Incidencia y factores asociados a candidiasis invasiva en una unidad de cuidados intensivos neonatales de México

Lona-Reyes, Juan Carlos; Gómez-Ruiz, Larissa María; Cordero-Zamora, Araceli; Cortés-González, Sandra I; Quiles-Corona, Moisés; Pérez-Ramírez, René Oswaldo; Pinto-Macedo, Herlinda

doi:10.1016/j.anpedi.2021.07.001

Cited by 3 publications

(2 citation statements)

References 22 publications

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“…In the cohort of neonates with NIC described here, 37% weighed >1500 gr and 38% were ≥32 weeks of gestational age. These results are similar to other studies in LMIC, 11 , 20 and contrast dramatically with the data from HICs, where extreme prematurity and ELBW neonates are the main high-risk groups for NIC. 21 In 2018, e.g., the DeNIS study reported unusually high rates of NIC in a cohort of neonates in India born outside the hospital; more than a quarter of neonates with a positive blood culture (90/339, 26.5%) had Candida spp.…”

Section: Discussionsupporting

confidence: 87%

Neonatal invasive candidiasis in low- and middle-income countries: Data from the NeoOBS study

et al. 2023

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Neonatal invasive candidiasis (NIC) has significant morbidity and mortality. Reports have shown a different profile of those neonates affected with NIC and of fluconazole resistant Candida spp. isolates in low-and-middle-income -countries (LMICs) compared to high-income-countries (HIC). We describe the epidemiology, Candida spp. distribution, treatment and outcomes of neonates with NIC from LMICs enrolled in a global, prospective, longitudinal, observational cohort study (NeoOBS) of hospitalised infants < 60 days postnatal age with sepsis (August 2018-February 2021). 127 neonates from 14 hospitals in 8 countries with Candida spp. isolated from blood culture were included. Median gestational age of affected neonates was 30 weeks (IQR: 28-34) and median birth weight was 1270 g (IQR: 990–1692). Only a minority had high risk criteria, such as being born < 28 weeks, 19% (24/127), or birth weight < 1000 g, 27% (34/127). The most common Candida species were C. albicans (n = 45, 35%), C. parapsilosis (n = 38, 30%) and Candida auris (n = 18, 14%). The majority of C. albicans isolates were fluconazole susceptible, whereas 59% of C. parapsilosis isolates were fluconazole resistant. Amphotericin B was the most common antifungal used [74% (78/105)], followed by fluconazole [22% (23/105)]. Death by day 28 post-enrolment was 22% (28/127). To our knowledge, this is the largest multi-country cohort of NIC in LMICs. Most of the neonates would not have been considered at high risk for NIC in HICs. A substantial proportion of isolates was resistant to first choice fluconazole. Understanding the burden of NIC in LMIC is essential to guide future research and treatment guidelines.

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Section: Discussionsupporting

confidence: 87%

Neonatal invasive candidiasis in low- and middle-income countries: Data from the NeoOBS study

et al. 2023

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“…También se debe a la prescripción de antibióticos de amplio espectro de larga duración. Se evidencia un alto porcentaje de riesgos de infección en los neonatos hospitalizados que se exponen a antibióticos de amplio espectro y periodos prolongados en las áreas críticas 9 .…”

Section: Introductionunclassified

Factores de riesgos relacionados a las infecciones por catéter venoso central en recién nacidos críticos

Pincay-Reyes,

Dávila-Quishpe,

Vega-Falcón

et al. 2023

Vida y Salud

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Objetivo: analizar los factores de riesgos relacionados a las infecciones por catéter venoso central en recién nacidos críticos. Método: Revisión sistemática de 16 trabajos de investigación, ubicados en PubMed, Scielo, en idioma español e inglés. Resultados y conclusión: Se plantea que los factores de riesgos en relación a las infecciones por catéter venoso central, donde se identificó que son ocasionadas por el personal de salud y características propias del recién nacidos que requieren la necesidad de la colocación del catéter venoso central al momento del ingreso a las unidades de cuidados intensivos al ser un procedimiento invasivo necesario también es una fuente de ingreso de complicaciones de tipo mecánico e infeccioso.

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Emerging threat of candida resistance among neonates at a teaching institute of Jharkhand

Biswas

Sharma

Seema

et al. 2023

Journal of Family Medicine and Primary Care

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A BSTRACT Purpose: In the past few decades, candidemia has escalated to worrisome levels, leading to substantial morbidity and mortality in neonates. The rise in anti-fungal drug resistance demands prompt diagnosis and treatment. This study aimed to determine the speciation and susceptibility pattern of Candida species recovered from special care new-born units and identify risk factors for developing candidemia in neonates. Method: A total of 580 blood samples from clinically suspected septicemic neonates were collected and subjected to culture. Cultures positive for yeasts were sub-cultured on Sabouraud dextrose agar. Identification of a suspected purified colony of Candida was confirmed to the species level by both conventional and automated techniques matrix-assisted laser desorption and ionization time-of-flight mass spectrometry. Anti-fungal susceptibility of isolates was performed by an automated method (VITEK 2 system) using VITEK 2 cards. Multi-variate logistic regression analysis was used to identify risk factors associated with candidemia. Result: A total of 56 (9.66%) isolates of Candida species were recovered from 580 blood cultures. Non-albicans Candida species predominated with 82.14% of cases, whereas 17.86% of cases were caused by Candida albicans . Candida tropicalis (46.42%) was the most common isolate recovered, followed by Candida albicans (17.8%). Risk factor analyses identified a very low birth weight [odds ratio (OR) =4.05, 95% confidence interval (CI) =2.03–8.08] and prolonged antibiotic therapy (OR = 3.79, 95% CI = 1.7–8.7) among others as significant predictors of candidemia. All the Candida isolates showed 100% sensitivity to voriconazole and micafungin, whereas the overall sensitivities for fluconazole, amphotericin B, caspofungin, and flucytosine were 85.71%, 96.43%, 96.43%, and 91.07%, respectively. Conclusion: Candidemia is a life-threatening condition in neonates. Identification of Candida species and routine anti-fungal susceptibility is a must to select a suitable and effective anti-fungal therapy to revoke emerging resistance to anti-fungals.

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Incidencia y factores asociados a candidiasis invasiva en una unidad de cuidados intensivos neonatales de México

Cited by 3 publications

References 22 publications

Neonatal invasive candidiasis in low- and middle-income countries: Data from the NeoOBS study

Neonatal invasive candidiasis in low- and middle-income countries: Data from the NeoOBS study

Factores de riesgos relacionados a las infecciones por catéter venoso central en recién nacidos críticos

Emerging threat of candida resistance among neonates at a teaching institute of Jharkhand

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