Retrospective evaluation of neonatal candidemia cases monitored inneonatal intensive care unit and determination of risk factors

Retrospective Evaluation of Neonatal Candidemia Cases monitored in Neonatal Intensive Care Unit and Determination of Risk Factors Introduction: Fungal infections are a major cause of mortality and morbidity in infantswith severe prematurity and birth weight of <1500 grams. The improvements in the field ofneonatalogy have increased the life expectancy of the babies with serious prematurity andbirth weight of <1500 grams, has also increased the incidence of fungal infections. Thisstudy was done with the aim of retrospective evaluation of neonatal fungal sepsis cases anddetermining the risk factors. Material method: This study was carried out by retrospective examination of file data of a total number of 159 patients hospitalized in KTU Farabi Hospital Neonatal Intensive Care Unit between 2003 and 2016, 79 of whom had fungal sepsis (study group) and 80 withproven bacterial sepsis (control group). Results: Fungal sepsis is observed more frequently in infants with severe prematurity and birth weight of <1000 grams, SGA, low APGAR score, resuscitation, usage of respiratory stimulants, intravenous steroids, stomach protectors and broad-spectrum antibiotics, in infants who were given surfactan and applied invasive mechanical ventilation for a long time, late on start of enteral nutrition and long duration of total parenteral nutrition (TPN)(p<0.05). It was found that their clinical course of fungal sepsis was more insidious than bacterial sepsis, also severe thrombocytopenia and a higher incidence of normal white blood cell count are more common (p<0.05). C. guilliermondii (41.7%) and C.parapisilosis (24%) were the most common types of fungi isolated in the blood culture ofthe patients. Multiple regression analysis found that mechanical ventilation over five days(OR 3,062), carbapenem+vancomyxin use (OR 3,565) and stomach protector use (OR2,738) significantly increased the insidence of fungal infection. Mortality rate was 16.5% in patients with invasive candida infection. Recommendations: Preventing premature births, applying antenatal steroids to pregnant women with premature labor whom endicated, delivering risky pregnancies in centers where advanced resuscitation and intensive care can be performed, aiming to onstart and achieve to full dose of enteral nutrition as soon as possible, avoiding long-term wide-spectrum antibiotic use, avoiding long-term use of steroids and stomach protectors as much as possible may reduce the risk of fungal sepsis. Keywords: Neonatal candidemia, Candida, newborn