[Colonization by Candida in a neonatal intensive care unit]

Area of Science:

• Medical Microbiology
• Infectious Diseases
• Neonatal Care

Background:

• Candida infections and fungemia are increasing, with prior colonization as a key risk factor.
• Understanding local Candida epidemiology is crucial for effective antifungal treatment selection.
• Neonatal intensive care units (NICUs) are vulnerable settings for Candida colonization and infection.

Purpose of the Study:

• To determine the prevalence of Candida colonization in NICU patients.
• To assess Candida colonization on healthcare staff hands.
• To identify Candida species colonizing medical devices within the NICU.

Main Methods:

• Prospective cohort study design.
• Collection of cultures from patient sites, medical devices, and staff hands.
• Identification of Candida species and antifungal susceptibility testing (amphotericin B, fluconazole, itraconazole, voriconazole, caspofungin).

Main Results:

• Overall Candida colonization rate in NICU patients was 40% (24% at admission, 15% acquired during stay).
• Healthcare staff hands showed high colonization rates (55% positive cultures).
• Candida parapsilosis (59%) was the predominant species, followed by Candida albicans (26%).

Conclusions:

• Candida colonization is a significant issue in NICU patients and a common finding on healthcare worker hands.
• Candida parapsilosis is the primary species responsible for colonization in this NICU setting.
• Antifungal resistance was limited, with resistance to itraconazole observed in only 13% of strains.