Neonatal candidiasis in Venezuela: clinical and epidemiological aspects.
A prospective study of the clinical and epidemiological aspects of Candida spp. sepsis was performed to assess the frequency, etiology, and risk factors in the neonatology service of the Pediatrics Hospital "Dr. Elías Toro" (2002-2003). Forty four out of 128 neonatal intensive care patients, with clinical sepsis and suspected fungal etiology, were chosen randomly for this study. Infant blood, urine, gastrointestinal tract, oral and skin samples were cultured. Samples were also taken from health care worker hands and the environment. The antifungal susceptibility patterns of the isolates were evaluated. The prevalence of Candida spp. from the clinical samples was: C. albicans (72.06%), C. parapsilosis (13.24%), C. tropicalis (10.29 %), C. guilliermondii (2.94%), and C. glabrata (1.47%). Due to the similarity of the susceptibility pattern of some isolates from infants and health care workers, we speculate a horizontal nosocomial infection. Statistical analysis revealed the following significant risk factors associated with Candida spp. isolation: prolonged hospitalization (p < 0.05), missing prenatal birth control (p < 0.05), and parenteral nutrition (p < 0.05). Blood cultures were all negative for bacteria and only 2.90% were positive for Candida spp. All 44 neonates receiving empirical therapy with amphotericin B (0.5-1.0 mg/k/day) evolved satisfactorily.
Hartung de Capriles
Claudia
C
Sección de Micología Médica, Instituto de Medicina Tropical, UCV. chartung@cantv.net
Mata-Essayag
Sofía
S
Azpiróz
Amparo
A
Ponente
Adriana
A
Magaldi
Sylvia
S
Pérez
Celina
C
Roselló
Arantza
A
Colella
María Teresa
MT
Machuca
Jensi
J
D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D002175:Candida / Q000302:isolation & purification; D002177:Candidiasis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D005260:Female; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D017757:Infectious Disease Transmission, Professional-to-Patient / Q000706:statistics & numerical data; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D008297:Male; D009035:Mothers; D009928:Organ Specificity; D010564:Personnel, Hospital; D011446:Prospective Studies; D012307:Risk Factors; D012494:Sampling Studies; D018805:Sepsis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D013045:Species Specificity; D014687:Venezuela / Q000453:epidemiology
D000935:Antifungal Agents; D000666:Amphotericin B