Candida parapsilosiscandidaemia in a neonatal unit over 7 years: a case series study
Open Access
- 6 August 2012
- Vol. 2 (4), e000992
- https://doi.org/10.1136/bmjopen-2012-000992
Abstract
Objective To evaluate Candida parapsilosis candidaemia in a neonatal unit over 7 years. Design Case series study. Setting A 2000-bed tertiary-care university hospital at São Paulo, Brazil. Participants Neonates hospitalised in a 63-bed neonatal unit. Primary and secondary outcome measures We evaluated the incidence of C parapsilosis fungemia in a neonatal unit from 2002 through 2008 and the main microbiological, clinical and epidemiological aspects of this disease in neonates. During the study period an outbreak occurred, an infection control programme was implemented, and isolates from blood and hand healthcare workers (HCWs) were submitted to molecular typing. Results During 7 years, there were 36 cases of C parapsilosis fungaemia and annual incidence varied from 0 to 19.7 per 1000 admissions. Evaluating 31 neonates with fungemia, the mean age at diagnosis was 19 days. All children except for one were premature; all had received total parenteral nutrition and all but one had used central venous catheter. Three neonates had received antifungal treatment previously to the diagnosis. Thirty-day mortality was 45%. Only lower birthweight was associated with mortality. C parapsilosis species complex was isolated from hand cultures in eight (11%) of the HCWs (one isolate was identified as C orthopsilosis). By molecular typing no HCW isolate was similar to any of the blood isolates. Conclusions The incidence of C parapsilosis fungemia in a neonatal unit varied widely over 7 years. We observed in our series a higher death rate than that reported in European countries and the USA.Keywords
This publication has 41 references indexed in Scilit:
- Costs and Consequences of Universal Sibling Screening for Vesicoureteral Reflux: Decision AnalysisPublished by American Academy of Pediatrics (AAP) ,2010
- Neonatal Candidiasis: Epidemiology, Risk Factors, and Clinical JudgmentPediatrics, 2010
- Neonatal candidaemia in Kuwait: a 12‐year study of risk factors, species spectrum and antifungal susceptibilityMycoses, 2009
- Outcomes Attributable to Neonatal CandidiasisClinical Infectious Diseases, 2007
- Risk Factors for Candidemia in Critically Ill Infants: A Matched Case-control StudyThe Journal of Pediatrics, 2005
- Neonatal candidiasis: analysis of epidemiology, drug susceptibility, and molecular typing of causative isolatesEuropean Journal of Clinical Microbiology & Infectious Diseases, 2004
- Yeasts species distribution in Neonatal Intensive Care Units in northeast ArgentinaMycoses, 2004
- Candida parapsilosisBloodstream Infection in Pediatric Oncology Patients: Results of an Epidemiologic InvestigationInfection Control & Hospital Epidemiology, 2004
- Neonatal Invasive Candidiasis: A Prospective Multicenter Study of 118 CasesAmerican Journal of Perinatology, 2003
- Risk factors for candidemia in Neonatal Intensive Care Unit patientsThe Pediatric Infectious Disease Journal, 2000