A study of a hospital cluster of systemic candidosis using DNA typing methods.

A cluster of disseminated Candida albicans infections, which occurred at the Intensive Care Unit of the Department of Heart Surgery, was investigated. Ten patients became infected and seven died. A wide microbiological surveillance was carried out. A total of 14 isolates of Candida albicans, four environmental and ten human, were examined using the Restriction Endonuclease Analysis (REA) of DNA. The isolates were classified into five different main groups. Five of the clinical isolates had the predominant pattern Ab and two more clinical strains were very closely related. Two more isolates from the emergency kit desk and the hands of a nurse gave the same REA profile. Such a relationship proved the epidemic nature of the cluster, with most of the patients cross-infected, and strongly suggested transmission on the hands of the staff as a determinant of the epidemic. Thus, REA has the potential to address many important questions in the study of nosocomial epidemiology of Candida albicans.