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An Ex vivo Assay to Study Candida albicans Hyphal Morphogenesis in the Gastrointestinal Tract
Published on: July 1, 2020
Incidence and factors associated with invasive candidiasis in a neonatal intensive care unit in Mexico
Juan C Lona-Reyes1, Larissa M Gómez-Ruiz2, Araceli Cordero-Zamora1
1División de Pediatría, Servicio de Infectología, Hospital Civil de Guadalajara «Dr. Juan I. Menchaca», Guadalajara, Jalisco, México; Centro Universitario de Tonalá, Universidad de Guadalajara, Tonalá, Jalisco, México.
Introduction:
Neonatal Candida spp. infections are serious events due to their morbidity and mortality, however, epidemiological information is insufficient in developing countries. The objective of this study was to describe the incidence and factors associated with invasive infection by Candida spp. in a Neonatal Intensive Care Unit in Mexico.
Methods:
Case-control study nested in a cohort and matched for birth weight. We estimated the incidence of invasive neonatal infection by Candida spp. For the bivariate analysis of the studied factors, McNemar's test was used to contrast hypotheses and multivariate analysis was made with logistic regression.
Results:
The incidence of infection was 2.27 events/1000 live newborns. The species identified were C. albicans 35.3% (n 30), C. parapsilosis 30.6% (n 26), C. glabrata 31.8% (n 27) and two events with C. lipolytica. The factors associated with a higher risk were mechanical ventilation (OR 3.04, 95% CI 1.13-8.14), systemic antibiotics (OR 7.48, 95% CI 1.30-42.9), number of antimicrobial regimens (OR 2.02, 95% CI 1.01-4.03), and days with total parenteral nutrition (OR 1.14, 95% CI 1.04-1.25) or with venous catheter central (OR 1.11, 95% CI 1.02-1.20). Fluconazole prophylaxis decreased the risk (OR 0.32, 95% CI 0.12-0.84).
Conclusions:
Invasive interventions (central catheter, mechanical ventilation, and parenteral nutrition) and the use of antimicrobials increase the risk of neonatal Candida spp. Infection, while prophylactic fluconazole is protective.
Insights
Neonatal Candida infections are a serious risk in developing countries. Invasive procedures and antibiotics increase risk, but fluconazole prophylaxis can protect newborns.
Area of Science:
- Neonatology
- Infectious Diseases
- Epidemiology
Background:
- Neonatal Candida spp. infections pose significant morbidity and mortality risks.
- Epidemiological data on these infections are limited in developing nations.
- This study addresses the knowledge gap by investigating neonatal Candida infections in Mexico.
Purpose of the Study:
- To determine the incidence of invasive Candida spp. infections in a Mexican Neonatal Intensive Care Unit (NICU).
- To identify factors associated with an increased risk of these infections.
- To evaluate the impact of prophylactic fluconazole on infection risk.
Main Methods:
- A case-control study nested within a cohort, matched for birth weight.
- Incidence of invasive neonatal Candida spp. infection was calculated.
- Bivariate and multivariate logistic regression analyses were employed to identify risk factors.
Main Results:
- The incidence of Candida infection was 2.27 per 1000 live newborns.
- Key risk factors included mechanical ventilation, systemic antibiotics, multiple antimicrobial regimens, and duration of total parenteral nutrition or central venous catheter use.
- Fluconazole prophylaxis was associated with a reduced risk of infection.
Conclusions:
- Invasive interventions like central catheters, mechanical ventilation, and parenteral nutrition elevate the risk of neonatal Candida infections.
- The use of antimicrobials is also a significant risk factor.
- Prophylactic fluconazole demonstrates a protective effect against these infections.
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