Candidacolonization in preterm babies admitted to neonatal intensive care unit in the rural setting

Abstract

Purpose: Candida colonization in neonates results in significant morbidity and mortality. The purpose of this study was to determine colonization of Candida spp. in preterm babies and identify the risk factors. Methods: Swabs from oral, rectum, groin and umblicus of 103 preterm and 100 term neonates were obtained within 24 hours of birth, day three, day five, day seven and thereafter every week till the neonate was admitted in the neonatal intensive care unit (NICU). Swabs were also collected from the mother's vagina prior to delivery. Twice every month, air of the NICU was sampled by settle plate and swabs were collected from the hands of health care workers and inanimate objects of NICU. Identification and speciation was done by standard methods. Antibiotic sensitivity was studied against amphotericin B, ketoconazole and fluconazole by disk diffusion method. Results: Colonization with Candida was significantly higher in preterms. Earliest colonization was of oral mucosa and 77.1% of the preterms had colonised at various sites by the first week of life. Significant risk factors in colonized versus non-colonized preterms were male sex, longer duration of rupture of membranes (DROM), administration of steroids and antibiotics and vaginal colonization of mothers, whereas those in preterms versus terms were low birth weight and gestational age. C. albicans was the commonest species, both in the colonized preterms (45.9%) and vagina of mothers. Resistance was seen to fluconazole and ketoconazole only. No Candida spp. was isolated from health care personnel or environment. Conclusions: Colonization of preterms by Candida is a significant problem in NICU and the significant risk factors observed in colonized preterms were male sex, longer DROM, administration of steroids and antibiotics and vaginal colonization of mothers.

Risk Factor Determination and Antifungal Susceptibility Patterns of Candida in Neonatal Oral Candidiasis

“…The results of the present study are in agreement with the study by others 17 .Candida colonization rate in oral cavity among control group was found to be 31.9%, and it was higher in neonates with low birth weight (73.6%). Candida could be isolated from the perianal region of 43 (36.1%) cases.…”

“…Candida could be isolated from the perianal region of 43 (36.1%) cases. From the data it is clear that Candida can colonize in multiple anatomical sites of the body at a time that is with agreement with another study 17 . In the present study no yeast could be isolated from environment or inanimate objects.…”

Molecular and Genotypes Identification of C. Albicans Isolated from Children With Diarrea in Diyala Province-Iraq

“…[23]. The results also agree with previous studies showed genotype A of the C albicans, predominant in clinical samples, while genotype B, less frequency and this very close to previous studies [24] [25].…”

“…The results of this study are agreements with Intesare and Ahmed, that the fungal organism isolated most frequently was Candida non albican isolated (62.5%), followed by Candida albican (37.5%) Isolated was identified as non-albicans spp., of which (34.4%) isolated was C. tropicalis and (9.4%) of remaining isolates were C. kruzei, C. globrata and C. parapsilosis [17]. The result showed that, C. albicans the most common isolate from clinical samples and these agree with [18] [19] [20]. In Salah Alden, Ashraf found that, the total rate of Candida albican infection was (38%) of 508 examined stool specimens during 2007 at health centers in the Dour town [21].…”

A clinical study of neonatal dermatosis

“…6 (2%) of patients had oral thrush with a without involvement of napkin area ( Figure 5) and majority (71%) presented within first 2 weeks of life. This in view of the findings reported by Gupta et al and Mendiratte et al 17,18 History of antibiotic therapy was present in 6 patients but non-revealed any evidence of maternal viginal candidiasis. There was no marked difference in frequency with relation to birth weight and gestational age.…”