Med Bull Sisli Etfal Hosp. 2023; 57(2): 204-209 | DOI: 10.14744/SEMB.2023.36037

Candidal Infections in the Neonatal Intensive Care Unit: A Retrospective Observational Study

Gaffari Tunc¹, Arife Toksoz², Fatih Kilicbay^3
1Department of Pediatrics, Division of Neonatology, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Türkiye
²Department of Pediatrics, Hatay State Hospital, Hatay, Türkiye
³Department of Pediatrics, Division of Neonatology, Sivas Cumhuriyet University Faculty of Medicine, Sivas, Türkiye

Objectives: The aims of this study were to evaluate the demographic characteristics, risk factors, mortality rates, and laboratory findings of infants with fungal sepsis in the Neonatal Intensive Care Unit (NICU).
Methods: This retrospective multicenter study included patients in NICU with Candida spp isolated in blood cultures between November 01, 2019, and September 01, 2022. The patients were evaluated in two groups as Group 1 infants with Candida albicans and Group 2 infants with Candida non-albicans positive blood cultures.
Results: Candida infection was detected in blood cultures in 57 of 3450 patients admitted to the NICU. A total of 57 infants included in the study. Candida infection was determined 1.6% of infants in the study population, and 57% of them were extremely pre-term infants. There was no significant difference between the two groups in terms of laboratory data. Normal vaginal birth was determined at a higher rate in Group 1. In Group 2, length of hospital stay, duration of total parenteral nutrition (TPN), and mechanical ventilation (MV) were determined to be longer. The mortality due to Candida fungemia was determined as 35%, and of these patients, 65% had an additional medical condition.
Conclusion: In accordance with the literature, this study showed that prolonged MV and longer TPN increased the incidence of fungal sepsis. Therefore, to decrease the fungal sepsis rate of NICU, shortening the hospital stay and effective screening programs are recommended.

Keywords: Candida spp., candidemia, fungal sepsis, neonatal intensive care unit, nosocomial infection

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Yenidoðan yoðun bakým ünitesindeki kandidal enfeksiyonlar: retrospektif gözlemsel bir çalýþma

Gaffari Tunc¹, Arife Toksoz², Fatih Kilicbay^3
1Bursa Yüksek Ýhtisas Eðitim ve Araþtýrma Hastanesi, Çocuk Saðlýðý ve Hastalýklarý Ana Bilim Dalý, Neonatoloji Bilim Dalý, Bursa
²Hatay Devlet Hastanesi, Çocuk Saðlýðý ve Hastalýklarý Kliniði, Hatay
³Sivas Cumhuriyet Üniversitesi Týp Fakültesi, Çocuk Saðlýðý ve Hastalýklarý Ana Bilim Dalý, Neonatoloji Bilim Dalý, Sivas

Amaç: Yenidoðan yoðun bakým ünitemizde (YYBÜ) Candida spp. sepsisi nedeniyle takip ve tedavi edilen bebeklerin demografik özelliklerini, risk faktörlerini, mortalite oranlarýný ve laboratuvar bulgularýný retrospektif olarak deðerlendirmeyi amaçladýk.
Metod: Yenidoðan yoðun bakým üniterlerinde çok merkezli, retrospektif olarak, 1 Kasým 2019–1 Eylül 2022 yýllarý arasýnda, kan kültüründe Candida spp. üremesi olan hastalar çalýþmaya alýndý. Candida albicans(C.albicans) üreyenler (Grup 1) ve Candida Non-albicans üreyenler (Grup 2) þeklinde iki gruba ayrýlarak incelendi.
Bulgular: Candida enfeksiyon sýklýðý %1,6 olarak saptandý. Ýleri preterm bebeklerde ise %57 oranýnda saptandý. Grup 1’de normal doðumun daha yüksek olduðu saptandý. Grup 2’de ise hastanede kalýþ süresinin, Total Parenteral Beslenme (TPN) ve mekanik ventilasyon (MV) süresinin daha uzun olduðu saptandý. Ölüm oraný %35 olarak saptandý ve bu hastalarýn %65’ inde ek anomali eþlik etmekte idi. Laboratuvar verileri arasýnda her iki grupta da anlamlý fark saptanmadý.
Sonuç: Sistemik Candida enfeksiyonunu önlemek için hamile kadýnlarýn vajinal kandidiyazis açýsýndan taranmasý gerekir. Uzamýþ MV, TPN vb. fungal sepsis insidansýný arttýrýr. Bunu önlemek için hastanede kalýþ süresinin kýsaltýlmasý ve etkin tarama programlarý önerilir. (SETB-2022-11-243)

Anahtar Kelimeler: Candida spp., kandidemi, fungal sepsis, yenidoðan yoðun bakým ünitesi, nozokomiyal enfeksiyon

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