Candida isolates from neonates: frequency of misidentification and reduced fluconazole susceptibility

J L Rowen1, J M Tate, N Nordoff

  • 1Departments of Pediatrics, University of Texas Medical Branch, Galveston, Texas 77555, USA. jrowen@utmb.edu

Insights

Systemic candidiasis impacts vulnerable premature infants. A study found some Candida strains were misidentified, and several non-albicans species showed resistance to fluconazole, impacting treatment efficacy.

Area of Science:

  • Medical Mycology
  • Neonatal Intensive Care

Background:

  • Systemic candidiasis is a significant concern in very low birth weight infants.
  • Incidence ranges from 1.6% to 4.5% in this vulnerable population.

Purpose of the Study:

  • To assess the accuracy of Candida strain identification in neonatal intensive care units.
  • To evaluate the antifungal susceptibility of Candida isolates, particularly to fluconazole.

Main Methods:

  • Creation of a Candida strain archive from multiple intensive care nurseries.
  • Identification of 98 Candida isolates.
  • Antifungal susceptibility testing (MICs) for fluconazole.

Main Results:

  • Eight percent of isolates (8.2%) were initially misidentified.
  • Seven isolates (7.1%), all non-Candida albicans species, exhibited fluconazole minimum inhibitory concentrations (MICs) greater than 8 microg/ml.
  • One of the fluconazole-resistant isolates was initially misidentified.

Conclusions:

  • Inaccurate identification of Candida species can occur in clinical settings.
  • Emerging fluconazole resistance in non-albicans Candida species poses a therapeutic challenge for systemic candidiasis in neonates.

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