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Systemic candidiasis in premature infants detection by urine microscopy and culture
Insights
Routine urine screening for Candida in premature infants at risk can detect systemic candidiasis early. Prompt antifungal therapy is recommended for positive results, improving outcomes for vulnerable newborns.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Medical Mycology
Background:
- Premature infants face increased risk of systemic candidiasis due to factors like prolonged hospitalization, broad-spectrum antibiotics, and invasive devices.
- Early detection and treatment of systemic candidiasis are crucial for improving outcomes in this vulnerable population.
Purpose of the Study:
- To evaluate the utility of routine microscopic examination and/or urine culture for Candida in identifying systemic candidiasis in at-risk premature infants.
- To advocate for a standardized screening and treatment protocol for neonatal candidiasis.
Main Methods:
- Microscopic examination and urine cultures for Candida were performed on all premature infants with risk factors.
- Seven cases of systemic candidiasis were identified and analyzed over a two-year period.
- Cultures from endotracheal tubes and umbilical catheters were also assessed for significance.
Main Results:
- Microscopic examination and/or urine culture for Candida were positive in all but one of the seven infants diagnosed with systemic candidiasis.
- The findings highlight the sensitivity of urine screening in detecting candidiasis in this cohort.
Conclusions:
- Routine microscopic examination of urine in at-risk premature infants is a valuable tool for early detection of systemic candidiasis.
- A positive urine screening result should prompt initiation of antifungal therapy.
- The diagnostic significance of positive endotracheal tube and umbilical catheter cultures in neonatal candidiasis warrants further discussion.
Abstract:
Routine microscopic examinations and/or urine culture for Candida were done in all premature infants associated with perinatal factors viz prolonged hospitalisation, broad spectrum antibiotic therapy, use of intravascular catheter, endotracheal intubation. We report another seven infants with systemic candidiasis over a two year period (1983-1984). All, except one, had positive microscopic examination and/or urine culture. We advocate routine microscopic examination urine in premature infants at risk and a positive result is an indication for antifungal therapy. The significance of positive cultures of endotracheal tube and umbilical catheter is discussed.