Candidemia by Candida parapsilosis in a neonatal intensive care unit: human and environmental reservoirs, virulence fact
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BACTERIAL AND FUNGAL PATHOGENESIS - RESEARCH PAPER
Candidemia by Candida parapsilosis in a neonatal intensive care unit: human and environmental reservoirs, virulence factors, and antifungal susceptibility Ralciane de Paula Menezes 1 & Sávia Gonçalves de Oliveira Melo 2 & Meliza Arantes Souza Bessa 3 & Felipe Flávio Silva 4 & Priscila Guerino Vilela Alves 4 & Lúcio Borges Araújo 5 & Mário Paulo Amante Penatti 1 & Vânia Olivetti Steffen Abdallah 4 & Denise von Dollinger de Brito Röder 4,6 & Reginaldo dos Santos Pedroso 1,4 Received: 18 September 2019 / Accepted: 18 January 2020 # Sociedade Brasileira de Microbiologia 2020
Abstract The Candida parapsilosis complex has emerged as one of the main causes of candidemia worldwide. This study aims to evaluate possible C. parapsilosis sensu stricto reservoirs in a NICU, the expression of virulence factors, and antifungal susceptibility, and to analyze their genetic and phenotypic similarity. The study included 17 isolates of C. parapsilosis: seven environmental, one from a newborn’s mother, and nine samples from six newborns. We used molecular and phenotypic tests to characterize the isolates and to trace possible routes of infection. The genetic similarity was determined by random amplified polymorphic DNA. The hemolytic and DNAse activity was determined using sheep’s blood and DNAse agar, biofilm production by XTT method, and the susceptibility to antifungals through microdilution methodology. Two environmental strains isolated in the same month had high similarity. The 17 isolates expressed at least one of the three virulence factors studied, and one environmental isolate was resistant to fluconazole. This study shows that environmental contamination can be an important reservoir of potentially pathogenic microorganisms, since isolates of C. parapsilosis sensu stricto collected from the hospital environment were able to express virulence factors. Therefore, we emphasized the importance of determining the transmission routes in NICU in order to detect pathogen sources and reservoirs, as well as to establish prevention measures, such as adequate disinfection of the environment. Keywords Antifungals . Candida parapsilosis . Neonates . NICU . Virulence . RAPD-PCR
Responsible Editor: Rosana Puccia. * Ralciane de Paula Menezes [email protected] 1
HealthTechnical School, Federal University of Uberlandia, Av. Amazonas s/no - Block 4K – 111–Campus Umuarama, Umuarama, Uberlândia, MG ZIP 38400-902, Brazil
2
Undergraduation in Nursing, Faculty of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
3
Undergraduation in Biology - Institute of Biology, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
4
Health Sciences Postgraduate Program, Faculty of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
5
Mathematics College, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
6
Institute of Biomedical Sciences, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
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