An outbreak of Candida parapsilosis bloodstream infections in patients receiving parenteral nutrition.

From July to September 1981, five patients at one hospital had bloodstream infections or colonization of an intravascular cannula with Candida parapsilosis. All five cases, but none of 34 controls, were receiving parenteral nutrition at the onset of infection or colonization (P less than 0.01; Fisher's exact test, one-tailed). Epidemiologic investigation showed that human serum albumin was more frequently added to parenteral nutrition solutions during the epidemic period than during a comparable period a year earlier. The increase in human serum albumin use coincided with the more frequent use of an electrically powered vacuum pump to assist in compounding parenteral nutrition solutions. Cultures from the vacuum pump showed heavy growth of C parapsilosis from multiple sites. Laboratory investigation demonstrated that sterile solutions could be contaminated by use of the vacuum pump. Use of the vacuum pump was stopped, and no further cases occurred.