title: Emergence of non-albicans Candida species in neonatal candidemia.
abstract: BACKGROUND
  Candida species are one of the most common causes of blood stream infections among neonates and account for 9-13% of such infections. Although Candida albicans remains the most common fungal isolate from neonatal candidemia, longitudinal studies have detected a shift towards non-albicans Candida (NAC) species.
  
  
  OBJECTIVE
  To examine the prevalence and epidemiology of candidemia among infants admitted to our hospital.
  
  
  METHODS
  Blood samples were collected from 548 neonates and only those which yielded pure growth of Candida spp. were included in the study. The isolates were identified as per standard mycological techniques and antifungal susceptibility (AFS) was done by disc diffusion method.
  
  
  RESULTS
  Of the total 132 neonates included in the study, NAC species were responsible for 80.30% cases with C. parapsilosis (25.0%) and C. tropicalis (21.97%) as the most predominant species; whereas 19.70% of cases were caused by C. albicans. AFS results revealed that 65.91, 73.49, and 96.21% isolates were sensitive to fluconazole (FLK), itraconazole (ITR), and amphotericin B (AMB), respectively.
  
  
  CONCLUSIONS
  Candidemia in neonates is an ominous prognostic sign and is an important entity in our hospital. Strict infection control strategies, appropriate preventive and therapeutic measures such as prophylactic antifungal use and a restrictive policy of antibiotic use should be implemented.
authors.affiliation: Department of Microbiology and Immunology, Veer Chandra Singh Garhwali Government Medical Sciences and Research Institute, Srinagar Garhwal, Uttarakhand, India.
authors.forename: Deepak
authors.initials: D
authors.lastname: Juyal
authors.forename: Munesh
authors.initials: M
authors.lastname: Sharma
authors.forename: Shekhar
authors.initials: S
authors.lastname: Pal
authors.forename: Vyas Kumar
authors.initials: VK
authors.lastname: Rathaur
authors.forename: Neelam
authors.initials: N
authors.lastname: Sharma
keywords: Amphotericin B; Candida parapsilosis; Candida tropicalis; Low birth weight; Neonatal intensive care units (NICU); Neonates