding
- Fondo de Investigacion Sanitaria (FIS
- Instituto de Salud Carlos III
- Plan Nacional de I + D + I) [PI14/00740, MSI15/00115]
- European Regional Development Fund (ERDF)
- FIS [CPI15/00115, CPII15/00006]
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The presence of clusters in units with a high incidence of candidemia suggests the need for the prevention of candidemia. We analyzed the percentage of patients involved in clusters and its evolution over a large period of time in a tertiary hospital. We studied 432 patients admitted to Gregorio Maranon Hospital with candidemia caused by Candida albicans (n = 276) or Candida parapsilosis (n = 156) between January 2007 and December 2014. Incident isolates were genotyped. A cluster was defined as a group of >2 patients infected by an identical genotype; we considered clusters to be tracking clusters when the patients involved in the cluster were admitted to the same ward within a period of 24 months. The study period was split into two periods, 2007 to 2010 (period 1) and 2011 to 2014 (period 2). The number of episodes of C. albicans and C. parapsilosis candidemia (n = 262 versus n = 170, respectively), the mean incidence (1.62 versus 1.36 episodes per 1,000 admissions, respectively), and the percentage of episodes caused by clusters (overall clusters [40% versus 12%] and tracking clusters [18% versus 3%], respectively) were significantly lower in period 2 than in period 1. Linear regression analysis showed a positive correlation between the overall number of episodes of candidemia and episodes caused by clusters (r(2) = 0.89). We found a reduction in the number of episodes of candidemia caused by C. albicans and C. parapsilosis and a decrease in the percentage of episodes caused by clusters over time. Interestingly, the reduction was accompanied by the implementation of a campaign to reduce the number of catheter-related infections.
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