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Journal of Tropical Pediatrics 1998 44(2):104-108; doi:10.1093/tropej/44.2.104
© 1998 by Oxford University Press
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Epidemiology of Systemic Candidiasis in a Tertiary Care Neonatal Unit

Anil Narang, MD, Pankaj B. Agrawal, DM, A. Chakrabarti, MD and Praveen Kumar, DM

Division of Neonatology, Department of Pediatrics and Department of Medical Microbiology, Postgraduate Institute Medical Education and Research Chandigarh, India

Correspondence: Dr Anil Nararang, MD, Additional Professor, Dept of Pediatncs, PGIMER, Chandigarh, India. Tel. 0172 715678

143 neonates were diagnosed to have acquired systemic candidiasis out of a total 4530 admissions (3.2 per cent) to the neonatal intensive care unit (NICU) during a period of 61/2 years from January 1990 to June 1996. Mean age at onset was 10.4 days, mean birth weight 1454g, and mean gestation was 31.7 weeks. Ninety-four per cent were premature, 95 per cent low birth weight (LBW), and all had undergone peripheral vein catheterization and had received broad spectrum antibiotics, except one, prior to the diagnosis. Fifty-eight per cent were ventilated and 15 per cent received parenteral nutrition. Persistent/recurrent pneumonia, apnoea, lethargy, high gastric aspirates, and abdominal distension were the common clinical manifestations. Candida tropicalis, C. albicans, and C. guillermondii were the most common isolates. Blood and urine were the predominant sites for isolation of Candida. Fluconazole was the most used antifungal agent, with 24 per cent resistance against it. Fifty per cent of babies died due to all causes. Of all the deaths, two-thirds were Candida related. Candida-attributabie deaths occurred in 24 cases (17 per cent).


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