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The Scientific World Journal
Volume 2012, Article ID 138989, 7 pages
Clinical Study

Investigation of a Cluster of Candida albicans Invasive Candidiasis in a Neonatal Intensive Care Unit by Pulsed-Field Gel Electrophoresis

1UR02SP13 Research Unit, Ministry of Public Health, Tunisia
2Laboratory of Parasitology-Mycology, Farhat Hached University Hospital Sousse, Sousse 4000, Tunisia

Received 28 October 2011; Accepted 1 December 2011

Academic Editors: J. Varga and J. H. Zhao

Copyright © 2012 Jihene Ben Abdeljelil et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Nosocomial invasive candidiasis (IC) has emerged as a major problem in neonatal intensive care units (NICUs). We investigated herein the temporal clustering of six cases of neonatal IC due to Candida albicans in an NICU. Eighteen isolates obtained from the six neonates and two isolates from two health care workers (HCWs) working at the same unit and suffering from fingers’ onychomycosis were genotyped by electrophoretic karyotyping (EK) and restriction endonuclease analysis of genomic DNA by using Sfi I (PFGE-Sfi I). PFGE-Sfi I was more effective in discriminating between temporally related isolates. It showed that (i) both HCWs had specific strains excluding them as a source of infections in neonates. (ii) Isolates collected from three neonates were identical providing evidence of their clonal origin and the occurrence of a horizontal transmission of C. albicans in the unit. (iii) The three remaining neonates had specific strains confirming that the IC cases were coincidental. (iv) Microevolution occurred in one catheter-related candidemia case. Our results illustrate the relevance of the molecular approach to investigate suspected outbreaks in hospital surveys and the effectiveness of PFGE-Sfi I for typing of epidemiologically related C. albicans isolates.