[Neonatal systemic candidiasis in the nineties].
| Autor: | Romero Reyes MC; Unidad de Neonatología, Hospital Universitario Reina Sofia, Córdoba., Fernández Gutiérrez F, Poyato Domínguez JL, Párraga Quiles MJ, Huertas Muñoz MD, Guzmán Cabañas J, Zapatero Martínez M |
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| Jazyk: | Spanish; Castilian |
| Zdroj: | Anales espanoles de pediatria [An Esp Pediatr] 1996 Mar; Vol. 44 (3), pp. 257-61. |
| Abstrakt: | Objective: Retrospective study of newborns with systemic candidiasis during the period January 1990-March 1994 admitted to the Neonatology Unit at tertiary hospital. We analyzed the predisposing factors, clinical course, diagnosis, treatment and outcome. Material and Methods: Fourteen newborns were diagnosed of systemic candidiasis on the basis of positive blood culture associated with compatible clinical condition and/or involvement of any organ. All the patients had as predisposing factors the use of broad spectrum antibiotics, prolonged intravascular catheterization and parenteral nutrition, and 12 newborn infants had mechanical ventilation. Results: Twelve newborns were preterm infants, 10 of them weighing less than 1.500 g and 2 were term infants who required abdominal surgery due to ileal atresia and omphalocele. The mean age at onset of systemic candidiasis was 40 days. Clinical presentation was indistinguishable from that of bacterial sepsis. C. albicans was isolated from the blood of 12 infants, from the urine of 6 infants and from the cerebrospinal fluid of two infants. Six infants were treated with intravenous amphotericin, one infant was treated with intravenous amphotericin B associated with oral flucytosine and two infants were treated with liposomal amphotericin. Six of the infants died one of them while still receiving antifungal therapy. Conclusion: Systemic candidiasis should be considered in any septic infant mainly preterm infant less than 1.500 g with predisposing risk factors. We truly believe that a high index of suspicion, rapid diagnosis, early initiation of systemic fungal therapy, and removal of indwelling catheters may markedly reduce the mortality and improve the prognosis associated with neonatal systemic candidiasis. |
| Databáze: | MEDLINE |
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