CLINICAL AND LABORATORY CHARACTERISTICS OF NEONATAL CANDIDA SEPSIS
Introduction: Steady progress in intensive treatment worldwide has increased the survival of immature neonates, but with multiple invasive procedures, which has increased the risk of infection and, consequently, fungal sepsis. Candida is the dominant cause, with the rise of resistant non-albicans sp...
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| Format: | Article |
| Language: | English |
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Association of medical doctors Sanamed Novi Pazar
2019-12-01
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| Series: | Sanamed |
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| Online Access: | http://www.sanamed.rs/OJS/index.php/Sanamed/article/view/364/183 |
| _version_ | 1827333336781029376 |
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| author | Hadzic Devleta Skokic Fahrija Brkic Selmira Saracevic Amina |
| author_facet | Hadzic Devleta Skokic Fahrija Brkic Selmira Saracevic Amina |
| author_sort | Hadzic Devleta |
| collection | DOAJ |
| description | Introduction: Steady progress in intensive treatment worldwide has increased the survival of immature neonates, but with multiple invasive procedures, which has increased the risk of infection and, consequently, fungal sepsis. Candida is the dominant cause, with the rise of resistant non-albicans species. The mortality rate is high and requires timely suspicion and adequate treatment to counteract fatal outcomes.
Objectives:To analyze the clinical and laboratory characteristics of Candida sepsis, compared to bacterial sepsis, in neonates treated in the neonatal intensive care unit. Methods: A retrospective cohort study conducted at the Intensive care unit of Pediatric Clinic Tuzla over a three-year period (2016-2018) analyzed the clinical and laboratory characteristics of neonates with Candida sepsis, evidenced by positive blood culture. The control group was neonates treated at the same time for proven bacterial sepsis. Statistical analysis applied standard methods, and the research was approved by the Ethics Committee of the institution.
Results: Out of the total 921 neonates treated over a three-year period, culture-confirmed Candida sepsis was found in 48 (5.2%). Prematurity and low birth weight were the most significant risk factors and affected neonates had a more difficult clinical presentation, more receiving parenteral nutrition, mechanical ventilation, intravenous gamma globulin, and longer intensive treatment. Candida sepsis manifested mainly as late-onset. Laboratory abnormalities mainly included CRP elevation, anemia, leukocyte count deviations, and thrombocytopenia. There was no difference in mortality, 44 neonates recovered (91.7%), while 4 (8.3%) died. Antifungal therapy lasted 20.6 ± 6 days, and intensive treatment 38.2 ± 23.2 days, and was significantly longer compared to the control. All isolates were Candida species without in vitro resistance. In 8 neonates (16.7%) treatment complications were recorded.
Conclusions: Neonatal Candida sepsis endangers life, complicates treatment, increases costs and mortality rate. Recovery depends on timely suspicion, adequate treatment, and supervision. Antifungal susceptibility is also important and requires monitoring of local epidemiological dynamics. |
| first_indexed | 2024-03-07T17:19:47Z |
| format | Article |
| id | doaj.art-18e07a8693f74415a8f48d008f2ff317 |
| institution | Directory Open Access Journal |
| issn | 1452-662X 2217-8171 |
| language | English |
| last_indexed | 2024-03-07T17:19:47Z |
| publishDate | 2019-12-01 |
| publisher | Association of medical doctors Sanamed Novi Pazar |
| record_format | Article |
| series | Sanamed |
| spelling | doaj.art-18e07a8693f74415a8f48d008f2ff3172024-03-02T20:17:55ZengAssociation of medical doctors Sanamed Novi PazarSanamed1452-662X2217-81712019-12-0114325926710.24125/sanamed.v14i3.364CLINICAL AND LABORATORY CHARACTERISTICS OF NEONATAL CANDIDA SEPSISHadzic Devleta0Skokic Fahrija1Brkic Selmira2Saracevic Amina3Pediatric Clinic, University Clinical Center of Tuzla, Bosnia and HerzegovinaPediatric Clinic, University Clinical Center of Tuzla, Bosnia and HerzegovinaFaculty of Medicine University of Tuzla, Bosnia and HerzegovinaPediatric Clinic, University Clinical Center of Tuzla, Bosnia and HerzegovinaIntroduction: Steady progress in intensive treatment worldwide has increased the survival of immature neonates, but with multiple invasive procedures, which has increased the risk of infection and, consequently, fungal sepsis. Candida is the dominant cause, with the rise of resistant non-albicans species. The mortality rate is high and requires timely suspicion and adequate treatment to counteract fatal outcomes. Objectives:To analyze the clinical and laboratory characteristics of Candida sepsis, compared to bacterial sepsis, in neonates treated in the neonatal intensive care unit. Methods: A retrospective cohort study conducted at the Intensive care unit of Pediatric Clinic Tuzla over a three-year period (2016-2018) analyzed the clinical and laboratory characteristics of neonates with Candida sepsis, evidenced by positive blood culture. The control group was neonates treated at the same time for proven bacterial sepsis. Statistical analysis applied standard methods, and the research was approved by the Ethics Committee of the institution. Results: Out of the total 921 neonates treated over a three-year period, culture-confirmed Candida sepsis was found in 48 (5.2%). Prematurity and low birth weight were the most significant risk factors and affected neonates had a more difficult clinical presentation, more receiving parenteral nutrition, mechanical ventilation, intravenous gamma globulin, and longer intensive treatment. Candida sepsis manifested mainly as late-onset. Laboratory abnormalities mainly included CRP elevation, anemia, leukocyte count deviations, and thrombocytopenia. There was no difference in mortality, 44 neonates recovered (91.7%), while 4 (8.3%) died. Antifungal therapy lasted 20.6 ± 6 days, and intensive treatment 38.2 ± 23.2 days, and was significantly longer compared to the control. All isolates were Candida species without in vitro resistance. In 8 neonates (16.7%) treatment complications were recorded. Conclusions: Neonatal Candida sepsis endangers life, complicates treatment, increases costs and mortality rate. Recovery depends on timely suspicion, adequate treatment, and supervision. Antifungal susceptibility is also important and requires monitoring of local epidemiological dynamics.http://www.sanamed.rs/OJS/index.php/Sanamed/article/view/364/183candida sepsisneonatesclinical and laboratory characteristics |
| spellingShingle | Hadzic Devleta Skokic Fahrija Brkic Selmira Saracevic Amina CLINICAL AND LABORATORY CHARACTERISTICS OF NEONATAL CANDIDA SEPSIS Sanamed candida sepsis neonates clinical and laboratory characteristics |
| title | CLINICAL AND LABORATORY CHARACTERISTICS OF NEONATAL CANDIDA SEPSIS |
| title_full | CLINICAL AND LABORATORY CHARACTERISTICS OF NEONATAL CANDIDA SEPSIS |
| title_fullStr | CLINICAL AND LABORATORY CHARACTERISTICS OF NEONATAL CANDIDA SEPSIS |
| title_full_unstemmed | CLINICAL AND LABORATORY CHARACTERISTICS OF NEONATAL CANDIDA SEPSIS |
| title_short | CLINICAL AND LABORATORY CHARACTERISTICS OF NEONATAL CANDIDA SEPSIS |
| title_sort | clinical and laboratory characteristics of neonatal candida sepsis |
| topic | candida sepsis neonates clinical and laboratory characteristics |
| url | http://www.sanamed.rs/OJS/index.php/Sanamed/article/view/364/183 |
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