Risk factors and epidemiological features of candida septicemia in neonatal unites at King Hussein Medical Center

Abstract EN

Objective: To review the epidemiology of candidemia in neonatal intensive care unit (NICU), identify the risk factors associated with the development of the infection and suggest a rational approach to starting empirical antifungal treatment in neonate at risk of developing candida infection.

Methods: In this retrospective epidemiologic multicentre pilot study three neonatal intensive care units were included, where all the positive blood cultures for candida in neonates were recorded during 2016 and 2017.

Data of Candida species and antifungal drugs susceptibility were collected.

The medical records of those neonates were studied and the following information were taken; gestational age, birth weight, gender, age at onset of infection, previous use of antibiotics and steroid drugs with the duration of their use before candida infection, endotracheal intubation, presence of necrotizing enterocolitis, and the use of total parental nutrition.

Results: 18 neonates developed candida infection in the blood during that period with incidence of 0.5% of the total admission.

Male to female ratio was 3:1.

Most of the neonates were premature <32 weeks (p value 0.015) and very low birth weight<1500 gm (p value 0.015).Non candida albicans was the most common cause(66.6%).

Where candida parapsilosis was the most common non albicans (27.7%) and all the candida species were sensitive to most commonly used antifungal drugs.

Central line presence (p value 0.01) value, endotracheal tube>1 week (p value 0.01) and prolonged use of antibiotics>1 week (p value 0.002) were the most common associated risk factors.

Mortality rate 16.6% Conclusion: Candida infection is a serious infection in the neonates with increased incidence of non albicans candida species with no emerge of resistant species.