Molecular typing of Candida albicans strains isolated from nosocomial candidemia

Branchini, Maria Luiza Moretti; Geiger, Débora de Cassia Pires; Fischman, Olga; Pignatari, Antonio Carlos

doi:10.1590/S0036-46651995000600002

Abstracts

Yeasts of the genus Candida have been recognized as important microorganisms responsible for nosocomial fungemia. Six blood-stream and two intravenous central catheter C. albicans strains were isolated from eight patients and studied by electrophoretic karyotyping of chromosomal DNA by pulsed-field gel electrophoresis. Seven chromosomal DNA profiles were identified. Two patients showed isolates with the same profile, suggesting nosocomial transmission. Karyotyping of C. albicans revealed an excellent discriminatory power among the isolates and may therefore be useful in the study of nosocomial candidemia.

Candida albicans; Nosocomial candidemia; Pulsed-field gel electrophoresis; Molecular typing

Leveduras do gênero Candida têm sido reconhecidas como importantes causadoras de fungemias hospitalares. Foram estudados os DNA cromossômicos de oito cepas de C. albicans, obtidas de oito pacientes com fungemia hospitalar, por cariotipagem eletroforética através de "pulsed-field gel electrophoresis". As cepas foram obtidas pelo isolamento da levedura em seis hemoculturas e duas infecções relacionadas ao uso de cateter intra-venoso central. Foram identificados sete perfis de DNA cromossômico. Dois pacientes mostraram cepas com o mesmo perfil de DNA sugerindo transmissão nosocomial. A cariotipagem eletroforética revelou excelente capacidade discriminatória entre os isolados sendo útil no estudo das candidemias hospitalares.

MICOLOGY

Molecular typing of Candida albicans strains isolated from nosocomial candidemia

Tipificação molecular de espécies de Candida albicans isoladas de candidemia hospitalar

Maria Luiza Moretti Branchini^I; Débora de Cassia Pires Geiger^II; Olga Fischman^III; Antonio Carlos Pignatari^II

^IInfectious Diseases Division. Faculty of Medical Sciences, Universidade Estadual de Campinas - UNICAMP

^IIInfectious Diseases Division. Escola Paulista de Medicina, Universidade Federal do Estado de São Paulo

^IIICelular Biology Division. Escola Paulista de Medicina, Universidade Federal do Estado de São Paulo

^{Correspondence to} Correspondence to: Profª M. L. M. Branchini Disciplina de Doenças Transmissíveis, Faculdade de Ciências Médicas da UNICAMP Cidade Universitária Zeferino Vaz 13081-970 Campinas, São Paulo, Brasil

SUMMARY

Yeasts of the genus Candida have been recognized as important microorganisms responsible for nosocomial fungemia. Six blood-stream and two intravenous central catheter C. albicans strains were isolated from eight patients and studied by electrophoretic karyotyping of chromosomal DNA by pulsed-field gel electrophoresis. Seven chromosomal DNA profiles were identified. Two patients showed isolates with the same profile, suggesting nosocomial transmission. Karyotyping of C. albicans revealed an excellent discriminatory power among the isolates and may therefore be useful in the study of nosocomial candidemia.

Keywords:Candida albicans; Nosocomial candidemia; Pulsed-field gel electrophoresis; Molecular typing.

RESUMO

Leveduras do gênero Candida têm sido reconhecidas como importantes causadoras de fungemias hospitalares. Foram estudados os DNA cromossômicos de oito cepas de C. albicans, obtidas de oito pacientes com fungemia hospitalar, por cariotipagem eletroforética através de "pulsed-field gel electrophoresis". As cepas foram obtidas pelo isolamento da levedura em seis hemoculturas e duas infecções relacionadas ao uso de cateter intra-venoso central. Foram identificados sete perfis de DNA cromossômico. Dois pacientes mostraram cepas com o mesmo perfil de DNA sugerindo transmissão nosocomial. A cariotipagem eletroforética revelou excelente capacidade discriminatória entre os isolados sendo útil no estudo das candidemias hospitalares.

Full text available only in PDF format.

Texto completo disponível apenas em PDF.

ACKNOWLEDGMENTS

We thank very much to Dr. Michael A. Pfaller from the University of Iowa, IO, USA, that kindly provided us the agarose model containing C. albicans DNA chromosome included as a quality control.

Recebido para publicação em 06/07/1995.

Aceito para publicação em 17/11/1995.

1. BANERJEE, S.N.; EMORI, T.G.; CULVER, D.H. et al. - Secular trends in nosocomial primary bloodstream infections in the United States, 1980-1989. Amer. J. Med., 91 (Suppl. 3B): 86S-89S, 1991.
2. BRANCHINI, M.L.M.; PFALLER, M.A.; RHINE-CHALBERG, J.; FREMPONG, T. & ISENBERG, H.D. - Genotypic variation and slime production among blood and catheter isolates of Candida parapsilosis. J. clin. Microbiol., 32: 452-456, 1994.
3. BURNIE, J.P.; MATTHEWS, R.; LEE, W. et al. - Four outbreaks of nosocomial systemic candidiasis. Epidem. Infect., 99: 201-211, 1987.
4. BURNIE, J.; ODDS, F.C.; LEE, W.; WEBSTER, C. & WILLIAMS, J.D. - Outbreak of systemic Candida albicans in intensive care unit caused by cross infection. Brit. med. J., 290: 746-748, 1985.
5. DOEBBELING, B.N.; LEHMANN, P.F.; HOLLIS, R.J.; WU, L.C. et al. - Comparison of pulsed-field gel electrophoresis with isoenzyme profiles as a typing system for Candida tropicalis. Clin. infect. Dis., 16: 377-383, 1993.
6. HARVEY, R.L. & MYERS, J.P. - Nosocomial fungemia in a large community teaching hospital. Arch. intern. Med., 147: 2117-2120, 1987.
7. HOWELL, S.A. & NOBEL, W.C. - Typing tools fot the investigation of epidemic fungal infection. Epidem. Infect., 105: 1-9, 1990.
8. KAUFMANN, C.S. & MERZ, W.G. - Electrophoretic karyotypes of Torulopsis glabrata. J. clin. Microbiol., 27: 2165-2168, 1989.
9. KOMSHIAN, S.V.; UWAYDAH, A.K.; SOBEL, J.D. & CRANE, L.R. - Fungemia caused by Candida species and Torulopsis glabrata in the hospitalized patient: frequency, characteristics and evaluation of factors influencing outcome. Rev. infect. Dis., 11: 379-390, 1989.
10. LACAZ, C.S. - Candidiases. Săo Paulo, EDUSP, 1980.
11. LASKER, B.A.; CARLE, G.F.; KOBAYASHI, G.S. & MEDOFF, G. - Comparison of the separation of Candida albicans chromosome-sized DNA by pulsed-field gel electrophoresis techniques. Nucleic Acids Res., 17: 3783-3793, 1989.
12. LEE, W.; BURNIE, J.P. & MATTHEWS, R. - Fingerprinting Candida albicans. J. immunol. Meth., 93: 177-182, 1986.
13. LINARES, J.; STIGES-SERRA, A.; GARAN, J.; PEREZ, J.L. & MARTIN, R. - Pathogenesis of catheter sepsis: a prospective study with qualitative and semiquantitative cultures of hub and segments. J. clin. Microbiol., 21: 357-360, 1985.
14. MAGEE, B.B. & MAGEE, P.T. - Electrophoretic karyotypes and chromosome numbers in Candida species. J. gen. Microbiol., 133: 425-430, 1987.
15. MAKI, D.G.; WEISE, C.E. & SARAFIN, H.W.A. - A semiquantitative culture method for identifying intravenous-catheter infection. New Engl. J. Med., 296: 1305-1307, 1977.
16. MATTEWS, R. & BURNIE, J.P. - Assessment of DNA fingerprint for rapid identification of outbreaks of systemic candidiasis. Brit. med. J., 298: 354-357, 1989.
17. MERZ, W.G.; CONNELLY, C. & HIETER, P. - Variation of electrophoretic karyotypes among clinical isolates of Candida albicans. J. clin. Microbiol., 26: 842-845, 1988.
18. PERFECT, J.R.; MAGEE, B.B. & MAGEE, P.T. - Separation of chromosomes of Cryptococcus neoformans by pulsed field gel electrophoresis. Infect. Immun., 57: 2624-2627, 1989.
19. PFALLER, M.A. - Epidemiological typing methods for mycosis. Clin. infect. Dis., 14 (suppl. 1): S4-S10, 1992.
20. PFALLER, M.A.; CABEZUDO, I.; HOLLIS, R.; HUSTON, B. & WENZEL, R.P. - The use of biotyping and DNA fingerprint in typing Candida albicans from hospitalized patients. Diagn. Microbiol. infect. Dis., 13: 481-489, 1990.
21. PFALLER, M.A. & WENZEL, R.P. - Impact of the changing epidemiology of fungal infections in the 1990s. Europ. J. clin. Microbiol. infect. Dis., 11: 287-291, 1992.
22. REAGAN, D.R.; PFALLER, M.A.; HOLLIS, R.J. & WENZEL, R.P. - Characterization of the sequence of colonization and nosocomial candidemia using DNA fingerprinting and a DNA probe. J. clin. Microbiol., 28: 2733-2738, 1990.
23. SCHERER, S. & STEVENS, D.A. - Application of DNA typing methods to epidemiology and toxonomy of Candida species. J. clin. Microbiol., 25: 675-679, 1987.
24. SOLOMKIN, J.S.; FLOHR, A.M. & SIMMONS, R.L. - Indications for therapy for fungemia in post operative patients. Arch. Surg., 117: 1272-1275, 1982.
25. SOLOMON, S.L.; KHABBAZ, R.F.; PARKER, R.H. et al. - An outbreak of Candida parapsilosis bloodstream infections in patients receiving parenteral nutrition. J. infect. Dis., 149: 98-102, 1984.
26. VASQUEZ, J.A.; BECKLEY, A.; DONABEDIAN, S.; SOBEL, J.F. & ZERVOS, M.J. - Comparison of restriction enzyme analysis versus pulsed-field gradient gel electrophoresis as a typing system for Torulopsis glabrata and Candida species other than Candida albicans. J. clin. Microbiol., 31: 2021-2030, 1993.
27. VAUDRY, W.L.; TIERNEY, A.J. & WENMAN, W.M. - Investigation of a cluster of systemic Candida albicans infections in a neonatal intensive care unit. J. infect. Dis., 158: 1375-1379, 1988.
28. WALSH, T.J. & PIZZO, P.A. - Laboratory diagnosis of candidiasis. In: BODEY, J.P., ed. - Candidiasis: pathogenesis, diagnosis and treatment. New York, Raven Press, 1993. p. 110-135.
29. WENZEL, R.P. & PFALLER, M.A. - Candida species: emerging hospital bloodstream pathogens. Infect. Control Hosp. Epidem., 12: 523-524, 1991.
30. WEY, S.B.; MORI, M.; PFALLER, M.A.; WOOLSON, R.F. & WENZEL, R.P. - Hospital-acquired candidemia: the attributable mortality and excess length of stay. Arch. intern. Med., 148: 2642-2645, 1988.

Correspondence to:

Profª M. L. M. Branchini

Disciplina de Doenças Transmissíveis, Faculdade de Ciências Médicas da UNICAMP

Cidade Universitária Zeferino Vaz

13081-970 Campinas, São Paulo, Brasil

Publication Dates

Publication in this collection
22 Sept 2006
Date of issue
Dec 1995

History

Received
06 July 1995
Accepted
17 Nov 1995

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. BANERJEE, S.N.; EMORI, T.G.; CULVER, D.H. et al. - Secular trends in nosocomial primary bloodstream infections in the United States, 1980-1989. Amer. J. Med., 91 (Suppl. 3B): 86S-89S, 1991.

[2] 2. BRANCHINI, M.L.M.; PFALLER, M.A.; RHINE-CHALBERG, J.; FREMPONG, T. & ISENBERG, H.D. - Genotypic variation and slime production among blood and catheter isolates of Candida parapsilosis. J. clin. Microbiol., 32: 452-456, 1994.

[3] 3. BURNIE, J.P.; MATTHEWS, R.; LEE, W. et al. - Four outbreaks of nosocomial systemic candidiasis. Epidem. Infect., 99: 201-211, 1987.

[4] 4. BURNIE, J.; ODDS, F.C.; LEE, W.; WEBSTER, C. & WILLIAMS, J.D. - Outbreak of systemic Candida albicans in intensive care unit caused by cross infection. Brit. med. J., 290: 746-748, 1985.

[5] 5. DOEBBELING, B.N.; LEHMANN, P.F.; HOLLIS, R.J.; WU, L.C. et al. - Comparison of pulsed-field gel electrophoresis with isoenzyme profiles as a typing system for Candida tropicalis. Clin. infect. Dis., 16: 377-383, 1993.

[6] 6. HARVEY, R.L. & MYERS, J.P. - Nosocomial fungemia in a large community teaching hospital. Arch. intern. Med., 147: 2117-2120, 1987.

[7] 7. HOWELL, S.A. & NOBEL, W.C. - Typing tools fot the investigation of epidemic fungal infection. Epidem. Infect., 105: 1-9, 1990.

[8] 8. KAUFMANN, C.S. & MERZ, W.G. - Electrophoretic karyotypes of Torulopsis glabrata. J. clin. Microbiol., 27: 2165-2168, 1989.

[9] 9. KOMSHIAN, S.V.; UWAYDAH, A.K.; SOBEL, J.D. & CRANE, L.R. - Fungemia caused by Candida species and Torulopsis glabrata in the hospitalized patient: frequency, characteristics and evaluation of factors influencing outcome. Rev. infect. Dis., 11: 379-390, 1989.

[10] 10. LACAZ, C.S. - Candidiases. Săo Paulo, EDUSP, 1980.

[11] 11. LASKER, B.A.; CARLE, G.F.; KOBAYASHI, G.S. & MEDOFF, G. - Comparison of the separation of Candida albicans chromosome-sized DNA by pulsed-field gel electrophoresis techniques. Nucleic Acids Res., 17: 3783-3793, 1989.

[12] 12. LEE, W.; BURNIE, J.P. & MATTHEWS, R. - Fingerprinting Candida albicans. J. immunol. Meth., 93: 177-182, 1986.

[13] 13. LINARES, J.; STIGES-SERRA, A.; GARAN, J.; PEREZ, J.L. & MARTIN, R. - Pathogenesis of catheter sepsis: a prospective study with qualitative and semiquantitative cultures of hub and segments. J. clin. Microbiol., 21: 357-360, 1985.

[14] 14. MAGEE, B.B. & MAGEE, P.T. - Electrophoretic karyotypes and chromosome numbers in Candida species. J. gen. Microbiol., 133: 425-430, 1987.

[15] 15. MAKI, D.G.; WEISE, C.E. & SARAFIN, H.W.A. - A semiquantitative culture method for identifying intravenous-catheter infection. New Engl. J. Med., 296: 1305-1307, 1977.

[16] 16. MATTEWS, R. & BURNIE, J.P. - Assessment of DNA fingerprint for rapid identification of outbreaks of systemic candidiasis. Brit. med. J., 298: 354-357, 1989.

[17] 17. MERZ, W.G.; CONNELLY, C. & HIETER, P. - Variation of electrophoretic karyotypes among clinical isolates of Candida albicans. J. clin. Microbiol., 26: 842-845, 1988.

[18] 18. PERFECT, J.R.; MAGEE, B.B. & MAGEE, P.T. - Separation of chromosomes of Cryptococcus neoformans by pulsed field gel electrophoresis. Infect. Immun., 57: 2624-2627, 1989.

[19] 19. PFALLER, M.A. - Epidemiological typing methods for mycosis. Clin. infect. Dis., 14 (suppl. 1): S4-S10, 1992.

[20] 20. PFALLER, M.A.; CABEZUDO, I.; HOLLIS, R.; HUSTON, B. & WENZEL, R.P. - The use of biotyping and DNA fingerprint in typing Candida albicans from hospitalized patients. Diagn. Microbiol. infect. Dis., 13: 481-489, 1990.

[21] 21. PFALLER, M.A. & WENZEL, R.P. - Impact of the changing epidemiology of fungal infections in the 1990s. Europ. J. clin. Microbiol. infect. Dis., 11: 287-291, 1992.

[22] 22. REAGAN, D.R.; PFALLER, M.A.; HOLLIS, R.J. & WENZEL, R.P. - Characterization of the sequence of colonization and nosocomial candidemia using DNA fingerprinting and a DNA probe. J. clin. Microbiol., 28: 2733-2738, 1990.

[23] 23. SCHERER, S. & STEVENS, D.A. - Application of DNA typing methods to epidemiology and toxonomy of Candida species. J. clin. Microbiol., 25: 675-679, 1987.

[24] 24. SOLOMKIN, J.S.; FLOHR, A.M. & SIMMONS, R.L. - Indications for therapy for fungemia in post operative patients. Arch. Surg., 117: 1272-1275, 1982.

[25] 25. SOLOMON, S.L.; KHABBAZ, R.F.; PARKER, R.H. et al. - An outbreak of Candida parapsilosis bloodstream infections in patients receiving parenteral nutrition. J. infect. Dis., 149: 98-102, 1984.

[26] 26. VASQUEZ, J.A.; BECKLEY, A.; DONABEDIAN, S.; SOBEL, J.F. & ZERVOS, M.J. - Comparison of restriction enzyme analysis versus pulsed-field gradient gel electrophoresis as a typing system for Torulopsis glabrata and Candida species other than Candida albicans. J. clin. Microbiol., 31: 2021-2030, 1993.

[27] 27. VAUDRY, W.L.; TIERNEY, A.J. & WENMAN, W.M. - Investigation of a cluster of systemic Candida albicans infections in a neonatal intensive care unit. J. infect. Dis., 158: 1375-1379, 1988.

[28] 28. WALSH, T.J. & PIZZO, P.A. - Laboratory diagnosis of candidiasis. In: BODEY, J.P., ed. - Candidiasis: pathogenesis, diagnosis and treatment. New York, Raven Press, 1993. p. 110-135.

[29] 29. WENZEL, R.P. & PFALLER, M.A. - Candida species: emerging hospital bloodstream pathogens. Infect. Control Hosp. Epidem., 12: 523-524, 1991.

[30] 30. WEY, S.B.; MORI, M.; PFALLER, M.A.; WOOLSON, R.F. & WENZEL, R.P. - Hospital-acquired candidemia: the attributable mortality and excess length of stay. Arch. intern. Med., 148: 2642-2645, 1988.

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