Profile of fungal septicaemia in new born at a tertiary care hospital in North India

Abstract

Background: Advances in neonatal management have led to considerable improvement in new-born survival. The objective of this study was to determine the predominant organisms, antifungal sensitivity patterns and clinical risk factors in neonatal fungal blood stream infection cases (BSI) admitted to our hospital.Methods: This is a retrospective study of all neonatal fungal BSI cases between January 2015 to December 2015.Results: Fungal sepsis was found in 50/360 (13.6%) of cases. Non Albicans candida (NAC)species were responsible for 88% of cases with Candida. glabrata (54%)as the most predominant species. Other species isolated were C. tropicalis 9 (18%). C. albicans 6 (12%). C. paraspinolosis 5 (10%), C. Krusei 2 (4%) and C. Kodo1 (2%). Antifungal sensitivity results revealed that most of the NAC isolates especially candida glabrata,candida paraspinolosis were resistant to flucanazole, than Candida albicans. Amphoterician B had greater sensitivity than FLK over NAC species Among the risk factor observed for candidemia were low birth weight (62%), prematurity (60%,), broad spectrum antibiotic use (60%), ventilater support (56%) and total parentral nutrition (50%).Conclusions: The increase in neonatal fungal BSI and resistant organisms highlights the need to review use of strict infection control strategies, appropriate preventive and therapeutic measures such as prophylactic antifungal use and a restrictive policy of antibiotic use.

Neonatal sepsis due to non-albicans Candida species and their susceptibility to antifungal agents: first report from Bangladesh

“…All the C. parapsilosis and C. auris were resistant to fluconazole while C. tropicalis isolates were 93.6% resistant. These findings were in agreement with Pandita et al and Yadav et al[37,38]. : MIC 50 and MIC 90 of fluconazole, amphotericin B and anidulafungin of isolated NAC species Compared to other species of Candida, C. parapsilosis demonstrates higher in vitro MICs to echinocandin, and treatment failures with these antifungal agents have been reported for C. parapsilosis infections[39,40].…”

A Study of Predisposing factors for Fungal Sepsis and Causative Organisms

“…Administration of contaminated intravenous solutions, notably the solution for total parental nutrition (especially the intralipid) may result in NICU outbreaks. Spread may also occur from patient to patient or through a colonized health care worker [3]. Broad-spectrum antibiotics (eg third generation cephalosporins) enhance fungal colonization by destroying competing bacterial flora.…”

“…Culturing for microorganisms from a sample of CSF, blood or urine, is the gold standard test for definitive diagnosis of neonatal sepsis. Widespread infection despite negative culture is common [3]. It is often difficult to establish the diagnosis of fungal sepsis because there are no easy, reliable and rapid test that is why doctors have to attend to clinical signs and various laboratory findings.…”

“…Advances in neonatal management have led to considerable improvement in newborn survival. However, early (<72 hours) and late (>72 hours) onset systemic infections, both bacterial and fungal remain a devastating complication and an important cause of morbidity in these babies [3].…”

Neonatal Sepsis - A Study of Predisposing Factors and Causative Organisms

“…Advances in neonatal management have led to considerable improvement in newborn survival. However, early (<72 hours) and late (>72 hours) onset systemic infections, both bacterial and fungal remain a devastating complication and an important cause of morbidity in these babies [3]. The objective of this study is to identify risk factors and different infections causing sepsis in neonates depending on their birth weight and gestational age.…”