Candida albicans strain carriage in patients and nursing staff of an intensive care unit: a study of morphotypes and resistotypes.

Candida albicans carriage of patients and nursing staff of an intensive care unit (ICU) was studied over an 8-month period. Swabs were taken at weekly intervals from multiple sites from patients. None of the patients had clinical Candida infection at the time of the first sampling. The hands and mouth of the nursing staff were sampled at fortnightly intervals. Of the 68 patients investigated for varying periods, 37 (54%) yielded C. albicans from one or more body sites, resulting in the isolation of 269 strains. Nosocomial acquisition of C. albicans was recorded in seven (19%) patients. The frequency of C. albicans isolation increased with extended stay in ICU. Sixteen of the 180 samples taken from hands and mouth of nursing staff, yielded C. albicans, 12 of which came from the mouth. Morphotyping of 88 randomly selected strains of C. albicans originating from 31 patients yielded 34 morphotypes. There appeared to be no preference for any morphotype to colonize a particular anatomic site. Based on the susceptibility results, nine resistotypes were recognized. No correlation was apparent between any specific morphotype and resistotype patterns. The differences in morphotype and resistogram patterns of C. albicans isolates originating from same patients over a period of time suggest that some of the patients were colonized with more than one strain. Similarities in the morphotype and resistotype patterns of C. albicans strains isolated from patients and nursing staff tend to suggest possibility of exogenous acquisition.