Prevention of &lt;i&gt;Candida&lt;/i&gt; Colonization Prevents Infection in a Neonatal Unit

Borderon, J.C.; Therizol-Ferly, M.; Saliba, E; Laugier, J; Quentin, Roland

doi:10.1159/000071441

Cited by 15 publications

(10 citation statements)

References 24 publications

(42 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…S et al who showed non albicans Candida sepsis in 86.4%. 8 A shift towards Non albicans Candida was also noted by Borderon et al, Mendirata et al and Heljic et al [15][16][17] Among non albicans Candida, Candida tropicalis and Candida guilliermondii were the predominant species in our study 21% each followed by Candida famata 11.53%, Candida Krusei 11.53% and Candida Parapsilosis 5.76%. Niranjan HS et al demonstrated Candida Krusei to be the predominant non albicans species followed by Candida tropicalis.…”

Section: Discussionsupporting

confidence: 81%

Neonatal candidiasis: clinical spectrum and epidemiology in a tertiary care centre

Koppad

Prakash

2017

Int J Contemp Pediatr

View full text Add to dashboard Cite

Background: Candidial infections are a serious problem in neonatal intensive care units (NICU) which increases the mortality and morbidity in addition to increasing health care costs. Confirming the diagnosis by laboratory tests is difficult and a high index of suspicion is required. The objective of this study was to identify the clinical spectrum and epidemiology of neonatal candidiasis in a tertiary care NICU.Methods: The present study was carried out in the NICU of SDM medical college and hospital, Dharwad. All babies who were admitted to NICU and who had positive blood culture for Candida were included in the study. One year Data (1st December 2015 to 31st November 2016) was collected retrospectively from NICU case records. Statistical test used was chi square test.Results: Total admissions to the NICU during the study period were 2591. Blood cultures were positive in 132 babies. Among these, Candidial sepsis was noted in 39.39% (52) babies. Out of the 52 positive fungal cultures, 15 were Candida albicans, 35 were Candida non albicans and 2 were mixed cultures (Candida albicans and non albicans) showing an increasing incidence of non-albicans Candida infections. Among the non albicans Candida, Candida tropicalis and Candida guilliermondii were the predominant species (11 each) followed by Candida famata (6), Candida krusei (6) and Candida parapsilosis (3). Candidial sepsis was seen to be more common among preterm and low birth weight babies. Usage of antibiotics, Total parenteral nutrition (TPN) and mechanical ventilation were common risk factors noted in our study.Conclusions: Systemic Candidiasis is a disease of modern neonatal intensive care. It deserves urgent attention for its prevention as well as effective treatment in order to minimize neonatal morbidity and mortality.

show abstract

Section: Discussionsupporting

confidence: 81%

Neonatal candidiasis: clinical spectrum and epidemiology in a tertiary care centre

Koppad

Prakash

2017

Int J Contemp Pediatr

View full text Add to dashboard Cite

show abstract

“…Colonised neonates are asymptomatic. However, colonisation could be the first step for the development of mucocutaneous candidiasis or systemic disease . Systemic Candida infections are common in neonatal intensive care units, especially among preterm and very low birth neonates.…”

Section: Introductionmentioning

confidence: 99%

“…However, colonisation could be the first step for the development of mucocutaneous candidiasis or systemic disease. 1,6 Systemic Candida infections are common in neonatal intensive care units, especially among preterm and very low birth neonates. It is estimated that 15% of these neonates are colonised from their mother, whereas the rest 85% are colonised horizontally inside the units.…”

Section: Introductionmentioning

confidence: 99%

The effect of maternal flora on Candida colonisation in the neonate

Filippidi

Galanakis

Maraki

et al. 2013

Mycoses

View full text Add to dashboard Cite

Colonisation may be the first step for the development of Candida infection. The source of neonatal colonisation is thought to be the hospital environment or the maternal vaginal tract. This study investigated to what extend Candida isolates in neonates are similar to isolates from their mother's vaginal tract. Vaginal samples were collected from 347 pregnant women within 48 h before delivery. Samples from oral and rectal mucosa of their neonates were collected within 24-72 h after delivery, were cultured and yeast species were identified. Antifungal susceptibility tests against six antifungal agents were performed. All paired isolates from mother and infant were genotyped by pulse field gel electrophoresis. A total of 82 mothers and of 16 infants were found colonised by Candida spp. C. albicans was the most common species in pregnant women (n = 68) followed by C. glabrata (n = 11). Only C. albicans was isolated from infants, mainly (14/16) from rectal site. All colonised neonates were born to mothers colonised by C. albicans. Candida genotyping revealed identical strains in all investigated neonate-mother pairs. All isolates were susceptible to amphotericin B. Our findings strongly suggest that vertical transmission has the principal role in the neonatal colonisation by C. albicans in the very first days of life.

show abstract

“…23 In ill neonates, oral candidiasis may be a step in the pathogenesis of systemic candidiasis, a condition with a high mortality rate. 24 A Cochrane Review by Austin and Darlow 25 indicates that there is insufficient evidence to support the use of prophylactic oral antifungal agents in very low birth weight infants to reduce oral candida. They suggest that reducing oral candida among ill neonates is worthwhile, but that additional studies are needed to determine how this can be accomplished.…”

Section: Discussionmentioning

confidence: 99%

ETCare: a randomized, controlled, masked trial comparing two solutions for upper airway care in the NICU

et al. 2007

View full text Add to dashboard Cite

Objective: Small quantities of normal saline are sometimes instilled into the endotracheal tube of intubated neonates, to assist with the removal of thick secretions and maintain patency of the endotracheal tube. However, saline is detrimental to the innate immune system of the upper airway mucosa, rapidly unfolding and inactivating antimicrobial peptides such as LL-37. We previously reported the preparation and feasibility testing of 'ETCare', a low-sodium, physiologically based solution for airway care, and we now report results of a randomized, masked, controlled, two-centered study testing ETCare vs sterile saline among 60 intubated NICU patients.Study Design: Sixty intubated NICU patients were randomized to having their airway care with ETCare vs saline. Three hypotheses were tested: (1) tolerance -patients will tolerate ETCare for airway care as well as they tolerate saline, (2) nosocomial infections -ETCare will result in fewer tracheal aspirates where organisms grow and fewer cases of nosocomial sepsis, and (3) chronic lung disuse -ETCare will result in fewer patients discharged home on supplemental O 2 .Result: Thirty NICU patients with an endotracheal tube in place were randomized to receive their airway care with ETCare, and 30 to receive their care with saline. Only the pharmacist was aware of the randomization; the two solutions were visually indistinguishable and were dispensed in identical syringes. Tolerance of the solutions was similar. The ETCare recipients had trends toward fewer positive blood cultures (odds ratios (OR), 0.48; 95% confidence interval (CI), 0.13 to 1.68), and fewer discharges home on supplemental O 2 (OR, 0.43; 95% CI, 0.14 to 1.32; P ¼ 0.075). Conclusion:On the basis of this study and our previous 10-patient feasibility trial, we maintain that, for airway care, intubated NICU patients tolerate ETCare as well as saline. Data from this study can be used in estimating the sample sizes needed for a phase III trial. We speculate that such a trial will demonstrate that, compared with saline, ETCare will result in fewer nosocomial infections and less chronic lung disease.

show abstract

Prevention of <i>Candida</i> Colonization Prevents Infection in a Neonatal Unit

Cited by 15 publications

References 24 publications

Neonatal candidiasis: clinical spectrum and epidemiology in a tertiary care centre

Neonatal candidiasis: clinical spectrum and epidemiology in a tertiary care centre

The effect of maternal flora on Candida colonisation in the neonate

ETCare: a randomized, controlled, masked trial comparing two solutions for upper airway care in the NICU

Contact Info

Product

Resources

About