Healthcare-associated Candida infections in neonates: A clinical perspective on risk and outcome
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View abstract on PubMed
Summary
This summary is machine-generated.Healthcare-associated Candida bloodstream infections (HAIs) are a significant threat in neonatal intensive care units (NICUs), especially for premature infants. Enhanced infection control and antifungal stewardship are crucial to combat these serious infections.
Area Of Science
- Neonatology
- Infectious Diseases
- Mycology
Background
- Healthcare-associated infections (HAIs) are a major cause of morbidity and mortality in neonatal intensive care units (NICUs).
- Candida species are common fungal pathogens in vulnerable neonates, particularly preterm and low birth weight infants.
- Understanding risk factors and resistance patterns is crucial for effective management.
Purpose Of The Study
- To investigate the incidence, risk factors, species distribution, antifungal resistance, and outcomes of Candida bloodstream infections (CBIs) in a tertiary NICU.
- To identify key predisposing factors and common Candida species in neonates with CBIs.
- To inform infection control strategies and antifungal stewardship.
Main Methods
- Retrospective analysis of neonates admitted to a tertiary NICU from January 1, 2015, to December 31, 2023.
- Active surveillance for HAIs and identification of neonates with Candida-positive blood cultures.
- Analysis of demographic data, clinical risk factors, laboratory findings, species identification, antifungal susceptibility, and treatment outcomes.
Main Results
- A total of 26 (0.28%) neonates developed Candida bloodstream infections out of 9065 admissions.
- The majority of infected infants were premature (84.6%) and low birth weight (80%), with significant risk factors including central venous catheter use (92.3%), total parenteral nutrition (96.2%), and broad-spectrum antibiotic exposure (88.4%).
- Candida parapsilosis (46.2%) and Candida albicans (42.3%) were the most common species; 15.4% exhibited fluconazole resistance. The overall mortality rate was 38.5%.
Conclusions
- Candida bloodstream infections pose a severe threat in NICUs, particularly for extremely low birth weight and premature infants.
- Invasive procedures and parenteral nutrition are significant risk factors for these infections.
- High mortality rates and emerging antifungal resistance necessitate strengthened infection control and antifungal stewardship programs.
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