Patterns and Dynamics of Colonization with Candida spp. in the Neonatal Intensive Care Unit (NICU)

Ref ID: 18800

Author:

E. Leibovitz, MD – Professor, T. Taraboulos-Klein, MD – Physician, I. Livshiz-Riven, RN – Research nurse, A. Borer, MD – Physician, E. Shani, MD – Physician, A. Golan, MD – Physician;

Author address:

Ben-Gurion Univ., Beer-Sheva, Israel.

Full conference title:

52nd Annual ICAAC

Date: 9 September 2014

Abstract:

Background: Knowledge of fungal colonization (FC) patterns in very low birth weight infants (VLBWI, birth weight <1,500g) is essential to understand FC process and its pathogenesis, its relationship with invasive disease and in directing preventive/therapeutic interventions. We analyzed prospectively during an 18-month period (2009-2010), the FC patterns/dynamics in VLBWI, including colonization timing, fungal species and anatomic sites. Methods: Weekly surveillance skin (S), oropharynx (OP) and rectum (R) fungal Cx. were collected from admission till discharge in all VLBWI admitted. No patients received antifungal prophylaxis. Results: 118 VLBWI yielded 1723 samples; 34 (29%) patients had 111 positive samples (104 during 1st 10 weeks of F/U) at least once till discharge. 39/118 (33%) weighed <1,000 g; 68 were delivered by C/S. Ten (9 <1000 g) died. C. albicans (CA, 57/104 [55%] isolates; 64%, 48% and 54% of all isolates from S, OP and R, respectively) and C. parapsilosis (CP, 26/104 [25%]; 12%, 36% and 25%) were the main strains isolated. 8/118 (7%) VLBWI were colonized during 1st week of life; FC was recorded in 1st 14 days of life in 23/34 (68%) VLBWI. No differences in F/C were recorded between VLBWI born by C/S and those delivered vaginally. The risk for FC at least once during the 1st 10 weeks at NICU was 23%, 14%, 27% and 38% at S, OP, R or any anatomic site sampled, respectively. Persistent FC during hospitalization was recorded in 5/34 (15%) while transient FC (w/o recolonization) was found in 14/34 (41%) VLBWI; 16/34 (47%) were discharged/died colonized with Candida spp. Candidemia was diagnosed in 4 (3%) VLBWI; previous /simultaneous FC was recorded in 3/4. Conclusions: 1) The cumulative risk of FC, at any sampled site and at least once during F/U, was high; 2) Initial FC occurred most often during the 1st 2 weeks of life; 3) Overall distribution of F/C revealed CA dominance over CP; 4) F/C dynamics was characterized by various persistence, disappearance and recolonization patterns; 5) Candidemia was rare.

Abstract Number: M-339

Conference Year: 2012

Link to conference website: NULL

New link: NULL

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