Detection of neonatal unit clusters of Candida parapsilosis fungaemia by microsatellite genotyping: Results from laboratory‐based sentinel surveillance, South Africa, 2009‐2010. Issue 5 (19th January 2017)

• Record Type: Journal Article
• Authors: Magobo, Rindidzani E.; Naicker, Serisha D.; Wadula, Jeannette; Nchabeleng, Maphoshane; Coovadia, Yacoob; Hoosen, Anwar; Lockhart, Shawn R.; Govender, Nelesh P.
• Other Names: van Rensburg Chris Janse investigator.; Whitelaw Andrew investigator.; Zietsman Inge investigator.; Miller Norman investigator.; Smith Peter investigator.; van Greune Johan investigator.; Brink Adrian investigator.; Perovic Olga investigator.; Nchabaleng Maphoshane investigator.; Orth Heidi investigator.; Badenhorst Loekie investigator.; Moolman Johan investigator.; Peer AK investigator.; Govind Chetna investigator.; Kularatne Ranmini investigator.; Bhagoobhai Barry investigator.; Prinsloo Ben investigator.; Haffejee Sumayya investigator.; Simpson John investigator.; Hoyland Greta investigator.; van Schalkwyk Marthinus investigator.; Bowie Glenda investigator.; Hanise Patricia investigator.; Vasaikar Sandeep investigator.; Wende Linda investigator.; Chiller Tom investigator.; Ahlquist‐Cleveland Angela investigator.; Patel Jaymati investigator.
• Is Part Of: Mycoses. Volume 60:Issue 5(2017)
• Page Start: 320
• Page End: 327
• Publication Date: 2017-01-19
• Subjects: Candida parapsilosis -- candidaemia -- neonates -- South Africa; Pathogenic fungi -- Periodicals; Medical mycology -- Periodicals; 616.969
• DOI: 10.1111/myc.12596
• Languages: English
• ISSNs: 0933-7407

Abstract

Summary: Neonatal candidaemia is a common, deadly and costly hospital‐associated disease. To determine the genetic diversity of Candida parapsilosis causing fungaemia in South African neonatal intensive care units (NICUs). From February 2009 through to August 2010, cases of candidaemia were reported through laboratory‐based surveillance. C. parapsilosis isolates from neonatal cases were submitted for identification by internal transcribed spacer (ITS) region sequencing, antifungal susceptibility testing and microsatellite genotyping. Cluster analysis was performed using Unweighted Pair Group Method with Arithmetic Mean (UPGMA). Of 1671 cases with a viable Candida isolate, 393 (24%) occurred among neonates. Isolates from 143 neonatal cases were confirmed as C. parapsilosis sensu stricto. Many isolates were resistant to fluconazole (77/143; 54%) and voriconazole (20/143; 14%). Of 79 closely‐related genotypes, 18 were represented by ≥2 isolates; 61 genotypes had a single isolate each. Seven clusters, comprised of 82 isolates, were identified at five hospitals in three provinces. Isolates belonging to certain clusters were significantly more likely to be fluconazole resistant: all cluster 7 isolates and the majority of cluster 4 (78%), 5 (89%) and 6 (67%) isolates ( P <.001). Candida parapsilosis‐ associated candidaemia in public‐sector NICUs was caused by closely related genotypes and there was molecular evidence of undetected outbreaks as well as intra‐hospital transmission.