Epidemiology and clinical presentation of neonatal fungal sepsis in intensive care units of Pediatric clinic Tuzla
DOI:
https://doi.org/10.5457/ams.v49i2.516Keywords:
fungal sepsis, neonates, epidemiology, clinical presentation, risk factorsAbstract
Introduction: Standing advances in neonatology increased survival of premature infants with the use of invasive procedures, which increases risk of infection and fungal sepsis. Risk factors for fungal sepsis are extensively studied. Candida is dominant, but there is increase in resistant C. non-albicans species. Mortality is high and requires timely suspicion of fungal sepsis, and adequate treatment to counteract the fatal outcome.
Objectives: To analyze the clinical and laboratory characteristics of neonates, treated in the neonatal intensive care unit because of microbiologically proven fungal sepsis.
Subjects and Methods:The restrospective observational study included 48 consecutive neonates, treated in Iintensive care unit of Pediatric Clinic Tuzla during three-year period (2016-2018), those with proven fungal sepsis, confirmed by positive blood culture. We analyzed perinatal history, clinical and laboratory presentation of disease, length of treatment and outcome. Statistical analysis applied standard methods, and the research was approved by the Ethics Committee of the institution.
Results: Of the total treated 921 neonates, confirmed fungal sepsis were found in 48 infants (5.2%), evenly distributed by gender. Of perinatal risk factors, confirmed the prematurity and low birth weight, and significant were the presence of umbilical venous catheter, parenteral nutrition, longer antibiotic therapy and mechanical ventilation. Clinically, fungal sepsis manifested as late sepsis with respiratory higher requirements, lethargy, feeding difficulties and abdominal distension. The most common laboratory abnormalities were increased CRP, leukocytosis and thrombocytopenia. Outcome: 44 neonates (91.7%) survived, while 4 neonates (8.3%) died. Antifungal therapy lasted 20.6 ± 6 days, and intensive treatment 38.2 ± 23.2 days. All isolates were Candida species, in vitro without resistance. In 8 neonates (16.7%) recorded a slight toxic hepatitis.
Conclusion: Recovery of neonates with fungal sepsis depend on timely clinical suspicion, adequate treatment and monitoring. Antifungal susceptibility is also important, which requires monitoring of local epidemiological data to improve treatment.
Â
Downloads
Published
Issue
Section
License
Copyright transfer
The listed authors warrant that they are the authors and sole owners of the submitted manuscript. The authors also warrant that the work is original; that it has not been previously published in print or electronic format and is not under consideration by another publisher or electronic medium; that it has not been previously transferred, assigned, or otherwise encumbered; and that the authors have full power to grant such rights. With respect to the results of this work, the manuscript of this or substantially similar content will not be submitted to any other journal until the review process in the Acta Medica Salinianana has been officially completed (acceptance or rejection of the manuscript). The paper will not be withdrawn from the review process by the Acta Medica Saliniana Editorial Board until the review process is completed. The authors will comply with the requests of the Acta Medica Saliniana Editors and reviewers to improve the paper for publication. The eventual disagreements will be submitted in a written form; the authors are aware that the disagreement(s) with the Acta Medica Saliniana requests may result in the rejection of the manuscript. The authors hereby grant to the Acta Medica Saliniana the right to edit, revise, abridge, and condense the manuscript. If the manuscript is accepted for publication in the Acta Medica Saliniana, the authors hereby transfer the copyright of the paper to the Acta Medica Saliniana. The authors permit the Acta Medica Saliniana to allow third parties to copy any part of the journal without asking for permission, provided that the reference to the source is given. For papers with more than one author: All other co-authors agree to allow the corresponding author to make decisions regarding prepublication release of the information in the paper to the media, federal agencies, or both.
