A Retrospective Analyses of Candida Spp. Infections in the Intensive Care Unit

Abstract

Introduction: Systemic fungal disease, by Candida species, are a much feared complication in NICU. Objectives: We evaluated the higher incidence of Candida A. infection and not particularly in VLBW and ELBW infants. Methods: Infection cases by Candida albicans and not recorded in NICU of Messina. Results: The cases were reported 42/1839 (2%) 21 premature infants , G.A. 30.5± 3.78 , weight 1550.4 ± 906.9, 14 term infants , G.A. 38.42 ± 1:45,weight 3128.9 ± 290.8 , 7 pediatric patients. The fungus most frequently isolated was Candida parapsilosis (19/42-46%), followed by C. albicans (13/42-32%), by C. lambica (5/42-12%), C. tropicalis (2/42-4%), C.zeylanoides (1/42-2%), C.krusei (1/42-2%), C.guillermondi (1/42-2%). Of the 15 preterm with GA ≤ 32, in 8 / 15 (53%) was isolated C.parapsilosis, in 4 / 15 (27%) C. albicans ,in 2 / 15 (13%) C.lambica, in one case (1 / 15-7%) C.zeylanoides. About patients studied 7 / 42 died (17%) which 6 / 21 preterm infants (28%), 1 / 7 pediatric patients (14%), no term baby died. We have registered two cases of mycetoma in a preterm baby. Conclusions: The increased incidence of Candida parapsilosis is a main cause of infections, linked to fungal adherence ability to prosthetic materials and to proliferate in presence of high glucose concentrations , especially in preterm infants in parenteral nutrition. Our study shown the problem of colonization,the selection of resistant strains of Candida in NICU and its new therapeutic options.