TY - JOUR
T1 - Detection of neonatal unit clusters of Candida parapsilosis fungaemia by microsatellite genotyping
T2 - Results from laboratory-based sentinel surveillance, South Africa, 2009-2010
AU - the TRAC-South Africa group
AU - Magobo, Rindidzani E.
AU - Naicker, Serisha D.
AU - Wadula, Jeannette
AU - Nchabeleng, Maphoshane
AU - Coovadia, Yacoob
AU - Hoosen, Anwar
AU - Lockhart, Shawn R.
AU - Govender, Nelesh P.
AU - van Rensburg, Chris Janse
AU - Whitelaw, Andrew
AU - Zietsman, Inge
AU - Miller, Norman
AU - Smith, Peter
AU - van Greune, Johan
AU - Brink, Adrian
AU - Perovic, Olga
AU - Nchabaleng, Maphoshane
AU - Orth, Heidi
AU - Badenhorst, Loekie
AU - Moolman, Johan
AU - Peer, A. K.
AU - Govind, Chetna
AU - Kularatne, Ranmini
AU - Bhagoobhai, Barry
AU - Prinsloo, Ben
AU - Haffejee, Sumayya
AU - Simpson, John
AU - Hoyland, Greta
AU - van Schalkwyk, Marthinus
AU - Bowie, Glenda
AU - Hanise, Patricia
AU - Vasaikar, Sandeep
AU - Wende, Linda
AU - Chiller, Tom
AU - Ahlquist-Cleveland, Angela
AU - Patel, Jaymati
N1 - Funding Information:
Funding Information The TRAC-SA surveillance project was supported by the National Institute for Communicable Diseases, a travel grant from The CDC Foundation awarded to Jaymati Patel and an investigator-initiated research grant from Pfizer awarded to N.P.G. and Inge Zietsman. The external funders had no role in study design, implementation or data collection, analysis and reporting. This sub-study was funded by the National Institute for Communicable Diseases and a National Research Fund Thuthuka Grant awarded to R.E.M. We acknowledge the technical assistance provided by staff members of the National Institute for Communicable Diseases (Centre for Opportunistic, Tropical and Hospital Infections) and U.S. Centers for Disease Control and Prevention (Mycotic Diseases Branch). Members of the TRAC-South Africa group (2009-2010): NHLS Chris Hani Baragwanath: Jeannette Wadula; van Rensburg and partners: Chris Janse van Rensburg; NHLS Groote Schuur: Andrew Whitelaw; Ampath National Laboratory Service: Inge Zietsman (co-principal investigator), Norman Miller, Peter Smith, Johan van Greune, Adrian Brink; NHLS Steve Biko Pretoria Academic: Anwar Hoosen, NHLS Charlotte Maxeke Johannesburg Academic: Olga Perovic; NHLS Dr George Mukhari: Maphoshane Nchabeleng; NHLS Tygerberg: Heidi Orth; NHLS Inkosi Albert Luthuli: Yacoob Coovadia; NHLS Universitas: Loekie Badenhorst; Lancet laboratories: Johan Moolman, AK Peer, Chetna Govind; NHLS Helen Joseph/Rahima Moosa: Ranmini Kularatne, Barry Bhagoobhai; Vermaak and partners: Ben Prinsloo; NHLS Grey's: Sumayya Haffejee; NHLS Greenpoint: John Simpson; NHLS Rob Ferreira: Greta Hoyland; PathCare laboratories: Marthinus van Schalkwyk; NHLS East London: Glenda Bowie; NHLS Mthatha: Patricia Hanise, Sandeep Vasaikar; NHLS Pelonomi: Linda Wende; U.S. Centers for Disease Control and Prevention: Tom Chiller, Angela Ahlquist-Cleveland, Shawn Lockhart; National Institute for Communicable Diseases: Jaymati Patel, Nelesh P. Govender (principal investigator).
Publisher Copyright:
© 2017 Blackwell Verlag GmbH
PY - 2017/5/1
Y1 - 2017/5/1
N2 - 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.
AB - 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.
KW - Candida parapsilosis
KW - South Africa
KW - candidaemia
KW - neonates
UR - http://www.scopus.com/inward/record.url?scp=85017105540&partnerID=8YFLogxK
U2 - 10.1111/myc.12596
DO - 10.1111/myc.12596
M3 - Article
C2 - 28101934
AN - SCOPUS:85017105540
VL - 60
SP - 320
EP - 327
JO - Mycoses
JF - Mycoses
SN - 0933-7407
IS - 5
ER -