Perfil molecular de espécies de Candida isoladas em uma Unidade de Terapia Intensiva Neonatal de um hospital universitário

Abstract

Introduction: Infections related to health care caused by Candida species are more and more frequent, compromising the health of inpatients even more, including the development of critical neonates due to their greater susceptibility. Despite its great importance, there are few reports in the literature that seek to establish a relationship between isolates from invasive infections and those from the hospital environment. Objectives: To analyze the molecular profile of Candida spp. Isolates from invasive infections in neonates, their oral and perianal mucosa and the environment of the Neonatal Intensive Care Unit (NICU) at Hospital de Clínicas, Universidade Federal de Uberlândia (HC-UFU), by the technique of Random Amplification of Polymorphic DNA (RAPD-PCR). Material and Methods: 40 samples of C. albicans and C. parapsilosis from the NICU of HC-UFU obtained between June 2015 and May 2017 by the RAPD-PCR methodology were evaluated, using two specific primers (OPB11 and OPA09) in order to check if there is any genetic relationship between the isolates and try to establish the possible routes of infection. Results: Of the 40 isolates, 23 (57.5%) were from C. albicans and 17 (42.5%) from the C. parapsilosis complex. The molecular analysis showed 23 genotypes for C. albicans and 14 for C. parapsilosis. High similarity was found among C. albicans isolates (CA05 and CA07), obtained from blood and perianal mucosa of the newborn (RN2) with the isolate (CA06) from the mother's oral mucosa. And also among isolates (CA11 and CA14) from different neonates (RN3 and RN4), in addition to isolates (CA16 and CA17) from oral and perianal mucosa (RN5). A similar situation was found among the environmental isolates of C. parapsilosis (CP7 and CP14) obtained from an incubator and hand washing sink, respectively, as well as (CP6 and CP8) obtained from the NICU entrance door and the room door hand hygiene, in addition to the isolates (CP4 and CP5) obtained from different incubators that had identical genotype. Conclusion: This study revealed that C. albicans isolates showed similarity between clinical samples of neonates indicating previous colonization, suggesting infection of endogenous origin. The C. parapsilosis isolates, on the other hand, showed greater genetic similarity between environmental isolates, indicating the environment as a possible reservoir, enabling the dissemination of the species in the unit. Knowing the kinship of the isolates is essential to establish possible control and prevention measures in order to avoid dissemination in the unit and to reduce the incidence of invasive candidiasis.