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Original Research

Open Access

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

  • GERACI DM1
  • VIRGA A1
  • VECCHIO D1
  • GRAZIANO G1
  • SAPORITO L1
  • INSINGA V1
  • MAIDA CM1
  • MAMMINA C1
  • GIUFFRÈ M1

1Department of Sciences for Health Promotion and Maternal-Infant Care “G. D’Alessandro,” Hygiene Section University of Palermo

DOI: 10.22514/SV132.112017.10 Vol.13,Issue 2,November 2017 pp.71-75

Published: 06 November 2017

*Corresponding Author(s): GERACI DM E-mail: danielamaria.geraci@unipa.it

Abstract

Fungal infections are an important cause of morbidity and mortality in neonatal intensive care units (NICUs). The identifi-cation of specific risk factors supports pre-vention of candidemia in neonates. Effec-tive prophylactic strategies have recently become available, but the identification and adequate management of high-risk in-fants is still a priority. Prior colonization is a key risk factor for candidemia. For this reason, surveillance studies to monitor in-cidence, species distribution, and antifun-gal 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%) pa-tients 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 rec-tal or nasal swab during their NICU stay. Moreover, 9 out of 15 patients tested nega-tive at the first sampling, suggesting they acquired Candida spp. during their stay. Twenty-five of forty-eight (52.1%) colo-nized 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, effec-tive and timely control measures in a high-risk setting.


Keywords

Candida, surveillance, NICU

Cite and Share

GERACI DM,VIRGA A,VECCHIO D,GRAZIANO G,SAPORITO L,INSINGA V,MAIDA CM,MAMMINA C,GIUFFRÈ M. The burden of Candida species colonization in NICU patients: a colonization surveillance study. Signa Vitae. 2017. 13(2);71-75.

References

1. Costa-de-Oliveira S, Pina-Vaz C, Mendonça D, Rodrigues AG. A first Portuguese epidemiological survey of fungaemia in a univer-sity hospital. Eur J Clin Microbio 2008;l27:365–74.

2. Rangel-Frausto MS, Wiblin T, Blumberg HM, Saiman L, Patterson J, Rinaldi M, Wenzel RP. National epidemiology of mycoses survey (NEMIS): variations in rates of bloodstream infections due to Candida species in seven surgical intensive care units and six neonatal intensive care units. Clin Infect Dis 1999;29.2:253-8.

3. Weese-mayer DE, Fondriest DW, Brouillette RT, Shulman ST. Risk factors associated with candidemia in the neonatal intensive care unit: a case-control study. Pediatr Infect Dis J 1987;6.2:190-6.

4. Saiman L, Ludington E, Pfaller M, Rangel-Frausto S, Wiblin RT, Dawson J, Wenzel RP. Risk factors for candidemia in neonatal inten-sive care unit patients. Pediatr Infect Dis J 2000;19.4:319-24.

5. Cole GT, Halaiva AA, Anaissie E. The role of the gastrointestinal tract in hematogenous candidiasis: from the laboratory to the bed-side. Clin Infect Dis 1996; 22(suppl 2):S73–88.

6. Kicklighter SD, Springer SC, Cox T, Hulsey TC, Turner RB. Fluconazole for prophylaxis against candidal rectal colonization in the very low birth weight infant. Pediatrics 2001;107.2:293-8.

7. Kaufman DA. Fluconazole prophylaxis: can we eliminate invasive Candida infections in the neonatal ICU? Curr Opin Pediatr 2008;20.3:332-40.

8. Kumar ARUN, Yadav APARNA, Gathwala GEETA, Gagneja DEEP, Chaudhary U, Gill PS, Gagneja D. Study of risk factors for can-dida species colonisation of neonatal intensive care unit patient. Int J Pharm Bio Sci 2012;3:193-9.

9. Bendel CM. Colonization and epithelial adhesion in the pathogenesis of neonatal candidiasis. Semin Perinatol 2003;27.5:357-64.

10. Giuffrè M, Amodio E, Bonura C, Geraci DM, Saporito L, Ortolano R, et al. Methicillin-resistant Staphylococcus aureus nasal coloni-zation in a level III neonatal intensive care unit: Incidence and risk factors. Am J Infect Contr 2015;43(5):476-81.

11. Geraci DM, Giuffrè M, Bonura C, Matranga D, Aleo A, Saporito L, et al. Methicillin-resistant Staphylococcus aureus colonization: A three-year prospective study in a neonatal intensive care unit in Italy. PLoS ONE 2014;9(2):e87760.

12. Giuffre M, Geraci DM, Bonura C, Saporito L, Graziano G, Insinga V, et al. The increasing challenge of multidrug-resistant gram-neg-ative bacilli: results of a 5-year active surveillance program in a neonatal intensive care unit. Medicine (United States) 2016;95(10): e3016.

13. Huang YC, Li CC, Lin TY, Lien RI, Chou YH, Wu JL, Hsueh C. Association of fungal colonization and invasive disease in very low birth weight infants. Pediatr Infect Dis J 1998;17.9:819-22.

14. Baley JE, Kliegman RM, Boxerbaum B. Fungal colonization in the very low birth weight infant. Pediatrics 1986;78:225-32.

15. El-Mohandes AE, Johnson-Robbins L, Keiser JF, et al. Incidence of Candida parapsilosis, colonization in an intensive care nursery population and its association with invasive fungal disease. Pediatr Infect Dis J 1994;13:520—524.

16. Kicklighter SD, Springer SC, Cox T, HulseyTC, Turner RB. Fluconazole for prophylaxis against candidal rectal colonization in the very low birth weight infant. Pediatrics 2001;107.2:293-8.

17. Manzoni P, Farina D, Leonessa M, d’Oulx EA, Galletto P, Mostert M, Gomirato G. Risk factors for progression to invasive fungal infection in preterm neonates with fungal colonization. Pediatrics 2006;118.6:2359-64.

18. Singhi S, Rao DSR, Chakrabarti A. Candida colonization and candidemia in a pediatric intensive care unit. Pediatr Crit Care Med 2008; 9(1), 91-95.

19. Carey AJ, Saiman L, Polin RA. Hospital-acquired infections in the NICU: epidemiology for the new millennium. Clin Perinatol 2008;35.1:223-49.

20. Kaufman D, Boyle R, Hazen KC, Patrie JT, Robinson M, Donowitz LG. Fluconazole prophylaxis against fungal colonization and infection in preterm infants. N Engl J Med 2001;345.23:1660-6.

21. Marr KA, Seidel K, White TC, Bowden RA. Candidemia in allogeneic blood and marrow transplant recipients: evolution of risk fac-tors after the adoption of prophylactic fluconazole. J Infect Dis 2000;181.1:309-16.

22. Vardakas KZ, Michalopoulos A, Falagas ME. Fluconazole versus itraconazole for antifungal prophylaxis in neutropenic patients with haematological malignancies: a meta‐analysis of randomised‐controlled trials. Br J Haematol 2005;131.1:22-8.

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