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[Neonatal systemic candidiasis in the nineties]

M C Romero Reyes1, F Fernández Gutiérrez, J L Poyato Domínguez

  • 1Unidad de Neonatología, Hospital Universitario Reina Sofia, Córdoba.

Anales Espanoles De Pediatria
|March 1, 1996
PubMed
Summary

Systemic candidiasis in newborns, particularly preterm infants under 1.5kg, presents like bacterial sepsis. Early diagnosis and antifungal treatment are crucial for improving outcomes in neonatal candidiasis.

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Area of Science:

  • Neonatal Medicine
  • Infectious Diseases
  • Mycology

Context:

  • Systemic candidiasis is a significant cause of morbidity and mortality in neonatal intensive care units.
  • Predisposing factors include prematurity, low birth weight, broad-spectrum antibiotic use, prolonged intravascular catheterization, parenteral nutrition, and mechanical ventilation.

Purpose:

  • To analyze the predisposing factors, clinical presentation, diagnostic methods, treatment strategies, and outcomes of systemic candidiasis in newborns.
  • To identify key elements for improving the prognosis of neonatal candidiasis.

Summary:

  • A retrospective study identified 14 newborns with systemic candidiasis. Common predisposing factors included prematurity (12 infants), low birth weight (<1.500 g in 10), antibiotic use, intravascular catheters, and mechanical ventilation.

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  • Candida albicans was the most common pathogen. Clinical presentation mimicked bacterial sepsis. Treatment involved various antifungal agents, including amphotericin B and liposomal amphotericin.
  • Mortality was high, with 6 out of 14 infants dying. The study highlights the importance of a high index of suspicion, rapid diagnosis, and prompt antifungal therapy.

    • Impact:

    • Findings underscore the need for early recognition and management of systemic candidiasis in at-risk neonates.
    • Early intervention, including prompt antifungal treatment and removal of indwelling devices, can potentially reduce mortality and improve outcomes.
    • This study contributes to understanding the challenges and critical management aspects of neonatal fungal infections.