<i>Candida parapsilosis</i>candidaemia in a neonatal unit over 7 years: a case series study

Miranda, Lourdes das Neves; Rodrigues, Eliete C A; Costa, Sílvia Figueiredo; Heijden, Inneke M. van der; Dantas, Kátia Cristina; Lobo, R.; Basso, Matteo; Varkulja, Glaucia Fernanda; Krebs, Vera Lúcia Jornada; Gibelli, Maria Augusta Bento Cicaroni; Criado, Paulo Ricardo; Levin, Anna S.

doi:10.1136/bmjopen-2012-000992

Cited by 24 publications

(18 citation statements)

References 41 publications

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“…(1,20) The study showed bacterial sepsis to have a significant association with candidaemia in VLBW infants and is consistent with results in similar studies. (1,5,15) At the time of the study, the empiric antibiotics for late onset bacterial sepsis were meropenem and vancomycin. Fu et al demonstrated a strong association between carbapenem use and development of candidaemia.…”

Section: Discussionsupporting

confidence: 89%

“…(23,24) However, due to the lack of information in our database, these two risk factors were not included in the present study. (1,6,13,16,25,26) The increase in resistance to azoles by NAC is well demonstrated in this study with 41.2% of isolates of C. (28,29) The unit where the study was conducted, Amphotericin B was used to treat C. glabrata candidaemia.…”

Section: Discussionmentioning

confidence: 52%

“…Candidaemia is associated with significant morbidity and mortality in infants. (1) The mortality rate in infants with candidaemia ranges between 21% and 76%. (2,3) Ballot et al in their review of neonatal fungal bloodstream infections (BSI) at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) for the period January 2007 to December 2011 reported a mortality rate of 45.8%.…”

Section: Introductionmentioning

confidence: 99%

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A Case–Control Study of Candidaemia in Very Low Birthweight Infants in a Tertiary Hospital in Johannesburg

Malunga¹,

Nana²,

Ballot³

2020

Wits Journal of Clinical Medicine

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Background: Candidaemia is a significant cause of morbidity and mortality in infants. The mortality rate ranges between 21% and 76%. Non-albicans Candida (NAC) species are increasing in incidence as well as resistance to azoles. Very low birthweight (VLBW) infants have numerous risk factors which predispose them as a group to invasive candidaemia. Methods:A retrospective case-control study of candidaemia in VLBW infants admitted to the neonatal unit at Charlotte Maxeke Johannesburg Hospital between 1 January 2015 and 31 December 2017 was undertaken. Clinical and demographic characteristics of VLBW infants who developed candidaemia, commonest Candida species, antifungal susceptibility profiles and outcomes (death) were identified. A total of 71 infants with confirmed positive blood cultures for candidaemia from the National Health Laboratory Services database were selected, and each case was allocated 3 controls; the final sample comprised 284 infants.Results: Bacterial sepsis, chronic lung disease, necrotising enterocolitis (NEC) and NEC surgery, other surgery, anaemia and ventilation, all showed a strong association with development of candidaemia in the infants. The most common isolate was Candida parapsilosis (59.1%), followed by Candida albicans (30.9%). The cases of candidaemia overall and NAC isolates increased over the study years. Resistance to azoles by NAC was demonstrated. Mortality was 31.2% and 28.2% in controls and cases, respectively. The difference in death between the two groups was not statistically significant. Conclusions:The study demonstrated an increasing rate of candidaemia, predominance of NAC isolates and increased resistance to azoles. Stricter infection control measures and medical intervention strategies should be implemented.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 52%

Section: Introductionmentioning

confidence: 99%

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A Case–Control Study of Candidaemia in Very Low Birthweight Infants in a Tertiary Hospital in Johannesburg

Malunga¹,

Nana²,

Ballot³

2020

Wits Journal of Clinical Medicine

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“…This organism is the main Candida species responsible for a significant proportion of outbreaks of nosocomial fungaemia, particularly in neonate intensive care units (NICUs)131415161718. However, there are limited studies exclusively assessing the epidemiology of candidaemia caused by C. parapsilosis in China, and no description of C. parapsilosis clustering or outbreak cases has been reported to date19.…”

mentioning

confidence: 99%

Investigation of an unrecognized large-scale outbreak of Candida parapsilosis sensu stricto fungaemia in a tertiary-care hospital in China

Wang

Zhang

Kudinha

et al. 2016

Sci Rep

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A data analysis of yeast collections from the National China Hospital Invasive Fungal Surveillance Net (CHIF-NET) programme in 2013 revealed a sudden increase in the proportion of Candida parapsilosis complex isolates (n = 98) in one participating hospital (Hospital H). Out of 443 yeast isolates submitted to the CHIF-NET reference laboratory by Hospital H (2010–2014), 212 (47.9%) were identified as C. parapsilosis sensu stricto by sequencing analysis of the internal transcribed spacer region and D1/D2 domain of the 26S rRNA gene. Among the 212 C. parapsilosis sensu stricto isolates, 176 (83.0%) bloodstream-based isolates and 25 isolates from tip cultures of various vascular catheters from 25 patients with candidaemia, were subjected to microsatellite genotyping, and a phylogenetic relationship analysis was performed for 152 isolates. Among the 152 isolates, 45 genotypes (T01 to T45) were identified, and two prevalent genotypes (63.8%) were found: T15 (n = 74, 48.7%) and T16 (n = 23, 15.1%). These two main clones were confined mainly to three different wards of the hospital, and they persisted for 16–25 months and 12–13 months, respectively. The lack of proper coordination between the clinical microbiology laboratory and infection control staff as part of public health control resulted in the failure to timely identify an outbreak, which led to the wide and long-term dissemination of C. parapsilosis sensu stricto in Hospital H.

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“…Candida epidemiyolojisindeki değişikliğin başlıca nedeni fl ukonazol kullanımındaki artış olarak bildirilmektedir 1,4,20,21 . Candida epidemiyolojisinde değişiklikler, C.albicans dışı kandidemi oranlarının, özellikle C.parapsilosis insidansının arttığını göstermektedir 22,23 . Bu çalışmada pediatri yoğun bakım üniteleri (YBÜ)'nde en sık, erişkin YBÜ'nde ise ikinci sıklıkla izole edilen türün C.parapsilosis olduğu görülmüştür.…”

Section: Gereç Ve Yöntemunclassified

Investigation of the Changes in Candida Epidemiology

Çiçek¹,

Yılmaz²,

Yılmaz³

et al. 2015

Mikrobiyol Bul

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The incidence of fungal infections has increased in recent years. Antifungal resistance is a major problem with increasing frequency due to the widespread use of antifungal agents in infections. Identification of the Candida species and susceptibility patterns with the appropriate tests for resistance and selection of the empirical agents used for treatment are important. The aim of the study was to evaluate the changes of the epidemiology of Candida species and minimum inhibitory concentrations (MIC) of the antifungal agents, isolated in Mycology Laboratory of Ondokuz Mayıs University Faculty of Medicine, between 1 January 2009 to 1 July 2012. The study was performed retrospectively based on records in the mycology unit and checked comparatively with the automation system in the hospital. The recurrent reproductions of the same patient were excluded. For the identification of Candida species API®ID 32C (bioMerieux, France) system was used. Information on the isolated material, patient's age, gender and the inpatients' clinics were recorded. The susceptibility of Candida species isolated from blood cultures were studied with Etest (bioMerieux, France) method. A total of 1238 isolates were included in the study. The most common species isolated from clinical samples was C.albicans with a rate of 51.1% (n= 632), followed by C.tropicalis with a rate of 15.8% (n= 195). Among the pediatric intensive care unit (ICU) patients C.parapsilosis 42% (n= 17) was the most common isolate and the second most common isolate was C.albicans 32% (n= 13). However, in the adult ICU the most common isolate was C.albicans 34% (n= 13) and the second was C.parapsilosis 31% (n= 12). When the distribution of Candida species were analyzed from the records of last four years, the frequency rate of C.albicans and non-albicans species was found as 51.1% (n= 632) and %48.9 (n= 606), respectively. Based on these data, a comparison was made between the years and no difference between the two groups in terms of the distribution of fungi within the specified time (x²: 3.2, df: 1, p: 0.073) was determined. Of the Candida species isolated from blood cultures, seven isolates (2.2%) were resistant to fluconazole in the study period. The differences of MIC levels in fluconazole were detected between the years 2010-2012 and 2011-2012. The geometric mean of the MICs in 2012 increased significantly compared to 2010 and 2011 (p< 0.01). There was no resistance to amphotericin B except for intrinsically resistant Candida lusitaniae. There were no significant differences among amphotericin MIC values between years (p> 0.05). According to the sensitivity results, fluconazole is still seen as an option that can be used for the first choice. Although it remains as the first antifungal choice, antifungal susceptibility testing of the identified fungi will help the clinician for the plan and continuation of the treatment.

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Candida parapsilosiscandidaemia in a neonatal unit over 7 years: a case series study

Cited by 24 publications

References 41 publications

A Case–Control Study of Candidaemia in Very Low Birthweight Infants in a Tertiary Hospital in Johannesburg

A Case–Control Study of Candidaemia in Very Low Birthweight Infants in a Tertiary Hospital in Johannesburg

Investigation of an unrecognized large-scale outbreak of Candida parapsilosis sensu stricto fungaemia in a tertiary-care hospital in China

Investigation of the Changes in Candida Epidemiology

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