Invasive Fungal Infections in the Neonatal Intensive Care Unit

Area of Science:

• Neonatal Medicine
• Infectious Diseases
• Clinical Microbiology

Background:

• Invasive fungal infections (IFIs) pose a substantial morbidity and mortality risk in neonatal intensive care units (NICUs) globally.
• Understanding the epidemiology and clinical aspects of IFIs is crucial for improving outcomes in vulnerable neonates.

Purpose of the Study:

• To investigate the epidemiological and clinical characteristics of IFIs in a NICU over a three-year period.
• To identify common fungal pathogens, risk factors, laboratory findings, and treatment outcomes for IFIs in neonates.

Main Methods:

• Retrospective analysis of clinical data from 22 neonates diagnosed with IFIs between January 2020 and December 2022.
• Data collection included patient demographics, perinatal conditions, fungal isolate types, risk factors, laboratory parameters, and clinical outcomes.
• Statistical analysis using SPSS, employing chi-square, Fisher's exact, Mann-Whitney U, and Wilcoxon signed-rank tests.

Main Results:

• The incidence of IFIs was 11.5 per 1,000 admissions annually, with *Candida albicans* being the most frequent isolate (54.5%).
• Key risk factors identified included prolonged broad-spectrum antibiotic use, parenteral nutrition, central venous catheter, mechanical ventilation, low birth weight (<1,500g), and prematurity.
• A significant increase in C-reactive protein and decrease in platelet count were observed. Overall mortality was 27.3%, with higher mortality in *C. albicans* cases.

Conclusions:

• *Candida albicans* is the predominant pathogen causing IFIs in this NICU population.
• Prematurity, low birth weight, and invasive procedures like central venous catheterization and mechanical ventilation are significant risk factors for IFIs.
• Infection with *C. albicans* is associated with a higher mortality rate compared to other *Candida* species, highlighting the need for targeted prevention and treatment strategies.