Patient isolation measures for infants with candida colonization or infection for preventing or reducing transmission of candida in neonatal units

Pammi, Mohan; Eddama, Oya; Weisman, Leonard E.

doi:10.1002/14651858.cd006068.pub2

Cited by 2 publications

(1 citation statement)

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“…Monitoring and surveillance for C. parapsilosis infections, awareness and compliance with hand hygiene, bundled strategies for prevention of central venous catheter infections and antifungal prophylaxis are important strategies (110). The benefit of isolation measures such as cohorting or single room isolation of neonates who are colonized or infected with Candida is not clear (111). It is also paramount to create awareness, institute educational policies for health care staff and provide feedback as a part of a quality improvement initiative.…”

Section: Resultsmentioning

confidence: 99%

Candida parapsilosis Is a Significant Neonatal Pathogen

Pammi

Holland

Butler

et al. 2013

Pediatric Infectious Disease Journal

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Background Candida is the third most common cause of late-onset neonatal sepsis in infants born at < 1500 g. C. parapsilosis infections are increasingly reported in preterm neonates in association with indwelling catheters. Methods We systematically reviewed neonatal literature and synthesized data pertaining to percentage of C. parapsilosis infections and mortality by meta-analyses. We also reviewed risk factors, virulence determinants, antimicrobial susceptibility patterns and outlined clinical management strategies. Results C. parapsilosis infections comprised 33.47 % [95% CI, 30.02, 37.31] of all neonatal Candida infections. C. parapsilosis rates were similar in studies performed before the year 2000, 33.53 % [95% CI, 30.06, 37.40] (28 studies), to those after 2000, 27.00% [95% CI, 8.25, 88.37] (8 studies). The mortality due to neonatal Candida parapsilosis infections was 10.02% [95% CI, 7.66, 13.12]. Geographical variations in C. parapsilosis infections included a low incidence in Europe and higher incidence in North America and Australia. Biofilm formation was a significant virulence determinant and predominant risk factors for C. parapsilosis infections were prematurity, prior colonization and catheterization. Amphotericin B remains the antifungal drug of choice and combination therapy with caspofungin or other echinocandins may be considered in resistant cases. Conclusion C. parapsilosis is a significant neonatal pathogen, comprises a third of all Candida infections and is associated with 10% mortality. Availability of tools for genetic manipulation of this organism will identify virulence determinants and organism characteristics that may explain predilection for preterm neonates. Strategies to prevent horizontal transmission in the neonatal unit are paramount in decreasing infection rates.

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Section: Resultsmentioning

confidence: 99%