Neonatal Systemic Candidiasis: Comparison of Albicans and Parapsilosis Infection

ABSTRACT

PURPOSE: Systemic Candidiasis has become an increasingly important cause of morbidity and mortality in NICU infants. Severe infections caused by non-albicans Candida species have been increasingly reported in NICU infants. The purpose of the present study was to compare relative severity, mortality rates for C albians(CA) and C parapsilosis(CP) infections in our NICU. METHODS: This study included 16 infants with systemic candidiasis who were admitted to the Neonatal Intensive Care Unit of Samsung Medical Center from Oct. 1, 1994 to Aug. 31, 1998. Systemic candidiasis was defined as candida recovery from blood with clinical symptoms and signs of infection. Systemic candidiasis was diagnosed in 16 infants, 11 with CA and 5 with CP. Retrospective analysis of the medical records of patients with systemic candidiasis was performed. The analysis included demographic findings, clinical feature, hospital course, morbidity and mortality. RESULTS: No differences were found between CA and CP for birth weight, sex, gestational age, age or weight at onset, presence of necrotizing enterocolitis, severe ROP, prior duration of antibiotics, endotracheal intubation, parenteral nutrition, steroids, or central line. Infants with CA were more likely to have antecedent thrush and perineal Candida derrnatitis(P<0.05). Infants with CP were more likely to have catheter-related infection(P<0.05) and treated with more curnulative dose of Amphotericin B and for a longer duration than those with CA(P<0.05). CONCLUSION: Though both pathogens occur in similar NICU infants and can cause severe disease, CA appears more likely to result in complications than CP.