{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T22:50:40Z","timestamp":1787871040844,"version":"build-2784847793"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,2,4]],"date-time":"2019-02-04T00:00:00Z","timestamp":1549238400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2019,2,4]],"date-time":"2019-02-04T00:00:00Z","timestamp":1549238400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Candida parapsilosis<\/jats:italic>\n                    causes ~35% of all candidemia cases in neonates. High-resolution fingerprinting of\n                    <jats:italic>C<\/jats:italic>\n                    .\n                    <jats:italic>parapsilosis<\/jats:italic>\n                    isolates from neonatal intensive care unit (NICU) patients in Maternity Hospital (MH) was performed to identify epidemiologically related strains. Sixty-eight bloodstream\/colonizing strains isolated from 59 NICU patients, two isolates from health care workers (HCWs) from MH and 18 bloodstream isolates from two other hospitals were used. Six microsatellite markers were employed, isolates were assigned a numerical microsatellite genotype (MSG), dendrogram was constructed and similarities between genotypes were visualized by minimum spanning tree. Fifty bloodstream isolates from MH yielded 37 MSGs with 20 isolates clustering in 7 MSGs. Duplicate isolates and colonizing strains yielded same\/highly similar MSG as bloodstream isolates. Colonizing strains from two non-candidemia patients yielded unique MSGs while others belonged to a cluster. All isolates from HCWs and from two other hospitals belonged to unique MSGs. Cluster isolates came from patients in NICU-1 or from neonates in NICU-1 and other NICUs. Clonal complexes comprising closely related genotypes indicative of microevolution were also detected. Our data show that some\n                    <jats:italic>C<\/jats:italic>\n                    .\n                    <jats:italic>parapsilosis<\/jats:italic>\n                    strains have persisted in MH environment over several years and these endemic genotypes were transmitted to other patients in NICU-1 and\/or other nearby NICUs.\n                  <\/jats:p>","DOI":"10.1038\/s41598-018-37855-2","type":"journal-article","created":{"date-parts":[[2019,2,4]],"date-time":"2019-02-04T06:04:09Z","timestamp":1549260249000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["High-resolution fingerprinting of Candida parapsilosis isolates suggests persistence and transmission of infections among neonatal intensive care unit patients in Kuwait"],"prefix":"10.1038","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3270-055X","authenticated-orcid":false,"given":"Mohammad","family":"Asadzadeh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suhail","family":"Ahmad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noura","family":"Al-Sweih","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferry","family":"Hagen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacques F.","family":"Meis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziauddin","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,2,4]]},"reference":[{"key":"37855_CR1","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1016\/j.clp.2010.06.003","volume":"37","author":"DA Kaufman","year":"2010","unstructured":"Kaufman, D. A. & Manzoni, P. Strategies to prevent invasive candidal infection in extremely preterm infants. Clin. Perinatol. 37, 611\u2013628 (2010).","journal-title":"Clin. Perinatol."},{"key":"37855_CR2","doi-asserted-by":"publisher","first-page":"e00140","DOI":"10.1128\/mSystems.00140-17","volume":"3","author":"TL Ward","year":"2018","unstructured":"Ward, T. L. et al. Development of the human mycobiome over the first month of life and across body sites. mSystems 3, e00140\u201317 (2018).","journal-title":"mSystems"},{"key":"37855_CR3","doi-asserted-by":"publisher","first-page":"165rv13","DOI":"10.1126\/scitranslmed.3004404","volume":"4","author":"GD Brown","year":"2012","unstructured":"Brown, G. D. et al. Hidden killers: human fungal infections. Sci. Transl. Med. 4, 165rv13\u2013165rv13 (2012).","journal-title":"Sci. Transl. Med."},{"key":"37855_CR4","doi-asserted-by":"publisher","first-page":"S69","DOI":"10.1016\/S0378-3782(12)70019-1","volume":"88","author":"CP Hornik","year":"2012","unstructured":"Hornik, C. P. et al. Early and late onset sepsis in very-low-birth-weight infants from a large group of neonatal intensive care units. Early Hum. Dev. 88, S69\u2013S74 (2012).","journal-title":"Early Hum. Dev."},{"key":"37855_CR5","doi-asserted-by":"publisher","first-page":"774","DOI":"10.1097\/INF.0000000000001570","volume":"36","author":"RG Greenberg","year":"2017","unstructured":"Greenberg, R. G. et al. Late-onset sepsis in extremely premature infants: 2000-2011. Pediatr. Infect. Dis. J. 36, 774\u2013779 (2017).","journal-title":"Pediatr. Infect. Dis. J."},{"key":"37855_CR6","doi-asserted-by":"publisher","first-page":"3435","DOI":"10.1128\/JCM.01283-12","volume":"50","author":"SR Lockhart","year":"2012","unstructured":"Lockhart, S. R. et al. Species identification and antifungal susceptibility testing of Candida bloodstream isolates from population-based surveillance studies in two U.S. cities from 2008 to 2011. J. Clin. Microbiol. 50, 3435\u20133442 (2012).","journal-title":"J. Clin. Microbiol."},{"key":"37855_CR7","doi-asserted-by":"publisher","first-page":"e101510","DOI":"10.1371\/journal.pone.0101510","volume":"9","author":"MA Pfaller","year":"2014","unstructured":"Pfaller, M. A. et al. Epidemiology and outcomes of invasive candidiasis due to non-albicans species of Candida in 2,496 patients: data from the Prospective Antifungal Therapy (PATH) registry 2004-2008. PLoS One 9, e101510 (2014).","journal-title":"PLoS One"},{"key":"37855_CR8","doi-asserted-by":"publisher","first-page":"e59373","DOI":"10.1371\/journal.pone.0059373","volume":"8","author":"M Nucci","year":"2013","unstructured":"Nucci, M. et al. Epidemiology of candidemia in Latin America: a laboratory-based survey. PLoS One 8, e59373 (2013).","journal-title":"PLoS One"},{"key":"37855_CR9","doi-asserted-by":"publisher","first-page":"O946","DOI":"10.1111\/1469-0691.12685","volume":"20","author":"D Delfino","year":"2014","unstructured":"Delfino, D. et al. Potential association of specific Candida parapsilosis genotypes, bloodstream infections and colonization of health workers\u2019 hands. Clin. Microbiol. Infect. 20, O946\u2013O951 (2014).","journal-title":"Clin. Microbiol. Infect."},{"key":"37855_CR10","doi-asserted-by":"publisher","first-page":"283","DOI":"10.3109\/10408410903213393","volume":"35","author":"EC van Asbeck","year":"2009","unstructured":"van Asbeck, E. C., Clemons, K. V. & Stevens, D. A. Candida parapsilosis: a review of its epidemiology, pathogenesis, clinical aspects, typing and antimicrobial susceptibility. Crit. Rev. Microbiol. 35, 283\u2013309 (2009).","journal-title":"Crit. Rev. Microbiol."},{"key":"37855_CR11","doi-asserted-by":"publisher","first-page":"1654","DOI":"10.1016\/j.meegid.2012.06.012","volume":"12","author":"E Reiss","year":"2012","unstructured":"Reiss, E. et al. Genotyping of Candida parapsilosis from three neonatal intensive care units (NICUs) using a panel of five multilocus microsatellite markers: broad genetic diversity and a cluster of related strains in one NICU. Infect. Genet. Evol. 12, 1654\u20131660 (2012).","journal-title":"Infect. Genet. Evol."},{"key":"37855_CR12","first-page":"1","volume":"32","author":"M Pammi","year":"2014","unstructured":"Pammi, M., Holland, L., Butler, G. & Gacser, A. Candida parapsilosis is a significant neonatal pathogen: a systematic review and meta-analysis. Pediatr. Infect. Dis. J. 32, 1\u201323 (2014).","journal-title":"Pediatr. Infect. Dis. J."},{"key":"37855_CR13","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1128\/JCM.43.1.284-292.2005","volume":"43","author":"A Tavanti","year":"2005","unstructured":"Tavanti, A., Davidson, A., Gow, N., Maiden, M. C. & Odds, F. C. Candida orthopsilosis and Candida metapsilosis spp. nov. to replace Candida parapsilosis groups II and III. J. Clin. Microbiol. 43, 284\u2013292 (2005).","journal-title":"J. Clin. Microbiol."},{"key":"37855_CR14","doi-asserted-by":"publisher","first-page":"745","DOI":"10.1099\/jmm.0.008235-0","volume":"58","author":"M Asadzadeh","year":"2009","unstructured":"Asadzadeh, M., Ahmad, S., Al-Sweih, N. & Khan, Z. U. Rapid molecular differentiation and genotypic heterogeneity among Candida parapsilosis and Candida orthopsilosis strains isolated from clinical specimens in Kuwait. J. Med. Microbiol. 58, 745\u2013752 (2009).","journal-title":"J. Med. Microbiol."},{"key":"37855_CR15","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1099\/jmm.0.080655-0","volume":"64","author":"LS Barbedo","year":"2015","unstructured":"Barbedo, L. S. et al. Different scenarios for Candida parapsilosis fungaemia reveal high numbers of mixed C. parapsilosis and Candida orthopsilosis infections. J. Med. Microbiol. 64, 7\u201317 (2015).","journal-title":"J. Med. Microbiol."},{"key":"37855_CR16","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1007\/s11046-007-9054-3","volume":"164","author":"EC Van Asbeck","year":"2007","unstructured":"Van Asbeck, E. C., Huang, Y. C., Markham, A. N., Clemons, K. V. & Stevens, D. A. Candida parapsilosis fungemia in neonates: genotyping results suggest healthcare workers hands as source, and review of published studies. Mycopathologia 164, 287\u2013293 (2007).","journal-title":"Mycopathologia"},{"key":"37855_CR17","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/j.diagmicrobio.2011.05.014","volume":"71","author":"C Vaz","year":"2011","unstructured":"Vaz, C. et al. Microsatellite multilocus genotyping clarifies the relationship of Candida parapsilosis strains involved in a neonatal intensive care unit outbreak. Diagn. Microbiol. Infect. Dis. 71, 159\u201362 (2011).","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"37855_CR18","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1016\/j.meegid.2012.09.006","volume":"13","author":"O Romeo","year":"2013","unstructured":"Romeo, O. et al. Microsatellite-based genotyping of Candida parapsilosis sensu stricto isolates reveals dominance and persistence of a particular epidemiological clone among neonatal intensive care unit patients. Infect. Genet. Evol. 13, 105\u2013108 (2013).","journal-title":"Infect. Genet. Evol."},{"key":"37855_CR19","doi-asserted-by":"publisher","first-page":"677","DOI":"10.1016\/j.cmi.2015.03.007","volume":"21","author":"LJ Marcos-Zambrano","year":"2015","unstructured":"Marcos-Zambrano, L. J. et al. Clusters of patients with candidaemia due to genotypes of Candida albicans and Candida parapsilosis: differences in frequency between hospitals. Clin. Microbiol. Infect. 21, 677\u2013683 (2015).","journal-title":"Clin. Microbiol. Infect."},{"key":"37855_CR20","doi-asserted-by":"publisher","first-page":"954.e1","DOI":"10.1016\/j.cmi.2015.06.001","volume":"21","author":"R Sabino","year":"2015","unstructured":"Sabino, R. et al. Analysis of clinical and environmental Candida parapsilosis isolates by microsatellite genotyping-a tool for hospital infection surveillance. Clin. Microbiol. Infect. 21, 954.e1\u2013954.e8 (2015).","journal-title":"Clin. Microbiol. Infect."},{"key":"37855_CR21","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41598-016-0001-8","volume":"6","author":"H Wang","year":"2016","unstructured":"Wang, H. et al. Investigation of an unrecognized large-scale outbreak of Candida parapsilosis sensu stricto fungaemia in a tertiary-care hospital in China. Sci. Rep. 6, 1\u201311 (2016).","journal-title":"Sci. Rep."},{"key":"37855_CR22","doi-asserted-by":"publisher","first-page":"2919","DOI":"10.1007\/s10096-012-1642-6","volume":"31","author":"G Pulcrano","year":"2012","unstructured":"Pulcrano, G. et al. MALDI-TOF mass spectrometry and microsatellite markers to evaluate Candida parapsilosis transmission in neonatal intensive care units. Eur. J. Clin. Microbiol. Infect. Dis. 31, 2919\u20132928 (2012).","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"37855_CR23","unstructured":"Clinical and Laboratory Standards Institute. Reference method for broth dilution antifungal susceptibility testing of yeasts; fourth informational supplement, M27-S4. Wayne, PA, USA. (2012)."},{"key":"37855_CR24","doi-asserted-by":"publisher","first-page":"247","DOI":"10.3389\/fmicb.2017.00247","volume":"8","author":"M Asadzadeh","year":"2017","unstructured":"Asadzadeh, M., Ahmad, S., Al-Sweih, N. & Khan, Z. Molecular fingerprinting studies do not support intrahospital transmission of Candida albicans among candidemia patients in Kuwait. Front. Microbiol. 8, 247 (2017).","journal-title":"Front. Microbiol."},{"key":"37855_CR25","doi-asserted-by":"publisher","first-page":"e17","DOI":"10.1086\/589298","volume":"47","author":"LR \u00c1smundsd\u00f3ttir","year":"2008","unstructured":"\u00c1smundsd\u00f3ttir, L. R. et al. Molecular epidemiology of candidemia: evidence of clusters of smoldering nosocomial infections. Clin. Infect. Dis. 47, e17\u2013e24 (2008).","journal-title":"Clin. Infect. Dis."},{"key":"37855_CR26","doi-asserted-by":"publisher","first-page":"1023","DOI":"10.1016\/j.idc.2016.07.008","volume":"30","author":"G Suleyman","year":"2016","unstructured":"Suleyman, G. & Alangaden, G. J. Nosocomial fungal infections: epidemiology, infection control, and prevention. Infect. Dis. Clin. North Am. 30, 1023\u20131052 (2016).","journal-title":"Infect. Dis. Clin. North Am."},{"key":"37855_CR27","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1056\/NEJMoa012657","volume":"347","author":"BJ Stoll","year":"2002","unstructured":"Stoll, B. J. et al. Changes in pathogens causing early-onset sepsis in very-low-birth-weight infants. N. Engl. J. Med. 347, 240\u2013247 (2002).","journal-title":"N. Engl. J. Med."},{"key":"37855_CR28","doi-asserted-by":"crossref","unstructured":"Lasker, B. A., Butler, G. & Lott, T. J. Molecular genotyping of Candida parapsilosis group I clinical isolates by analysis of polymorphic microsatellite markers. 44, 750\u2013759 (2006).","DOI":"10.1128\/JCM.44.3.750-759.2006"},{"key":"37855_CR29","doi-asserted-by":"publisher","first-page":"1677","DOI":"10.1128\/JCM.02151-09","volume":"48","author":"R Sabino","year":"2010","unstructured":"Sabino, R. et al. New polymorphic microsatellite markers able to distinguish among Candida parapsilosis sensu stricto isolates. J. Clin. Microbiol. 48, 1677\u20131682 (2010).","journal-title":"J. Clin. Microbiol."},{"key":"37855_CR30","doi-asserted-by":"publisher","first-page":"3422","DOI":"10.1128\/JCM.01179-12","volume":"50","author":"M Diab-Elschahawi","year":"2012","unstructured":"Diab-Elschahawi, M. et al. Microsatellite genotyping clarified conspicuous accumulation of Candida parapsilosis at a cardiothoracic surgery intensive care unit. J. Clin. Microbiol. 50, 3422\u20133426 (2012).","journal-title":"J. Clin. Microbiol."},{"key":"37855_CR31","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1016\/j.cmi.2015.06.024","volume":"21","author":"MH Tsai","year":"2015","unstructured":"Tsai, M. H. et al. Clinical and molecular characteristics of bloodstream infections caused by Candida albicans in children from 2003 to 2011. Clin. Microbiol. Infect. 21, e1\u2013e8 (2015).","journal-title":"Clin. Microbiol. Infect."},{"key":"37855_CR32","doi-asserted-by":"publisher","first-page":"e0142880","DOI":"10.1371\/journal.pone.0142880","volume":"10","author":"M Asadzadeh","year":"2015","unstructured":"Asadzadeh, M. et al. Simple, low-cost detection of Candida parapsilosis complex isolates and molecular fingerprinting of Candida orthopsilosis strains in Kuwait by ITS region sequencing and amplified fragment length polymorphism analysis. PLoS One 10, e0142880 (2015).","journal-title":"PLoS One"},{"key":"37855_CR33","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1111\/myc.12596","volume":"60","author":"RE Magobo","year":"2017","unstructured":"Magobo, R. E. et al. Detection of neonatal unit clusters of Candida parapsilosis fungaemia by microsatellite genotyping: results from laboratory-based sentinel surveillance, South Africa, 2009-2010. Mycoses 60, 320\u2013327 (2017).","journal-title":"Mycoses"},{"key":"37855_CR34","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1007\/s10482-008-9251-1","volume":"94","author":"ZU Khan","year":"2008","unstructured":"Khan, Z. U. et al. Actinomucor elegans var. kuwaitiensis isolated from the wound of a diabetic patient. Antonie Van Leeuwenhoek 94, 343\u2013352 (2008).","journal-title":"Antonie Van Leeuwenhoek"},{"key":"37855_CR35","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1007\/s10482-009-9406-8","volume":"97","author":"ZU Khan","year":"2010","unstructured":"Khan, Z. U. et al. Cryptococcus randhawai sp. nov., a novel anamorphic basidiomycetous yeast isolated from tree trunk hollow of Ficus religiosa (peepal tree) from New Delhi, India. Antonie Van Leeuwenhoek 97, 253\u2013259 (2010).","journal-title":"Antonie Van Leeuwenhoek"},{"key":"37855_CR36","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1111\/j.1439-0507.2008.01492.x","volume":"51","author":"M Asadzadeh","year":"2008","unstructured":"Asadzadeh, M., Al-Sweih, N. A., Ahmad, S. & Khan, Z. U. Antifungal susceptibility of clinical Candida parapsilosis isolates in Kuwait. Mycoses 51, 318\u201323 (2008).","journal-title":"Mycoses"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-018-37855-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-018-37855-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-018-37855-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,17]],"date-time":"2022-12-17T00:33:39Z","timestamp":1671237219000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-018-37855-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,4]]},"references-count":36,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2019,12]]}},"alternative-id":["37855"],"URL":"https:\/\/doi.org\/10.1038\/s41598-018-37855-2","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,4]]},"assertion":[{"value":"6 September 2018","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 December 2018","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 February 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}}],"article-number":"1340"}}