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1172 A 7-Years Retrospective Study of Nosocomial Candida Infection in Tertially NICU
  1. U Godula-Stuglik,
  2. J Balicz,
  3. MWB Kwiatkowska-Gruca,
  4. A Pukas
  1. Department of Pediatrics, NICU, Zabrze, Poland

Abstract

Background Nosocomial Candida infections (NCI) with dominant C. albicans account for 6–18% of lateonset sepsis in NICU, with mortality rate 22–32% and increase health care costs.

Aim Evaluation morbility and mortality rate of neonatal NCI, considering sex, GA, BW, perinatal risk factors, occurence of other diseases, types of Candida, number of NCI episodes.

Material and Methods The analysis involved 70 newborns (41 boys, 29 girls), 27 ELBW, 20 VLBW, 11 LBW and 12 >2.5 kg, treated wihin 2002–7 years (4.2% of all), all with flukonazole prophylaxis. Mycological examination was based on Sabouroud medium and using Vitek 2 apparatus.

Results 103 cases of NCI (46 single, 4 double, 7 ³ 3) were diagnosed between 8 and 117 day of hospitalization (27% £15th, 32% between 16th and 30th, 41% >30th day). Eighteen types of C. were isolated (44% in blood), most often albicans (26%), sake (25%) and lusitaniae (18%). The significant dependence was stated between newbons’ death and their GA and number of C. episodes. Presence of central catheters, MV, bacterial sepsis and ventilator associated pneumonia, total parenteral nutrition and severe RDS, BPD, IVH, NEC were founded as major risk factors for neonatal NCI.

Conclusions

  1. Fetal maturity and number of NCI episodes determine the prognosis in newborns infected due to Candida.

  2. Risk factors must be evaluated carefully in all sick newborns, because of longer NICU stay and necessity of invasive procedures.

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