Article Text
Abstract
Introduction The invasive candidiasis supposes an important problem in NICUs with a direct mortality of 15–40%.
Aims and methods To describe the incidence of systemic Candida infection before and after the introduction of fluconazole prophylaxis in January 2009. Retrospective descriptive study of diagnosed patients with invasive fungal infection for 3 years in a level III hospital.
85% had more than 4 risk factors, the most common: NICU admission(100%), central catheter(100%), parenteral nutrition(93%), broad-spectrum ATB use(86%) and IMV(71%). The most frequent associated pathology was catheter-related infection(43%) and necrotizing enterocolitis(22%). No CNS involvement was identified in any case.
Conclusions Systemic prophylaxis with fluconazole has been an effective measure for the reduction of invasive fungal infection in our unit, with a decrease between 40–70%. However, optimization of this strategy is necessary, focusing on those at highest risk (< 1000g and/or ≤27weeks).