The burden of Candida species colonization in NICU patients: a colonization surveillance study

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Abstract

Fungal infections are an important cause of morbidity and mortality in neonatal intensive care units (NICUs). Te identification of specific risk factors supports prevention of candidemia in neonates. Effective prophylactic strategies have recently become available, but the identification and adequate management of high-risk infants is still a priority. Prior colonization is a key risk factor for candidemia. For this reason, surveillance studies to monitor incidence, species distribution, and antifungal susceptibility profiles, are mandatory. Among 520 infants admitted to our NICU between January 2013 and December 2014, 472 (90.77%) were included in thestudy. Forty-eight out of 472 (10.17%) patients tested positive for Candida spp. (C.), at least on one occasion. All the colonizedpatients tested positive for the rectal swab, whereas 7 patients also tested positive for the nasal swab. Fifteen out of 472 patients(3.18%) had more than one positive rectal or nasal swab during their NICU stay. Moreover, 9 out of 15 patients tested negativeat the first sampling, suggesting they acquired Candida spp. during their stay. Twenty-five of forty-eight (52.1%) colonizedpatients carried C.albicans and 15/48 (31.25%) C.parapsilosis. We identified as risk factors for Candida spp. colonization:antibiotic therapy, parenteral nutrition, the use of a central venous catheter, and nasogastric tube. Our experience suggeststhat efective microbiological surveillance can allow for implementing proper, effective and timely control measures in a high risksetting.
Original languageEnglish
Pages (from-to)71-75
Number of pages5
JournalSigna Vitae
Volume13
Publication statusPublished - 2017

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Neonatal Intensive Care Units
Candida
Candidemia
Nose
Central Venous Catheters
Mycoses
Parenteral Nutrition
Risk Management
Newborn Infant
Anti-Bacterial Agents
Morbidity
Mortality
Incidence
Therapeutics

All Science Journal Classification (ASJC) codes

  • Emergency Medicine
  • Critical Care and Intensive Care Medicine

Cite this

@article{a1afc97a2db744e184ab53005b9d4a29,
title = "The burden of Candida species colonization in NICU patients: a colonization surveillance study",
abstract = "Fungal infections are an important cause of morbidity and mortality in neonatal intensive care units (NICUs). Te identification of specific risk factors supports prevention of candidemia in neonates. Effective prophylactic strategies have recently become available, but the identification and adequate management of high-risk infants is still a priority. Prior colonization is a key risk factor for candidemia. For this reason, surveillance studies to monitor incidence, species distribution, and antifungal susceptibility profiles, are mandatory. Among 520 infants admitted to our NICU between January 2013 and December 2014, 472 (90.77{\%}) were included in thestudy. Forty-eight out of 472 (10.17{\%}) patients tested positive for Candida spp. (C.), at least on one occasion. All the colonizedpatients tested positive for the rectal swab, whereas 7 patients also tested positive for the nasal swab. Fifteen out of 472 patients(3.18{\%}) had more than one positive rectal or nasal swab during their NICU stay. Moreover, 9 out of 15 patients tested negativeat the first sampling, suggesting they acquired Candida spp. during their stay. Twenty-five of forty-eight (52.1{\%}) colonizedpatients carried C.albicans and 15/48 (31.25{\%}) C.parapsilosis. We identified as risk factors for Candida spp. colonization:antibiotic therapy, parenteral nutrition, the use of a central venous catheter, and nasogastric tube. Our experience suggeststhat efective microbiological surveillance can allow for implementing proper, effective and timely control measures in a high risksetting.",
keywords = "Candida, NICU, surveillance",
author = "Maida, {Carmelo Massimo} and Mario Giuffre and Davide Vecchio and Geraci, {Daniela Maria} and Laura Saporito and Caterina Mammina and Giorgio Graziano and Vincenzo Insinga",
year = "2017",
language = "English",
volume = "13",
pages = "71--75",
journal = "Signa Vitae",
issn = "1334-5605",
publisher = "Pharmamed Mado Ltd.",

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TY - JOUR

T1 - The burden of Candida species colonization in NICU patients: a colonization surveillance study

AU - Maida, Carmelo Massimo

AU - Giuffre, Mario

AU - Vecchio, Davide

AU - Geraci, Daniela Maria

AU - Saporito, Laura

AU - Mammina, Caterina

AU - Graziano, Giorgio

AU - Insinga, Vincenzo

PY - 2017

Y1 - 2017

N2 - Fungal infections are an important cause of morbidity and mortality in neonatal intensive care units (NICUs). Te identification of specific risk factors supports prevention of candidemia in neonates. Effective prophylactic strategies have recently become available, but the identification and adequate management of high-risk infants is still a priority. Prior colonization is a key risk factor for candidemia. For this reason, surveillance studies to monitor incidence, species distribution, and antifungal susceptibility profiles, are mandatory. Among 520 infants admitted to our NICU between January 2013 and December 2014, 472 (90.77%) were included in thestudy. Forty-eight out of 472 (10.17%) patients tested positive for Candida spp. (C.), at least on one occasion. All the colonizedpatients tested positive for the rectal swab, whereas 7 patients also tested positive for the nasal swab. Fifteen out of 472 patients(3.18%) had more than one positive rectal or nasal swab during their NICU stay. Moreover, 9 out of 15 patients tested negativeat the first sampling, suggesting they acquired Candida spp. during their stay. Twenty-five of forty-eight (52.1%) colonizedpatients carried C.albicans and 15/48 (31.25%) C.parapsilosis. We identified as risk factors for Candida spp. colonization:antibiotic therapy, parenteral nutrition, the use of a central venous catheter, and nasogastric tube. Our experience suggeststhat efective microbiological surveillance can allow for implementing proper, effective and timely control measures in a high risksetting.

AB - Fungal infections are an important cause of morbidity and mortality in neonatal intensive care units (NICUs). Te identification of specific risk factors supports prevention of candidemia in neonates. Effective prophylactic strategies have recently become available, but the identification and adequate management of high-risk infants is still a priority. Prior colonization is a key risk factor for candidemia. For this reason, surveillance studies to monitor incidence, species distribution, and antifungal susceptibility profiles, are mandatory. Among 520 infants admitted to our NICU between January 2013 and December 2014, 472 (90.77%) were included in thestudy. Forty-eight out of 472 (10.17%) patients tested positive for Candida spp. (C.), at least on one occasion. All the colonizedpatients tested positive for the rectal swab, whereas 7 patients also tested positive for the nasal swab. Fifteen out of 472 patients(3.18%) had more than one positive rectal or nasal swab during their NICU stay. Moreover, 9 out of 15 patients tested negativeat the first sampling, suggesting they acquired Candida spp. during their stay. Twenty-five of forty-eight (52.1%) colonizedpatients carried C.albicans and 15/48 (31.25%) C.parapsilosis. We identified as risk factors for Candida spp. colonization:antibiotic therapy, parenteral nutrition, the use of a central venous catheter, and nasogastric tube. Our experience suggeststhat efective microbiological surveillance can allow for implementing proper, effective and timely control measures in a high risksetting.

KW - Candida

KW - NICU

KW - surveillance

UR - http://hdl.handle.net/10447/271747

M3 - Article

VL - 13

SP - 71

EP - 75

JO - Signa Vitae

JF - Signa Vitae

SN - 1334-5605

ER -