title: [Prospective study of Candida-related sepsis in the neonate].
abstract: OBJECTIVE
  Our objective was to carry-out a prospective study of newborns with systemic candidiasis admitted to our Neonatology Unit in a teritiary hospital during the period of March 1994-September 1997.
  
  
  METHODS
  To be included in the study the patient had to have Candida sp recovered from a normally sterile body fluid and clinical signs of sepsis. We analyzed perinatal and neonatal antecedents, risk factors, clinical course, diagnosis, treatment and outcome.
  
  
  RESULTS
  The incidence of systemic candidiasis was 0.62% (14 newborns). Two were term infants and 12 preterm infants, 9 of which weighed less than 1500 g. All of the patients had as predisposing factors the use of broad spectrum antibiotics, prolonged intravascular catheterization and parenteral nutrition, while 64% had mechanical ventilation. The mean age at onset of sepsis was 22 days, with non-specific clinical presentation. Four infants were treated with intravenous amphotericin B and 9 with liposomal amphotericin B in association with fluconazole in one patient and with flucytosine and fluconazole in another. No adverse effects were observed. Mortality was 21%. C. parapsilosis was isolated in 7 cases and C. albicans in another 7 patients, with an important increase in C. parapsilosis in the last few years.
  
  
  CONCLUSIONS
  Clinical suspicion of invasive candidiasis requires the removal of indwelling catheters and early initiation of systemic ungal therapy to reduce mortality. The increased incidence of species with more epidemic presentation like C. parapsilosis reinforce the importance of control measures such as handwashing for all personnel and aseptic management of intravascular catheters and solutions in order to prevent infections.
authors.affiliation: Departamento de Pediatría, Hospital Universitario Reina Sofía, Córdoba.
authors.forename: S
authors.initials: S
authors.lastname: Jaraba Caballero
authors.forename: M P
authors.initials: MP
authors.lastname: Jaraba Caballero
authors.forename: F
authors.initials: F
authors.lastname: Fernández Gutiérrez
authors.forename: I
authors.initials: I
authors.lastname: Muriel Zafra
authors.forename: M D
authors.initials: MD
authors.lastname: Huertas Muñoz
authors.forename: R
authors.initials: R
authors.lastname: Alvarez Marcos
authors.forename: J
authors.initials: J
authors.lastname: Guzmán Cabañas
authors.forename: M
authors.initials: M
authors.lastname: Zapatero Martínez
mesh_terms: D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D002177:Candidiasis / Q000150:complications* / Q000188:drug therapy; D004359:Drug Therapy, Combination; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D007231:Infant, Newborn; D011446:Prospective Studies; D018805:Sepsis / Q000382:microbiology*
chemical_list: D000935:Antifungal Agents; D000666:Amphotericin B; D015725:Fluconazole
vernacular_title: Estudio prospectivo de sepsis por Candida en el recién nacido.