Jesús Guinea1,2,3, Sergio Mezquita1,2, Ana Gómez1,2, Belén Padilla1,2,3, Elena Zamora2,4, Manuel Sánchez-Luna2,4,5, Carlos Sánchez-Carrillo1,2,3, Patricia Muñoz1,2,3,6, Pilar Escribano1,2. 1. Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, 28007, Spain. 2. Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, 28007, Spain. 3. CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Spain. 4. Neonatology Department, Hospital General Universitario Gregorio Marañón, Madrid, 28007, Spain. 5. Pediatrics Department, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, 28007, Spain. 6. Medicine Department, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, 28007, Spain.
Abstract
Whole genome sequencing has been extensively used to describe infection outbreaks, although with limited application on Candida albicans and Candida parapsilosis.We retrospectively studied all patients admitted to the neonatal care unit diagnosed with candidemia caused by C. albicans (n = 46) or C. parapsilosis (n = 31) between 2007 and 2010 (Period 1) and 2011 and 2014 (Period 2). All isolates were genotyped by microsatellite markers. A cluster was defined as a group of ≥ 2 patients infected by strains with identical genotypes. For the validation of microsatellite markers and outbreak investigation, phylogenetic analyses and whole genome pairwise strain comparisons were performed.The number of episodes was significantly higher in Period 1 than in Period 2 (51 vs 32; P = 0.003); the reduction in the number of cases coincided with the educational campaign for catheter care implementation in 2011. Overall, eight genotypes were clusters involving 29 patients. All C. albicans (n = 5) and C. parapsilosis (n = 3) clusters were found during Period 1 before the educational campaign. No statistically significant differences were found between the percentage of C. albicans and C. parapsilosis clusters, but the percentage of patients associated to the clusters was significantly higher for C. parapsilosis clusters in comparison to C. albicans clusters (52 vs 28.2%; P = 0.03). Whole genome sequencing confirmed microsatellite-defined clusters with high bootstrap values.Whole genome sequences confirmed microsatellite-defined clusters, corroborating the presence of outbreaks. Persistent or sporadic Candida clusters causing candidemia in neonates disappeared after the implementation of catheter care educational campaigns. LAY SUMMARY: We retrospectively studied all patients admitted to the neonatal care unit diagnosed with candidemia caused by C. albicans or C. parapsilosis. Reliable whole genome sequences confirmed microsatellite-defined clusters, corroborating the presence of outbreaks before educational campaigns for catheter care.
Whole genome sequencing has been extensively used to describe infection outbreaks, although with limited application on Candida albicans and Candida parapsilosis.We retrospectively studied all patients admitted to the neonatal care unit diagnosed with candidemia caused by C. albicans (n = 46) or C. parapsilosis (n = 31) between 2007 and 2010 (Period 1) and 2011 and 2014 (Period 2). All isolates were genotyped by microsatellite markers. A cluster was defined as a group of ≥ 2 patients infected by strains with identical genotypes. For the validation of microsatellite markers and outbreak investigation, phylogenetic analyses and whole genome pairwise strain comparisons were performed.The number of episodes was significantly higher in Period 1 than in Period 2 (51 vs 32; P = 0.003); the reduction in the number of cases coincided with the educational campaign for catheter care implementation in 2011. Overall, eight genotypes were clusters involving 29 patients. All C. albicans (n = 5) and C. parapsilosis (n = 3) clusters were found during Period 1 before the educational campaign. No statistically significant differences were found between the percentage of C. albicans and C. parapsilosis clusters, but the percentage of patients associated to the clusters was significantly higher for C. parapsilosis clusters in comparison to C. albicans clusters (52 vs 28.2%; P = 0.03). Whole genome sequencing confirmed microsatellite-defined clusters with high bootstrap values.Whole genome sequences confirmed microsatellite-defined clusters, corroborating the presence of outbreaks. Persistent or sporadic Candida clusters causing candidemia in neonates disappeared after the implementation of catheter care educational campaigns. LAY SUMMARY: We retrospectively studied all patients admitted to the neonatal care unit diagnosed with candidemia caused by C. albicans or C. parapsilosis. Reliable whole genome sequences confirmed microsatellite-defined clusters, corroborating the presence of outbreaks before educational campaigns for catheter care.
Authors: Pilar Escribano; Jesús Guinea; Judith Díaz-García; Ana Gómez; Luis Alcalá; Elena Reigadas; Carlos Sánchez-Carrillo; Ana Pérez-Ayala; Elia Gómez-García de la Pedrosa; Fernando González-Romo; Paloma Merino-Amador; María Soledad Cuétara; Coral García-Esteban; Inmaculada Quiles-Melero; Nelly Daniela Zurita; María Muñoz-Algarra; Isabel Sánchez-Romero; María Teresa Durán-Valle; Aída Sánchez-García; Eva Alcoceba; Patricia Muñoz Journal: Antimicrob Agents Chemother Date: 2022-07-19 Impact factor: 5.938