Neonatal systemic candidiasis in a tertiary care centre

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.
• 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.