Clinico-epidemiological profile, risk factors, and prognosis of neonatal candidemia due to Candida parapsilosis: An emerging threat to neonates

Juyal, Deepak; Kotian, Swapna; Sangwan, Jyoti; Rathaur, Vyas Kumar; Sharma, Neelam

doi:10.4103/2278-344x.132694

Cited by 2 publications

(6 citation statements)

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“…In this study, 65% of the patients were females, with a male to female ratio of 1:1.8. Consistent with our finding, Juyal et al (6) reported that 60.4% of their patients were females, with a male to female ratio of 1:1.5.…”

Section: Discussionsupporting

confidence: 93%

“…In accordance with that, Garzillo et al (21) stated that NAC was linked to birth weight, gestational age, and the duration of central venous catheterization, but not to the length of hospital stay. These results were in line with those of Juyal et al (6) who reported low birth weight and indwelling catheters as contributory factors to NAC; yet, they added broad-spectrum antibiotics as a risk factor.…”

Section: Discussionsupporting

confidence: 92%

“…The diagnosis of candidemia was settled by the presence of at least one positive blood culture showing pure growth of Candida spp. together with supportive clinical findings (6). The isolated Candida spp.…”

Section: Microbiological Methodssupporting

confidence: 58%

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Candidemia in the Neonatal Intensive Care Unit: Insights on Epidemiology and Antifungal Drug Susceptibility Patterns

Hassan

Yousef

Elhamed

et al. 2018

Arch Pediatr Infect Dis

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Background: Being the culprit in 9%-13% of neonatal bloodstream infections (BSIs), candidemia has been escalating to worrisome levels in the past few decades. While C. albicans has traditionally been the most common isolate, non-albicans Candida spp. are currently gaining a foothold. Objectives: We endeavored to investigate the epidemiological features of neonatal candidemia with special emphasis on nonalbicans candidemia. Hence, we evaluated the incidence, risk factors, antifungal susceptibility, and case fatality rate of candidemia patients in the NICU. Methods: Blood samples were collected from 1296 neonates admitted to the NICU of a tertiary care hospital. Then, only neonates with positive blood cultures were enrolled. Incidence and risk factors of albicans and non-albicans candidemia were evaluated. The Etest was employed to determine the minimum inhibitory concentrations of fluconazole, itraconazole, voriconazole, amphotericin B, and caspofungin. Results: Out of 214 neonates with BSI, candidemia afflicted 32 neonates (15%). The predominant isolate was C. tropicalis (43.8%), followed by C. albicans (25%). Both antibiotic use and antifungal prophylaxis were contributing factors (P values of 0.02 and < 0.01, respectively). Susceptibility testing revealed that 87.5% of the retrieved Candida isolates were sensitive to amphotericin B, 81.25% to fluconazole, 75% to voriconazole, and 62.5% to itraconazole while 48.75% were sensitive to caspofungin. Conclusions: Neonatal candidemia often carries an ominous prognosis. The worldwide progressive shift towards non-albicans candidemia necessitates regular surveillance and monitoring of laboratory data. An epidemiological knowledge is critical in terms of preemptive management that should encompass disciplined infection control practices and a restrictive policy for antibiotic and antifungal prophylaxis.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 92%

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Candidemia in the Neonatal Intensive Care Unit: Insights on Epidemiology and Antifungal Drug Susceptibility Patterns

Hassan

Yousef

Elhamed

et al. 2018

Arch Pediatr Infect Dis

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“…LBW, prematurity and use of broad spectrum antibiotics were the major risk factors implicated followed by total parenteral nutrition, ventilator support and indwelling catheters in the present study. This was in consistence with other studies done by Sardana et al, Juyal et al, Srinivas Rao et al and Wadile et al 13,6,14,16 Failure to thrive (60%), lethargy (50%) and respiratory distress (30%) were the most common clinical presentations seen, followed by feed intolerance (26.67%), abdominal distension (13.33%) and fever (10%). Failure to thrive (18/30) and lethargy (15/30) were consistent clinical findings in our neonatal cases, similar to other studies.…”

Section: Failure To Thrive Lethargy Respiratory Distress Feed Intolersupporting

confidence: 90%

“…17,18,6,19 Respiratory distress (74.55%) followed by failure to thrive and lethargy were most common clinical findings in a study by Sardana et al whereas Juyal et al showed failure to thrive (74.42%) followed by abdominal distension and feed intolerance. 13,16 Candida species are an increasingly common cause of neonatal sepsis and are responsible for considerable morbidity and mortality. 20,21,17 Modern day neonatal care has definitely improved the survival rate of neonates but also increased the use of multiple invasive medical equipment, which has further enhanced the acquired sepsis among the newborns.…”

Section: Failure To Thrive Lethargy Respiratory Distress Feed Intolermentioning

confidence: 99%

Candida Species Causing Neonatal Septicaemia - Experience in a Tertiary Care Centre

Lakra¹,

Baradkar²,

Shastri³

et al. 2020

jemds

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BACKGROUND Candida species is one of the most common causes of bloodstream infections among neonates and accounts for 9-13% of such infections. Non-albicans Candida have emerged as important opportunistic pathogens, notably C. tropicalis, C. glabrata, C. parapsilosis and C. krusei. With the introduction of antifungal agents, the causes of Candida infections shifted from an almost complete dominance of Candida albicans to the common involvement of Candida glabrata and other non-albicans Candida species. METHODS This prospective, microbiological observational study was conducted in a tertiary care hospital for one and a half years from July 2016 to December 2017. Blood samples of neonates collected into Bactec Peds Plus/F Culture vials of an automated blood culture system (Bactec 9120, Becton Dikinson, USA) from clinically suspected cases of neonatal septicaemia were subjected to culture. Detailed clinical history such as presence of respiratory distress, abdominal distension, lethargy, feed intolerance, failure to thrive, poor perfusion, history of convulsions, duration of NICU stay and antibiotic use was taken from the medical records. The Candida species isolated were identified using standard mycological techniques. RESULTS Out of the total 250 clinically suspected cases of neonatal septicaemia, fungal growth was positive in 30 (12%) cases. Candida albicans accounted for 10% and non albicans Candida accounted for 90% of the fungal isolates. Candida glabrata (73.33%) was the commonest species followed by Candida tropicalis (16.67%) and Candida albicans (10%). Failure to thrive (60%), lethargy (50%) and respiratory distress (30%) were the most common clinical presentations seen, followed by feed intolerance (26.67%), abdominal distension (13.33%) and fever (10%). Among the risk factors observed for neonatal candidemia, low birth weight (76.67%) and prematurity (73.33%) were commonest followed by broad spectrum antibiotic use (66.67%), total parenteral nutrition (53.3%), ventilator support (36.67%) and indwelling catheters (26.67%). CONCLUSIONS Non-albicans Candida has emerged as an important pathogen causing neonatal septicaemia. Fungal sepsis is more common among preterm, low birth weight infants, those with prolonged antibiotic use and those on total parenteral nutrition. Candida glabrata caused the highest number of cases of fungal septicaemia.

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Clinico-epidemiological profile, risk factors, and prognosis of neonatal candidemia due to Candida parapsilosis: An emerging threat to neonates

Cited by 2 publications

References 0 publications

Candidemia in the Neonatal Intensive Care Unit: Insights on Epidemiology and Antifungal Drug Susceptibility Patterns

Candidemia in the Neonatal Intensive Care Unit: Insights on Epidemiology and Antifungal Drug Susceptibility Patterns

Candida Species Causing Neonatal Septicaemia - Experience in a Tertiary Care Centre

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