Candida infections in neonatology

Abstract

Background: Nosocomial fungal infections have significantly increased over the past 2 decades. Candida species are recognized as leading nosocomial pathogens in neonatal intensive care unit.

Objective: To describe the clinical and microbiological profile of Candida infections in a neonatal intensive care unit.

Method: Retrospective case-control study in a period of 10 years (1994-2004), performed in all newborns admitted to our unit. Each case was compared with 2 control neonates who did not have fungal infection.

Results: 14 cases of Candida infections were identified. Compared with match controls (n = 28), newborns with Candida infections had significantly (p < 0,05) longer hospitalizations and duration of mechanical ventilation, use of parenteral nutrition and broad spectrum antibiotics, along with surgical interventions and mortality. In the group with fungal infections, 9 were term or near-term newborns, mean age at onset was 21 days and Candida albicans was recovered from 8 of 14 cases. Blood was the main source for positive cultures (8/14), fungal dissemination was rare and 28% died (4/14).

Conclusions: Candida infections predominate in term and near-term newborns and Candida no albicans have become common agents of nosocomial fungal infections in our unit. Improvement of diagnosis and multiple organ evaluation are further required.