Epidemiology, Clinical Spectrum and Outcomes of Fungal Sepsis in Neonates in Neonatal Intensive Care Unit: A Prospective Observational Study
Journal Title: International Journal of Contemporary Medical Research - Year 2018, Vol 5, Issue 1
Abstract
Introduction: With the advancement in the management of newborn there has been significant improvement in the survival of prematurely delivered newborns. Study aimed to describe the epidemiology of fungal sepsis in neonatal intensive care unit at a tertiary care level. Also to identify risk factors and possible predictors of mortality of fungal sepsis. Material and Methods: A prospective observational study was done in a tertiary care centre of Northern India during 2014-2015. All neonates who were admitted in neonatal intensive care unit during August 2014 to July 2015 with suspected sepsis. Outcome measures assessed was the incidence of candidemia in our NICU with clinical profiles and associated risk factors. Results: Of the 526 neonates enrolled with suspected sepsis 83 (15.7%) were candida positive. 53 (63.8%) were C. krusei, 22 (26.5%) were C. albicans and 5 (6%) were C. tropicalis. On multivariate analysis of risk factors of fungal sepsis, very low birth weight babies (OR 2.3, 95% CI 1.4-6.8) and preterm babies (OR 1.9, 95% CI 1.0-5.3) were most significant. Other risk factors were prolonged mechanical ventilation >7 days (OR 5.2, 95% CI 1.4-19.1), prolonged stay in NICU (13±4.7 days) and administration of broad spectrum antibiotics, more than 7 days (OR 4.9, 95% CI 1.9 – 12.7). Very low birth weight (OR 3.9,95% CI 1.3-11.8), need of ventilation (OR 2.9, 95% CI 1.0-8.3) and NEC (OR 0.3, 95% CI 0.1-0.9) were significant risk factors for death. Conclusion: Fungal sepsis is common infection among neonates in NICU, specially preterm and very low birth weight babies. There is progressive epidemiological shift in candida species from C. albicans to non albicans candida species.C. krusei is an emerging fungal pathogen.
Authors and Affiliations
MohdYunus . , Vikas Agarwal, Priya Tomar, Priyanka Gupta, Amit Upadhyay
Keywords
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