Impact factor 0.175

Signa Vitae

Journal of Intensive Care and Emergency Medicine

The burden of Candida species colonization in NICU patients: a colonization surveillance study

Abstract

Fungal infections are an important cause of morbidity and mortality in neonatal intensive care units (NICUs). The identification of specific risk factors supports prevention of candidemia in neonates. Effective prophylactic strategies have recently become available, but the identification and adequate management of high-risk infants is still a priority. Prior colonization is a key risk factor for candidemia. For this reason, surveillance studies to monitor incidence, species distribution, and antifungal susceptibility profiles, are mandatory. Among 520 infants admitted to our NICU between January 2013 and December 2014, 472 (90.77%) were included in the study. Forty-eight out of 472 (10.17%) patients tested positive for Candida spp. (C.), at least on one occasion. All the colonized patients tested positive for the rectal swab, whereas 7 patients also tested positive for the nasal swab. Fifteen out of 472 patients (3.18%) had more than one positive rectal or nasal swab during their NICU stay. Moreover, 9 out of 15 patients tested negative at the first sampling, suggesting they acquired Candida spp. during their stay. Twenty-five of forty-eight (52.1%) colonized patients carried C.albicans and 15/48 (31.25%) C.parapsilosis. We identified as risk factors for Candida spp. colonization: antibiotic therapy, parenteral nutrition, the use of a central venous catheter, and nasogastric tube. Our experience suggests that effective microbiological surveillance can allow for implementing proper, effective and timely control measures in a high-risk setting.

Key words: Candida, surveillance, NICU

Read More

Invasive Candida infections in the nursery: state of the art

Abstract

Neonatal sepsis caused by fungi (mainly Candida spp.) causes a huge burden of morbidity and mortality, poor late outcomes, as well as increased hospital costs.

Invasive Candida Infections (ICI) include bloodstream, urine, cerebrospinal, peritoneal infections, infections starting from burns and wounds, or from any other usually sterile site.

Premature neonates are particularly prone to this kind of disease, due to their decreased innate and adaptive immunities, translating into a specific, decreased resistance to candidiasis.

This specific, increased risk for ICI is greatest when gestational age and birth weight are lowest. As the burden of ICI has been increasing over the last years, research efforts have been focused towards identifying key risk factors, effective preventative strategies, and efficacious and well-tolerated antifungal drugs for the neonatal population.

This article summarizes the most remarkable issues in these areas, and features an overview of the current diagnostic, preventative and treatment strategies.

Key words: Candida, neonate, infection, preterm, micafungin, fluconazole

Read More

© 2019. Signa Vitae. Except where otherwise noted, content on this site is licensed under a Creative Commons Attribution 4.0 International license.