title: Invasive fungal infection in neonatal intensive care units: a multicenter survey.
abstract: This study assesses the epidemiology of invasive fungal infection (IFI) in Portuguese Neonatal Intensive Care Units (NICUs) and compares the effectiveness and safety of antifungal therapies. A survey concerning the period 2005-2010 was carried out in NICUs of Greater Lisbon. Among 10 473 admitted neonates, 44 cases were identified, 29 among extreme low birth weight neonates (65.9%). Cumulative incidence rate was 0.42% (95%CI 0.309-0.559). A central vascular catheter was present before IFI in all cases. Candida albicans and Candida parapsilosis were the most frequent isolates. The initial antifungic was fluconazole in 22 cases and liposomal amphotericin B (L-AmB) in 18. Therapy was switched in 10 patients on fluconazole and 3 on L-AmB. Case fatality rate was 11.4% (95%CI 4.39-23.91). No serious adverse drugs reactions (SADRs) or clinical side effects were observed. The knowledge of the local epidemiology helps to identify adequate prophylactic and treatment strategies.
authors.affiliation: a Neonatology Department, Maternidade Dr. Alfredo da Costa , Centro Hospitalar Lisboa Central , Portugal.
authors.forename: Monica Isabel
authors.initials: MI
authors.lastname: Baptista
authors.affiliation: a Neonatology Department, Maternidade Dr. Alfredo da Costa , Centro Hospitalar Lisboa Central , Portugal.
authors.forename: José
authors.initials: J
authors.lastname: Nona
authors.affiliation: b Neonatology Department , Hospital Fernando da Fonseca , Lisbon , Portugal.
authors.forename: Marta
authors.initials: M
authors.lastname: Ferreira
authors.affiliation: c Neonatology Department , Hospital de Santa Maria , Centro Hospitalar Lisboa Norte , Portugal.
authors.forename: Isabel
authors.initials: I
authors.lastname: Sampaio
authors.affiliation: c Neonatology Department , Hospital de Santa Maria , Centro Hospitalar Lisboa Norte , Portugal.
authors.forename: Margarida
authors.initials: M
authors.lastname: Abrantes
authors.affiliation: a Neonatology Department, Maternidade Dr. Alfredo da Costa , Centro Hospitalar Lisboa Central , Portugal.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Tomé
authors.affiliation: d Neonatology Department , Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central , Portugal.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Neto
authors.affiliation: b Neonatology Department , Hospital Fernando da Fonseca , Lisbon , Portugal.
authors.forename: Rosalina
authors.initials: R
authors.lastname: Barroso
authors.affiliation: d Neonatology Department , Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central , Portugal.
authors.forename: Micaella
authors.initials: M
authors.lastname: Serelha
authors.affiliation: e Epidemiology and Statistics Office of the Research Unit of Centro Hospitalar de Lisboa Central , Portugal.
authors.forename: Daniel
authors.initials: D
authors.lastname: Virella
mesh_terms: D000666:Amphotericin B / Q000494:pharmacology; D000935:Antifungal Agents / Q000494:pharmacology*; D003428:Cross Infection / Q000517:prevention & control*; D025141:Drug Resistance, Fungal / Q000187:drug effects*; D005260:Female; D015725:Fluconazole / Q000494:pharmacology; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D000072742:Invasive Fungal Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology; D008826:Microbial Sensitivity Tests; D011174:Portugal / Q000453:epidemiology; D011247:Pregnancy; D011795:Surveys and Questionnaires
chemical_list: D000935:Antifungal Agents; C068538:liposomal amphotericin B; D000666:Amphotericin B; D015725:Fluconazole
keywords: Case fatality rate; Extreme low birth weight; Fluconazole; Incidence rate; Invasive fungal infection; Liposomal amphotericin B; Neonatal Intensive Care Units