[Bloodstream infections with Candida glabrata in a neonatal intensive care unit that uses prophylaxis with fluconazole].

Autor: Lona-Reyes JC; División de Pediatría, Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Guadalajara, Jalisco, México; Centro Universitario de Tonalá, Universidad de Guadalajara, Tonalá, Jalisco, México. Electronic address: carloslona5@hotmail.com., Gómez-Ruiz LM; División de Pediatría, Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Guadalajara, Jalisco, México., Cordero-Zamora A; División de Pediatría, Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Guadalajara, Jalisco, México; Centro Universitario de Tonalá, Universidad de Guadalajara, Tonalá, Jalisco, México., Chávez-Rodríguez M; División de Pediatría, Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Guadalajara, Jalisco, México., Gallegos-Marín JA; División de Pediatría, Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Guadalajara, Jalisco, México., Jiménez-Hernández DS; División de Pediatría, Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Guadalajara, Jalisco, México; Centro Universitario de los Altos, Universidad de Guadalajara, Tepatitlán de Morelos, Jalisco, México.
Jazyk: Spanish; Castilian
Zdroj: Revista iberoamericana de micologia [Rev Iberoam Micol] 2020 Jul - Oct; Vol. 37 (3-4), pp. 100-103. Date of Electronic Publication: 2020 Nov 20.
DOI: 10.1016/j.riam.2020.06.002
Abstrakt: Background: Candida glabrata is an emerging pathogen with the ability to develop tolerance and resistance to azole antifungals, which creates uncertainty about the usefulness of antifungal prophylaxis in newborns.
Aims: The aim of this study was to describe the factors associated with C. glabrata infection in a NICU that uses prophylaxis with fluconazole.
Methods: A case-control study paired by gestational age was designed and conducted at the Civil Hospital of Guadalajara Dr. Juan I. Menchaca. Newborns with C. glabrata infection were studied and for each one a matched control was selected by gestational age. Odds ratios (OR) were estimated with 95% confidence intervals (95% CI) and McNemar test for contrast of hypothesis was applied.
Results: Twenty-one infected patients were identified, from whom 66.7% were male; the median gestational age was 31.5 weeks. Increased risk of infection with C. glabrata was observed when there was a prescription of more than one antimicrobial scheme (OR 21, 95% CI, 1.23 - 358.3; p=0.006) and also among patients with surgical comorbidities (OR 8, 95% CI 1.01 - 63.9; p=0.04). During the study period, exposure to fluconazole showed no difference in the risk of infection.
Conclusions: Neonates with more than one antimicrobial regimen and those with surgical comorbidities had a higher risk of C. glabrata infection.
(Copyright © 2020 Asociación Española de Micología. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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