Incidence of Candida parapsilosis colonization in an intensive care nursery population and its association with invasive fungal disease

El-Mohandes, Ayman E.; Johnson-Robbins, Lauren A.; Keiser, John; Simmens, Samuel J.; Aure, Marilou V.

doi:10.1097/00006454-199406000-00011

Cited by 59 publications

(22 citation statements)

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“…In present study, 13 babies were positive for candidiasis, of which 5 babies (38.3%) of birth weight between 1-1.5kg (P=0.0313) has developed candidiasis compared to 19% of cases as studied by el-mohandes and coworkers and 40% 0f cases by Ritu agarwal study. 9,10 As the birth weight decreases, the incidence of candidiasis in neonates increases as revealed by the present study.…”

Section: Discussionsupporting

confidence: 65%

Clinical profile of Candidiasis in neonates

Latha¹,

Babu²,

Thejraj³

2017

Int J Contemp Pediatr

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Background: Opportunistic infections are increasing in Neonatal Intensive Care Unit (NICU). Neonates often have compromised skin integrity, gastrointestinal tract disease, chronic malnutrition, central venous catheters, long term endotracheal intubation and other factors that lead to increased risk of acquiring such infections. Infections with fungi (candida) and with coagulase-negative staphylococci (CoNS) are especially prevalent. The need of study is to know the clinical profile of candidiasis in neonates in our setup and to determine associated risk factors of candidiasis.Methods: The present study was undertaken by Dept of paediatrics, SSIMS and RC Davangere among 296 neonates of which 96 babies admitted in NICU and 200 were in PNC ward to study clinical profile of candidiasis in neonates and risk factors associated with them. Parents of 296 babies were interviewed using preformed study proforma. Clinical examination was done and investigations included KOH examination of oral swab, Gram stain of the swab and blood culture of suspected sepsis babies. There are several factors associated with development of neonatal candidiosis. Of them, prematurity, LBW, perinatal birth asphyxia, long term antibiotics, central venous catheters, mechanical ventilation, septicemia, played a major role in development of candidosis.Results: In the present study, incidence of candidiasis in neonates revealed 13.8% of babies admitted in NICU. Male babies out numbered the female babies in incidence of candidiasis in neonates. Males formed 69% and females 31% of positive cases. Most of neonates admitted in NICU (96) were of low birth weight between 1.5kg to 2.5 kg. Out of which most of cases positive for candidiasis/candidemia were belonged to 1.0-1.5 kg. In present study, 13 babies were positive for candidiasis, of which 5 babies (38.3%) were of birth weight between 1-1.5kg. Birth asphyxia alone or with mechanical ventilation played an important risk factor in development of candidiasis in neonates. In present study, birth asphyxia and mechanical ventilation per se had played a significant role in development of candidiasis in neonates admitted in NICU.Conclusions: The present study revealed the clinical profile of candidiasis in neonates associated with various risk factors. Study shows that low birth weight, birth asphyxia and mechanical ventilation were significant risk factors for candidiasis in neonates. Blood cultures were positive in babies without mucosal lesions suggesting the importance of diagnosing fungal sepsis.

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Section: Discussionsupporting

confidence: 65%

Clinical profile of Candidiasis in neonates

Latha¹,

Babu²,

Thejraj³

2017

Int J Contemp Pediatr

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“…For instance, a 1994 report on 82 neonates at the George Washington University Hospital in the United States found that 19% of the infants were colonized with Candida species. Among those colonized, four developed fungal sepsis due to C. parapsilosis and one infant had congenital C. albicans sepsis (252). Vertical transmission often results in colonization of Candida species from mother to child; however, colonization in infants with C. parapsilosis cannot be accounted for by maternal isolates (25,283).…”

Section: Risk Factorsmentioning

confidence: 99%

Candida parapsilosis, an Emerging Fungal Pathogen

2008

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SUMMARY Candida parapsilosis is an emerging major human pathogen that has dramatically increased in significance and prevalence over the past 2 decades, such that C. parapsilosis is now one of the leading causes of invasive candidal disease. Individuals at the highest risk for severe infection include neonates and patients in intensive care units. C. parapsilosis infections are especially associated with hyperalimentation solutions, prosthetic devices, and indwelling catheters, as well as the nosocomial spread of disease through the hands of health care workers. Factors involved in disease pathogenesis include the secretion of hydrolytic enzymes, adhesion to prosthetics, and biofilm formation. New molecular genetic tools are providing additional and much-needed information regarding C. parapsilosis virulence. The emerging information will provide a deeper understanding of C. parapsilosis pathogenesis and facilitate the development of new therapeutic approaches for treating C. parapsilosis infections.

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“…Compared to other Candida species, C. albicans demonstrates increased adherence to and penetration of vascular endothelium, possibly accounting for its higher incidence as a cause of sepsis, end-organ dissemination, and mortality (158,225,352,494). C. parapsilosis is the second most prevalent species in VLBW infants, being present in 13 to 83% of patients with fungal colonization, and may initially colonize the gastrointestinal tract (126). In two large multicenter NICU studies, this species accounted for 26% of cases of fungal sepsis (57 of 219) from 1991 to 1993, increasing to 34% of cases of fungal sepsis (57 of 160) from 1998 to 2000 (451,454).…”

Section: Fungal Organismsmentioning

confidence: 99%

Clinical Microbiology of Bacterial and Fungal Sepsis in Very-Low-Birth-Weight Infants

2004

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Twenty percent of very-low-birth-weight (<1500 g) preterm infants experience a serious systemic infection, and despite advances in neonatal intensive care and antimicrobials, mortality is as much as threefold higher for these infants who develop sepsis than their counterparts without sepsis during their hospitalization. Outcomes may be improved by preventative strategies, earlier and accurate diagnosis, and adjunct therapies to combat infection and protect the vulnerable preterm infant during an infection. Earlier diagnosis on the basis of factors such as abnormal heart rate characteristics may offer the ability to initiate treatment prior to the onset of clinical symptoms. Molecular and adjunctive diagnostics may also aid in diagnosing invasive infection when clinical symptoms indicate infection but no organisms are isolated in culture. Due to the high morbidity and mortality, preventative and adjunctive therapies are needed. Prophylaxis has been effective in preventing early-onset group B streptococcal sepsis and late-onset Candida sepsis. Future research in prophylaxis using active and passive immunization strategies offers prevention without the risk of resistance to antimicrobials. Identification of the differences in neonatal intensive care units with low and high infection rates and implementation of infection control measures remain paramount in each neonatal intensive care unit caring for preterm infants

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Incidence of Candida parapsilosis colonization in an intensive care nursery population and its association with invasive fungal disease

Cited by 59 publications

References 0 publications

Clinical profile of Candidiasis in neonates

Clinical profile of Candidiasis in neonates

Candida parapsilosis, an Emerging Fungal Pathogen

Clinical Microbiology of Bacterial and Fungal Sepsis in Very-Low-Birth-Weight Infants

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