Candidemia in neonatal ICUs Barcelona Spain

 

Candidemia in neonatal intensive care units: Barcelona, Spain.

Rodriguez D¹, Almirante B, Park BJ, Cuenca-Estrella M, Planes AM, Sanchez F, Gene A, Xercavins M, Fontanals D, Rodriguez-Tudela JL, Warnock DW, Pahissa A; Barcelona Candidemia Project Study Group.

Author information

• ¹Infectious Diseases Department, Medicine Department, Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain. dolorodriguez@vhebron.net

Abstract

BACKGROUND:

Candida spp. are increasingly important hospital-acquired pathogens in neonatal intensive care units (NICU) and cause considerable mortality in preterm infants. Most studies have been limited to a single institution. The aim of this study was to determine the epidemiology of candidemia in all Barcelona NICUs.

METHODS:

We conducted prospective population-based surveillance for candidemia in Barcelona, Spain, during 2002-2003. This report focuses on the results from 5 participating hospitals with NICUs.

RESULTS:

We detected 24 cases, resulting in an annual incidence of 32.6 cases per 100,000 live births and 1.1 cases per 100 NICU discharges. Median gestational age was 27.5 weeks (range, 24-40.5), and there were 21 cases among very low birth weight infants. Among the 20 (83%) cases evaluated for the presence of end organ infection, endophthalmitis occurred in 2 cases, and endocarditis, meningitis and peritonitis occurred in 1 case each. Candida parapsilosis was the most frequent species isolated (67%). All isolates were fluconazole-susceptible. Crude mortality was 21%.

CONCLUSIONS:

The preponderance of C. parapsilosis candidemias observed in Barcelona NICUs is similar to reports from the literature. Morbidity and mortality associated with neonatal candidemia remain high