Fungal Sepsis in a Tertiary Neonatal Intensive Care Unit: A Cross-sectional Study

Uttam, Kheya Ghosh; Gupta, Purbasha; Poddar, Sumon

doi:10.5005/jp-journals-10081-1320

Cited by 2 publications

(1 citation statement)

References 18 publications

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“…Among hospital-born infants, hospital-acquired infections account for an estimated 4% to 56% of all deaths in the neonatal period, depending on the study population and geographical area ( 1 , 2 ). Although nosocomial bloodstream infections (BSIs) by bacteria are still more frequent, the frequency of fungal sepsis caused by species of Candida and other fungi is increasingly recognized as an important cause of morbidity and mortality in neonatal intensive care units (NICUs) ( 3 – 5 ). In the last 2 decades, several outbreaks of nosocomial BSIs due to rare and emerging yeasts have been reported worldwide, stressing the importance of early detection and timely interventions to prevent and control outbreaks ( 6 – 9 ).…”

Section: Introductionmentioning

confidence: 99%

Genomic Analyses of a Fungemia Outbreak Caused by Lodderomyces elongisporus in a Neonatal Intensive Care Unit in Delhi, India

Yadav

Jain

et al. 2023

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Section: Introductionmentioning

confidence: 99%

Genomic Analyses of a Fungemia Outbreak Caused by Lodderomyces elongisporus in a Neonatal Intensive Care Unit in Delhi, India

Yadav

Jain

et al. 2023

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A Chart Review for Epidemiology and Outcome of Fungal Bloodstream Infections Among Neonates in a Tertiary Care Hospital at  North India

Gupta,

Bir,

Kushwaha

et al. 2024

Journal of Neonatology

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Background and Aims The risk of fungal bloodstream infection (BSI) and accompanying mortality in neonates varies widely in between centres depending on the region, the population characteristics and the risk factors. Methods This chart review of neonatal cases with fungal BSI admitted in a tertiary care teaching hospital in North India aimed to comprehensively investigate the epidemiology, profile of fungal species (and their susceptibility to various antifungal agents), risk factors, clinical profile and outcomes in these neonates. The study spanned over a one-year period, from September 2022 to August 2023, included all symptomatic neonates with positive blood cultures for fungal pathogen. Results Over one year, 24 out of 1,174 neonates at risk were diagnosed with fungal BSI, with a cumulative risk of 2.0 per 100 neonates. A peak in cases occurred in February. Candida pelliculosa was the predominant species (75% of isolates), while Candida albicans constituted 4.2%. Most isolates were sensitive to fluconazole, except for some fluconazole-resistant Candida pelliculosa (5.5%) and Candida tropicalis (25.0%), which remained susceptible to amphotericin-B and voriconazole. Around 60% of neonates were preterm, 40% had very low birth weight and 37% were small for gestational age. Nearly all had received prior broad-spectrum antibiotics, with 92% receiving prolonged courses over five days. Respiratory support, including intubation and mechanical ventilation, was used in 83% before onset of fungal sepsis. Intriguingly, all neonates had some invasive device in place for more than seven days. Mortality rate of 25% was observed, with preterm birth and gastrointestinal anomalies contributing to adverse outcomes. Conclusions This study confirms the ongoing shift in trend from albicans to non-albicans Candida infections in our region as well. A seasonal peak of fungal sepsis noted in the month of February hinted at potential seasonal variation or lapses in infection control practices during colder months. The analysis of trends in fungal BSI might hold a significance within neonatal intensive care units (NICUs) for the prompt detection of outbreaks. Simultaneously, understanding and analysing risk factors associated with fungal BSI are essential for targeted prevention.

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Fungal Sepsis in a Tertiary Neonatal Intensive Care Unit: A Cross-sectional Study

Cited by 2 publications

References 18 publications

Genomic Analyses of a Fungemia Outbreak Caused by Lodderomyces elongisporus in a Neonatal Intensive Care Unit in Delhi, India

Genomic Analyses of a Fungemia Outbreak Caused by Lodderomyces elongisporus in a Neonatal Intensive Care Unit in Delhi, India

A Chart Review for Epidemiology and Outcome of Fungal Bloodstream Infections Among Neonates in a Tertiary Care Hospital at  North India

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Fungal Sepsis in a Tertiary Neonatal Intensive Care Unit: A Cross-sectional Study

Cited by 2 publications

References 18 publications

Genomic Analyses of a Fungemia Outbreak Caused by Lodderomyces elongisporus in a Neonatal Intensive Care Unit in Delhi, India

Genomic Analyses of a Fungemia Outbreak Caused by Lodderomyces elongisporus in a Neonatal Intensive Care Unit in Delhi, India

A Chart Review for Epidemiology and Outcome of Fungal Bloodstream Infections Among Neonates in a Tertiary Care Hospital at North India

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A Chart Review for Epidemiology and Outcome of Fungal Bloodstream Infections Among Neonates in a Tertiary Care Hospital at  North India