Neonatal candidemia: Clinical importance of species identification

Abstract

Context: This study was undertaken considering the recent increase in infections caused by non-albicans Candida (NAC) species around the world. Candidemia is a major cause of nosocomial morbidity and mortality in neonates. Although Candida albicans remains the most common fungal isolate from blood, longitudinal studies have detected a trend toward an increased prevalence of NAC species. There are multiple risk factors like neonatal birth weights less than 1250 g, indwelling intravascular catheters and admission in the ICU that are responsible for the emergence of neonatal candidemia in recent years. Aims: To study the changing pattern and importance of species identification of Candida. Settings and Design: This is a three-year retrospective study. Materials and Methods: The neonates born or admitted during Jan. 2010-Dec. 2012 were included in the study. A total of 69 neonates with candidemia as evidenced by positive blood cultures were considered. All blood samples were collected aseptically and were processed by standard procedures. Statistical analysis used: No. Results: During the study period, a total of 922 samples were collected. Out of the 922 samples, 69 were found to be positive for candidemia. Out of the 69, 10 [14.4%] were identified as Candida albicans while the remaining 59 [85.5%] were identified as NAC species. Among the NAC species, 29/59 (49.1%) were Candida tropicalis, 26/59 (44.06%) were Candida krusei while 04/59 (6.7% were Candida glabrata). Conclusions: Candidemia due to NAC species increased morbidity, mortality and complications. In our study, we found the changing pattern of Candida species and importance of species identification in cases of neonatal candidemia. Species identification is important because NACs are resistant to azole drugs.