Neonatal candidiasis: clinical spectrum and epidemiology in a tertiary care centre

Koppad, Bhavana; Prakash, Kulkarni Poornima

doi:10.18203/2349-3291.ijcp20170684

Cited by 4 publications

(6 citation statements)

References 9 publications

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“…The results in this study showed that candidal sepsis commonly occurred in low weight and preterm neonates, similar results were reported in other studies by Schellack and Gous (32), Femitha and Joy (33), Kapila (34), and Koppad and Prakash (35). Low weight and preterm are risk factors for fungal sepsis because of immaturity of their immune system and invasive intervention.…”

Section: Discussionsupporting

confidence: 90%

Fungal neonatal and infantile sepsis in Egypt: Risk factors and identification of fungal isolates

Ahmed¹,

Mokhtar²,

El-Kholy³

et al. 2019

Af J Clin Exp Micro

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Background: Invasive fungal diseases (IFDs) are opportunistic infections associated with significant mortality in paediatric patients, especially in those with compromised immune system and neonates with very low birth weight (VLBW). The objectives of this study are to determine the prevalence, clinical features and fungi isolates of neonatal sepsis in three hospitals in Egypt. Methodology: The study is a cross sectional survey of 176 neonates with clinical sepsis admitted to the neonatal intensive care units (NICU) of the three hospitals over a period of one year (February 2015 to January 2016). A minimum of two blood samples (collected within 24 hours) from each neonate were cultured for bacteria in automated BacT/AlerT and conventional culture bottles, while Saboraud-Brain Heart Infusion broth was inoculated for fungi culture. Positive growths from the broth were sub-cultured on Sabouraud Dextrose Agar (SDA) plates for aerobic incubation at 25 o C and 37 o C for 2 weeks. Identification of fungi colonies on SDA was by conventional morphology and confirmation on chromogenic agar media. Phylogenetic analysis of representative fungi isolates was done by partial nucleotide sequencing of D1-D2 domain of the large subunit rRNA gene. Results: Of the 176 neonates, blood culture was positive for pathogens in 55 (31.3 %) samples and fungi were isolated in 26 (14.8 %); yeast (25) and mould (1). The commonly isolated yeasts were Candida albicans, Candida tropicalis, and Candida krusei representing 34.6%, 30.8% and 23.1%, respectively of the total fungi isolated. The phylogenetic analysis in comparison to Genbank data showed defined clades for Candida tropicalis, Candida parapsilosis, Candida albicans and Pichia kudriavzevii Conclusion: This current study highlights the changing pattern of neonatal infections in Egypt caused by Candida, with increasing incidence of infections caused by non-albicans Candida species.

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Section: Discussionsupporting

confidence: 90%

Fungal neonatal and infantile sepsis in Egypt: Risk factors and identification of fungal isolates

Ahmed¹,

Mokhtar²,

El-Kholy³

et al. 2019

Af J Clin Exp Micro

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“…This is similar to studies from Pakistan, India and Italy which showed non-albicans Candida species as a cause of sepsis in neonates. 2,36,37 However, we found C. albicans to be associated with LOD along with the use of antibiotics as a significant risk factor, similar to other studies from India. 10,33,34 Despite high usage of carbapenems and cephalosporins in 2019 (60% and 53% in EOD and 73% and 57% in LOD, respectively) as compared with vancomycin (36% in EOD and 55% in LOD), the association of vancomycin with LOD was the only statistically significant finding.…”

Section: Discussionsupporting

confidence: 90%

Spectrum and Antifungal Resistance of Candidemia in Neonates With Early- and Late-Onset Sepsis in Pakistan

Rattani

Farooqi

Hussain

et al. 2021

Pediatric Infectious Disease Journal

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Background: Neonatal candidemia leads to high morbidity and mortality in developing countries. We studied the trends, spectrum and antifungal resistance in neonatal candidemia isolates from the year 2014 to 2019. Methods: This was a cross-sectional study conducted at the Aga Khan University, Pakistan. Neonates with positive blood cultures with Candida species were retrospectively identified from the laboratory database (2014)(2015)(2016)(2017)(2018) and prospectively in 2019 where clinical information was also collected as part of routine laboratory reporting. Results: We identified 669 neonates with Candida species in blood cultures. Three hundred forty-six neonates had early-onset disease (EOD age ≤7 days) and 323 had late-onset disease (LOD age >7 days). Non-albicans Candida species (86.7%) were predominant versus C. albicans (13.3%; P-value 0.024) with Candida tropicalis being most common in both EOD and LOD. Candida pelliculosa and Candida guilliermondii were associated with EOD and C. albicans with LOD. Isolation of fluconazole nonsusceptible non-albicans Candida species was significantly higher in early-onset (5.9%) versus late-onset (2%) neonatal candidemia (P-value 0.005; crude odds ratio [COR] 2.73, 95% CI: 1.34-5.53). LOD in neonates was more likely associated with the use of vancomycin (COR 3.89, 95% CI: 1.39-10.89). EOD was more likely seen in patients with vaginal delivery (COR 4.16,) and in neonates with respiratory distress leading to intensive care unit admission (COR 3.31, 95% CI: 1.05-10.42). Conclusions: Non-albicans Candida species were increasingly isolated from neonates with candidemia during recent years from Pakistan. Amphotericin remains first-line option for neonatal candidemia in our setting as fluconazole nonsusceptible Candida species are commonly isolated.

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“…20 Niranjan et al also demonstrated Candida krusei to be the predominant nonalbicans species followed by Candida tropicalis. 21 In this study we isolated C. parasilopsis and C. tropicalis amongst the second and third commonest species of nonalbicans Candida similar to studies done by Koppad et al 22 Although C. parasilopsis is less virulent, but because of indwelling catheters and high IV glucose infusion, the virulence may increase and is thus difficult to eradicate this organism. 23 All neonates with candidemia received antifungal treatment.…”

Section: Discussionsupporting

confidence: 78%

Persisting non-albicans candidemia in low birth weight neonates in a tertiary care hospital, Jammu and Kashmir

2023

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Background: Neonatal candidemia is among the leading causes of mortality in neonatal intensive care units of the developing countries like India. This work aimed at determining the prevalence of candidemia, spectrum of disease, risk factors and the antifungal susceptibility in low birth weight neonates in neonatal intensive care unit (NICU)’s at a tertiary care level. Methods: This was a prospective cross-sectional study of blood culture positive candidemia cases in neonates admitted to the neonatal intensive care unit of tertiary care hospital, SMHS, Jammu and Kashmir, India, between July 2021 to December 2022. All neonates with a clinical suspicion of candidemia with a positive blood culture (BacT alert) were identified. Patient demographics, clinical details, neonatal risk factors, and laboratory data and antifungal susceptibilities (using VITEK 2 compact system) were recorded and analyzed. Results: A total of 680 neonatal blood culture samples were collected from NICU’s, out of which 88 (12.94%) developed candidemia. Low birth weight (33.33%), indwelling catheters (31.52%), prematurity (31.31%) and prolonged use of antibiotics were important risk factors. The commonest clinical manifestation was feed intolerance 66.1% and respiratory distress 62.2%. Non-albicans candida was seen in majority cases 86.36% with Candida krusei 77.27%. All the Candida spp. showed 100% sensitivity to voriconazole and caspofugin followed by amphotericin B, fluconazole and micafugin. Conclusions: In this study, we focussed on determining the prevalence of candidemia in low birth weight neonates. The persistently emerging non-albicans Candida particularly Candida krusei has emerged as a big concern and needs attention for its prevention and treatment to minimize the morbidity and mortality rate.

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Neonatal candidiasis: clinical spectrum and epidemiology in a tertiary care centre

Cited by 4 publications

References 9 publications

Fungal neonatal and infantile sepsis in Egypt: Risk factors and identification of fungal isolates

Fungal neonatal and infantile sepsis in Egypt: Risk factors and identification of fungal isolates

Spectrum and Antifungal Resistance of Candidemia in Neonates With Early- and Late-Onset Sepsis in Pakistan

Persisting non-albicans candidemia in low birth weight neonates in a tertiary care hospital, Jammu and Kashmir

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