Outbreak of Candida parapsilosis in a neonatal intensive care unit: a health care workers source.

Nosocomial neonatal candidiasis is a major problem in infants, which require intensive therapy. The subjects of the present study were three preterm infants admitted to the neonatal intensive care unit of the General Hospital "Dr. Manuel Gea Gonzalez". The infants developed Candida parapsilosis infection on the mean age of 13.6 day of life. Prior to fungemia, infants had received assisted ventilation and hyperalimentation through central venous catheter. Sequence analysis of the internal transcribed spacer gene ruled out other Candida species and revealed that the eight isolates were C. parapsilosis. The isolates were examined based on their molecular relation by random amplified polymorphic DNA analysis. The profiles allowed the identification of two main genotypes of C. parapsilosis as the outbreak cause and as a result of the cross-infection with health care workers' hands. We conclude that C. parapsilosis commonly colonize through horizontal transmission due to the staff's noncompliance of hand hygiene procedures.