Nosocomial outbreak of Candida parapsilosis fungemia related to intravenous infusions

Arch Intern Med. 1977 Dec;137(12):1686-9.

Abstract

Candida parapsilosis is rarely isolated from blood cultures. Our hospital surveillance detected an increased rate of isolation of C parapsilosis during a four month period. Fourteen postoperative patients receiving intravenous (IV) hyperalimentation and eight burn patients receiving IV albumin were involved. Hectic fever, the major clinical manifestation, was seen in 61% of cases. Therapy in the postoperative patients consisted merely of discontinuing IV catheters and hyperalimentation, while amphotericin B was needed in five of eight burn patients to control persistent fungemia. Epidemiologic analysis identified a source of the organism in the IV-additive preparation room where C parapsilosis was found contaminating a vacuum system. Organisms apparently refluxed into IV bottles when aliquots were removed to accommodate additives. Of 103 patients who received fluids prepared with the contaminated system, 21% became infected with C parapsilosis. Infection surveillance was instrumental in detection and control of the outbreak. Routine guideline should be established to insure the sterility of IV fluids containing additives.

MeSH terms

  • Adult
  • Aged
  • Burns / therapy
  • Candida / isolation & purification
  • Candidiasis / microbiology
  • Candidiasis / transmission*
  • Cross Infection / microbiology
  • Cross Infection / transmission*
  • Disease Outbreaks*
  • Humans
  • Michigan
  • Middle Aged
  • Parenteral Nutrition / adverse effects*
  • Parenteral Nutrition, Total / adverse effects*
  • Parenteral Nutrition, Total / instrumentation
  • Postoperative Care
  • Postoperative Complications / microbiology
  • Sepsis / microbiology
  • Sepsis / transmission*
  • Wound Infection / microbiology