Epidemiological indicators and predictors of lethality associated with fungal infections in a NICU: a historical series.

Autor:	Menezes RP; Universidade Federal de Uberlândia, Curso Técnico em Análises Clínicas, Escola Técnica de Saúde, Uberlândia, MG, Brazil. Electronic address: ralciane@ufu.br., Ferreira ICDS; Universidade Federal de Uberlândia, Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Uberlândia, MG, Brazil., Lopes MSM; Universidade Federal de Uberlândia, Curso de Biomedicina, Instituto de Ciências Biomédicas, Uberlândia, MG, Brazil., de Jesus TA; Universidade Federal de Uberlândia, Curso de Biomedicina, Instituto de Ciências Biomédicas, Uberlândia, MG, Brazil., de Araújo LB; Universidade Federal de Uberlândia, Faculdade de Matemática, Uberlândia, MG, Brazil., Santos Pedroso RD; Universidade Federal de Uberlândia, Curso Técnico em Análises Clínicas, Escola Técnica de Saúde, Uberlândia, MG, Brazil., Röder DVDB; Universidade Federal de Uberlândia, Departamento de Microbiologia, Instituto de Ciências Biomédicas, Uberlândia, MG, Brazil.
Jazyk:	angličtina
Zdroj:	Jornal de pediatria [J Pediatr (Rio J)] 2024 May-Jun; Vol. 100 (3), pp. 267-276. Date of Electronic Publication: 2023 Dec 22.
DOI:	10.1016/j.jped.2023.11.005
Abstrakt:	Objectives: Fungal infections (FI) pose a public health concern and significantly increase mortality rates, especially within Neonatal Intensive Care Units (NICU). Thus, this study aimed to investigate epidemiological indicators, risk factors, and lethality predictors associated with FI in a NICU. Methods: This study included 1,510 neonates admitted to the NICU of a reference hospital in Brazil between 2015 and 2022. Demographic data, such as sex, birth weight, gestational age, and use of invasive devices were analyzed. Results: Thirty neonates developed invasive FI, totaling 33 episodes and an incidence of 1.2 per 1,000 patient days. Candida albicans was the most frequent species (52.9 %), the bloodstream was the most affected site (78.9 %), and 72.7 % of infections occurred between 2015 and 2018. The lethality rate associated with FI was 33.3 %, and 90 % of deaths occurred within 30 days of diagnosis of infection. Weight < 750 g, prolonged hospital stay, use of parenteral nutrition, and broad-spectrum antimicrobials were independent risk factors for infection occurrence, especially glycopeptides and 4 th generation cephalosporins, having a considerable role in the increase in fungal infections. Weight < 750 g was considered a significant predictor of lethality, and C. albicans had the highest lethality rate (40 %). Conclusion: These findings highlight the elevated lethality rate associated with these infections, reinforcing the importance of developing strategies to control FI within NICU. Competing Interests: Conflicts of interest The authors declare no conflicts of interest. (Copyright © 2023. Published by Elsevier Editora Ltda.)
Databáze:	MEDLINE
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