Invasive candidiasis in a neonatal intensive care unit in Fukuoka

Abstract

Background Invasive candidiasis (IC) is a leading cause of morbidity and mortality in preterm infants. The objective of this study was to determine the prevalence of IC infection in newborns in the neonatal intensive care unit (NICU) of a tertiary hospital in Japan, and to identify specific predisposing factors for IC. Methods We retrospectively collected data on demographics, clinical characteristics, and outcomes of infants with IC, who were discharged from a tertiary NICU in Japan between January 2009 and December 2020. We compared predisposing factors associated with the occurrence of early‐onset IC (EOIC < 72 h) and late‐onset IC (LOIC ≥ 72 h) with those of early‐onset and late‐onset bacterial sepsis. Results Between January 2009 and December 2020, 3,549 infants were admitted to the NICU, including 344 extremely‐low birthweight (ELBW) infants. Eleven infants (including nine ELBW infants) had IC (incidence 0.31%), and the mortality rate of IC was 0%. Four (36%) infants had EOIC and seven (64%) had LOIC. All those with EOIC presented with skin lesions and 86% with LOIC had thrombocytopenia. Maternal vaginal Candida colonization was a more specific predisposing factor for EOIC, while gestational age <26 weeks, broad‐spectrum antibiotic use, prior bacterial infection, prior gastrointestinal (GI) surgery, and GI diseases were more specific predisposing factors for LOIC. Conclusions The findings suggest that maternal vaginal Candida colonization and skin lesions in ELBW infants may contribute to early recognition of EOIC. LOIC should be suspected if ELBW infants with several predisposing factors of LOIC have thrombocytopenia.

Congenital candidiasis in a full-term infant: A case report

“…Unlike hospital-acquired systemic candidiasis, which is common in neonatal intensive care units worldwide, congenital systemic candidiasis is extremely rare and can occur in full-term and preterm infants. 1,2 A meta-analysis conducted in 2020 found that fewer than 50 recognized cases had been reported in the literature over the past 54 years. 2 The disease may be localized (i.e., congenital cutaneous candidiasis, CCC) and present as an extensive skin rash which eventually results in widespread desquamation, or generalized (i.e., congenital systemic candidiasis) which usually lacks cutaneous involvement and presents with respiratory distress, meningitis, sepsis, and death.…”