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Neonatal systemic candidiasis in a tertiary care centre.

S Narain1

  • 1Department of Microbiology Medical College Mumbai-400012, India.

Indian Journal of Medical Microbiology
|July 24, 2007
PubMed
Summary

This study identified Candida infections in neonates, finding Candida albicans, C. tropicalis, and C. krusei. Most isolates showed resistance to fluconazole, but none to amphotericin B, highlighting treatment challenges.

Area of Science:

  • Medical Mycology
  • Neonatal Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Neonatal candidiasis is a significant concern in intensive care units.
  • Risk factors in neonates include prematurity, low birth weight, and broad-spectrum antibiotic use.
  • Candida species are common causes of invasive fungal infections in vulnerable infant populations.

Purpose of the Study:

  • To identify Candida species causing bloodstream infections in neonates.
  • To determine the antifungal susceptibility patterns of isolated Candida species.
  • To evaluate resistance to fluconazole and amphotericin B in neonatal Candida isolates.

Main Methods:

  • Blood culture samples from 30 neonates were analyzed for Candida species identification.

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  • Clinical data including birth weight, gestational age, and prior antibiotic therapy were collected.
  • Antifungal susceptibility testing was performed using NCCLS guidelines for fluconazole and amphotericin B.

    • Main Results:

    • Candida albicans (53.3%), Candida tropicalis (23.3%), and Candida krusei (23.3%) were the predominant species.
    • High rates of fluconazole resistance were observed: 18.75% of C. albicans, 14.5% of C. tropicalis, and 100% of C. krusei.
    • No resistance to amphotericin B was detected among any of the isolated Candida species.

    Conclusions:

    • Candida bloodstream infections in neonates are often caused by species with emerging resistance to fluconazole.
    • Fluconazole resistance in C. krusei is a significant finding, necessitating alternative treatment strategies.
    • Amphotericin B remains a reliable treatment option, showing no resistance in this neonatal cohort.