Abstract:
Background: The most frequently isolated fungi in patients using TPN belongs to the Candida genus. Various infections
including venous catheter infections, fungemia, endocarditis and ophthalmitis may be encountered. Objective: Upon
growth of Candida in the blood cultures from the pediatric (neonatal) unit of our hospital, a surveillance was performed
in this unit and involving the health care workers. Clonal relationships of the isolates were investigated with molecular
tests. Methods: Blood samples obtained from the patients in pediatric neonatal unit were studied with automatized blood
culture [BacT/Alert (Bio Mérioux, France)]. Yeast isolates from environmental surveillance cultures (TPN solutions,
hands of healthcare personnel, étagère, etc) and patients were identified as C. albicans with conventional methods and
ID 32 C and ATBTM Fungus 3 (Biomerieux, France) kits. Clonal similarity was determined by using AP-PCR as initial
method and we have also typified all strains by the method of REP-PCR (diversilab system,bioMérieux). Finally; Pulsed
Field Gel Electrophoresis (PFGE) was used for confirmation. Results: C. albicans was isolated in blood cultures of
seven patients. Similar antifungal susceptibility patterns were observed in all isolates. AP-PCR and REP-PCR showed
that the C. albicans isolates grown in the TPN solution and from the patients’ blood cultures were clonally same strains.
PFGE analysis further confirmed this clonality. Conclusion: According to results of the molecular methods, we thought
that a C. albicans outbreak had occurred in the neonatal pediatric unit, due to contamination of TPN solution.
