Emergence of Non- Albicans Candida Species in Neonatal Candidemia in A Tertiary Care Hospital in Meerut City
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 4
Abstract
Background: Candidemia is a significant cause of nosocomial mortality and morbidity in neonates. The changing pattern in the isolation of Candida species from C. albicans to non-albicans Candida (NAC) species has resulted in the emergence of resistance to antifungal drugs. Aims & Objectives:i) To study the frequency of neonatal candidemia in our tertiary care hospital ii) To identify the Candida isolates upto species level. iii) To determine the risk factors and correlate the data clinically. Methods: Blood samples collected from clinically suspected cases of neonatal septicaemia were inoculated into automated BacT/Alert 3D system (bioMerieux). Any growth indicated was sub-cultured on 5% sheep blood agar and Sabouraud's dextrose agar (SDA) with chloramphenicol and incubated at 37°C for 24 hours. Candida species isolated was identified upto species level as per standard mycological techniques and by automated Vitek 2 YST identification card (bioMerieux). Result: The frequency of neonatal candidemia was 37.5% (117/312). Out of the total of 117 cases of neonatal candidemia,non –albicansCandida (NAC) species were isolated in 82.06% cases and in the remaining 17.94% cases C. albicans was isolated. The predominant isolate was C. tropicalis (43.58%), followed by C.albicans (17.94%), C. parapsilosis(17.09%), C. glabrata (8.54%) and C. krusei (5.12%).Candidemia was most commonly associated with prematurity (76.92%), followed by low birth weight (64.10%), prolonged antibiotic usage (48.71%), steroid therapy (13.67%) and ventilatory support (11.11%). The most common clinical presentation was feed intolerance, followed by abdominal distension, lethargy and failure to gain weight. Conclusions: Isolation of NAC species definitely indicates a changing trend and the emergence of antifungal drug resistance. Strict infection control strategies and a restrictive policy of antibiotic use should be implemented
Authors and Affiliations
Gautam Panwar, Vandana Sardana, Anita Pandey
Keywords
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