Non-albicans Candida in Neonatal Septicemia - An emerging clinical entity

Abstract

Background:- Over the past two decades the frequency of invasive mycosis in neonates has increased significantly. Candida species account for a significant percentage of all neonatal bloodstream infections and recently non-albicans Candida (NAC) have emerged as important opportunistic pathogens, notably Candida tropicalis , C. parapsilosis, C. krusei, and C. glabrata. Aims: This study was undertaken to know the distribution and antifungal susceptibility pattern of Candida species in neonatal septicemia cases. Materials and Methods: In a prospective analysis blood samples from 350 clinically suspected cases of neonatal septicaemia were collected aseptically. Only those which yielded pure growth of Candida spp. were included in the study. Identification of Candida species as well as antifungal sensitivity testing was performed with Vitek2 Compact (Biomerieux France) using vitek 2 cards for identification of yeast and yeast like organisms (ID-YST cards). Results: Isolation rate of Candida from neonatal septicemia cases was 10%. Most common isolate was C . tropicalis (57.14%), followed by C . albicans (17.1%), C . krusei (17.1%), and C . guillermondii (5.7% ) . Low birth weight and previous antibiotic prophylaxis were the main risk factors found in 100% cases. 62.85% candida isolates were sensitive to fluconazole whereas sensitivity to amphotericin B was 94.28% Conclusion: Non albicans Candida has emerged as an important cause of neonatal septicemia. Therefore speciation & antifungal susceptibility is a must in management of neonatal candidemia cases.