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Retrospective Evaluation of The Cases with Newborn Candida Sepsis

Year 2020, Volume: 4 Issue: 3, 72 - 76, 12.12.2020
https://doi.org/10.46332/aemj.748413

Abstract

Purpose: We aimed to evaluate demographic characteristics, risk factors, mortality rates and laboratory findings of the infants who were followed up due to the candida sepsis in the neonatal intensive care unit.

Materials and Methods: This retrospective study was carried out in the neonatal intensive care unit of a university hospital between January 2015 and June 2019. Blood samples were taken from 4385 infants with sepsis. Only the first attack of the patients who underwent multiple sepsis attacks was included in the study.

Results: During the study period, the breeding of Candida spp. was seen in 33 (0,75%) of 4385 blood cultures which were suspected of the sepsis. 33 babies were included in the study. 72.7% of the cases were premature and 57.6% were ≤2500 gram. It was found that the mortality developed in the 39.4% of the cases and there was an additional pathology in 87.9% of them. Patients with candida sepsis showed a statistically significant elevation in C-reactive protein and neutrophil levels while platelet count was significantly lower.
No statistically significant difference was found for the lymphocyte and white blood cell counts.

Conclusion Candida sepsis should be considered in patients with comorbid conditions, low gestational age, use of peripheral and central catheters, and total parenteral nutrition. High C-reactive protein and neutrophil levels and low platelet counts may indicate candida sepsis in the setting of the above-mentioned conditions.

References

  • 1. Waliullah MS, Islam MN, Siddika M, Hossain MK, Hossain MA. Risk factors, clinical manifestation and bacteriological profile of neonatalsepsis in a tertiary level pediatric hospital. Mymensingh Med J. 2009;18(1):66-72.
  • 2. Iregbu KC, Elegba OY, Babaniyi IB. Bacteriological profile of neonatal septicaemia in a tertiary hospital in Nigeria. Afr Health Sci. 2006;6(3):151-154.
  • 3. Shitaye D, Asrat D, Woldeamanuel Y, Worku B. Risk factorsandetiology of neonatalsepsis in Tikur Anbessa University Hospital, Ethiopia. Ethiop Med J. 2010;48(1): 11-21.
  • 4. Kelly MS, Benjamin DK, Smith PB. The epidemiology and diagnosis of invasive candidiasis among prematüre infants. Clin Perinatol. 2015;42(1):105-117.
  • 5. Uslu S, Bolat F, Can E, Comert S, Nuhoğlu A. Yenidoğan yoğun bakım ünitelerinde hastane enfeksiyonlarını önleme çalışmaları. Med J Bakirkoy. 2010;6(1):1-7.
  • 6. Garzillo C, Bagattini M, Bogdanović L, Di Popolo A, Iula VD, Catania MR. Risk factors for Candida parapsilosis bloodstream infection in a neonatal intensive care unit: a case-control study. Ital J Pediatr. 2017;19(43):1
  • 7. Lupetti A, Tavanti A, Davini P, Ghelardi E, Corsini V, Merusi I. Horizontal transmission of Candida parapsilosis candidemia in a neonatal intensive care unit. J. Clin. Microbiol. 2002;40(7):2363-2369.
  • 8. Benjamin DK, Ross K, McKinney RE, Auten R, Fisher RG. When to suspect fungal infection in neonates: a clinical comparison of Candida albicans and Candida parapsilosis fungemia with coagulase-negative staphylococcal bacteremia. Pediatrics. 2000;106(4):712-718.
  • 9. V. Krcmery, M. Huttova, F. Mateicka, et al. Breakthrough fungaemia in neonates and infants caused by Candida albicans and Candida parapsilosis susceptible to fluconazole in vitro. J Antimicrob Chemother. 2001;48(4):521-525.
  • 10. B. Almirante, D. Rodriguez, M. Cuenca Estrella, et al. Epidemiology and predictors of mortality in cases of Candida bloodstream infection: results from population-based surveillance, Barcelona, Spain, from 2002 to 2003. J Clin Microbiol. 2005; 43(4):1829-1835.
  • 11. Zaoutis T. Candidemia in children. Curr Med Res Opin. 2010;26(7):1761-1768.
  • 12. Steinbach WJ, Roilides E, Berman D, Hoffman J.A, Groll AH, Bin-Hussain İ. Results from a prospective, international, epidemiologic study of invasive candidiasis in children and neonates. Pediatr Infect Dis J. 2012;31(12):1252-1257.
  • 13. Brissaud O, Guichoux J, Harambat J, Tandonnet O, Zaoutis T. Invasive fungal disease in PICU: epidemiology and risk factors. Ann Intensive Care. 2012;2(1):1-8.
  • 14. Hofer N, Zacharias E, Müller W, Resch B. An update on the use of C-reactive protein in early-onset neonatal sepsis: current insights and new tasks. Neonatology. 2012;102(1):25-36.
  • 15. Pappas PG, Kauffman CA, Andes D, et al. Infectious Diseases Society of America. Clinical practice guidelines forthe management of candidiasis: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis. 2009;48(5):503-535.
  • 16. Weinstein MP, Patel JB, Bobenchik AM, et al. Performance Standards for Antimicrobial Susceptibility Testing. 29. Ed. Wayne, PA: Clinical and Laboratory Standards Institute;2019:32
  • 17. Bhat S, Naik S, Rafiq W, Tariq A. Incidence of thrombocytopenia and changes in various platelet parameters, in blood culture positive neonatal sepsis. Int J Pediatr. 2015;3(4.1):757-766.
  • 18. MY Lai, MH Tsai, CW Lee, et al. Characteristics of neonates with culture-proven bloodstream infection who have low levels of C-reactive protein (≦ 10 mg/L). BMC Infect. Dis. 2015;15(320):1-10.
  • 19. Nosocomial Infections Study Group. Nosocomial infections in neonatal units in Turkey: epidemiology, problems, unit policies and opinions of healthcare workers. Turk J Pediatr. 2010;52(1): 50-57.
  • 20. Gümüş H, Kazanasmaz H. Kültür Kanıtlı Geç Neonatal Sepsis Olgularında Sıklık, İzole Edilen Mikroorganizmalar ve Antibiyotik Direncinin Araştırılması. KSÜ Tıp Fak Der. 2018;13(3):88-91.
  • 21. Gülmez D, Gür D. Hacettepe Üniversitesi İhsan Doğramacı Çocuk Hastanesi’nde 2000 - 2011 yılları arasında kan kültürlerinden izole edilen mikroorganizmalar: 12 yıllık değerlendirme. J Pediatr Inf. 2012;6(13):679-683.
  • 22. Çopur Çiçek A, Şentürk Köksal Z, Ertürk A, Köksal E. Rize 82. Yıl Devlet Hastanesi’nde bir yıllık sürede kan kültürlerinden izole edilen mikroorganizmalar ve antibiyotiklere duyarlılıkları. Turk Hij Den Biyol Derg. 2011;68(4):175-184.
  • 23. Akova F, İlçe Z, Köksal F, Celayir S. The evaluation of septicemia in the surgical newborn intensive care unit. Cerrahpaşa Med J. 2001;32(4):214-220.
  • 24. Makhoul IR, Kassis I, Smolkin T, Tamir A, Sujov P. Review of 49 neonates with acquired fungal sepsis: Further characterization. Pediatrics. 2001;107(1):61-66.
  • 25. Acar A, Öncül O, Küçükardalı Y, Ozyurt M, Haznedaroğlu T, Cavuşlu S. Epidemiological features of Candida infections detected in intensive care units and risk factors affecting mortality. Mikrobiyol Bul. 2008;42(3):451-461.
  • 26. Taşbakan SM, Çeviker Y, Metin D, et al Candida pneumonia cases. 11. Annual TTS Congress, 2009, Antalya.

Yenidoğan Kandida Sepsisli Olguların Retrospektif Değerlendirilmesi

Year 2020, Volume: 4 Issue: 3, 72 - 76, 12.12.2020
https://doi.org/10.46332/aemj.748413

Abstract

Amaç: Yenidoğan yoğun bakım kliniğimizde kandida sepsisi nedeniyle takip ve tedavi edilen bebeklerin demografik özelliklerini, risk faktörlerini, mortalite oranlarını ve laboratuvar bulgularını retrospektif olarak değerlendirmeyi amaçladık.

Araçlar ve Yöntem: Bu çalışma retrospektif olarak, 2015 Ocak-2019 Haziran yılları arasında, 3. Basamak bir üniversite hastanesi yenidoğan yoğun bakım kliniğinde gerçekleştirildi. Sepsis düşünülen 4385 bebekten kan kültürü alındı. Birden fazla sayıda sepsis atağı geçiren hastaların ilk atağı çalışmaya dahil edildi.

Bulgular: Çalışma döneminde sepsis şüphesiyle bakılan 4385 kan kültürünün 33’ünde (%0,75) Candida spp. üremesi görüldü. Sepsis tanısı alarak tedavi gören 33 bebek çalışmaya dahil edildi. Olguların %72,7’si prematür ve %57,6’sı ≤2500 gr idi. Olguların % 39,4’ünde mortalite geliştiği ve %87,9’unda ek patoloji olduğu tespit edildi. Kandida sepsisli olguların C-reaktif protein ve nötrofil, değerlerinde istatiksel olarak anlamlı yükseklik ve trombosit değerlerinde ise istatiksel olarak anlamlı düşüklük tespit edildi. Lenfosit ve beyaz küre değerlerinde ise istatiksel olarak anlamlı farklılık bulunmadı.

Sonuç: Düşük doğum haftası, periferik ve santral kateter kullanımı, total parenteral nutrisyon ve ek patolojileri olan hastalarda CRP ve nötrofil değerlerinde anlamlı yükseklik, trombosit değerlerinde ise anlamlı düşüklük olan hastalarda Kandida sepsisi ön tanılar arasında düşünülmelidir

References

  • 1. Waliullah MS, Islam MN, Siddika M, Hossain MK, Hossain MA. Risk factors, clinical manifestation and bacteriological profile of neonatalsepsis in a tertiary level pediatric hospital. Mymensingh Med J. 2009;18(1):66-72.
  • 2. Iregbu KC, Elegba OY, Babaniyi IB. Bacteriological profile of neonatal septicaemia in a tertiary hospital in Nigeria. Afr Health Sci. 2006;6(3):151-154.
  • 3. Shitaye D, Asrat D, Woldeamanuel Y, Worku B. Risk factorsandetiology of neonatalsepsis in Tikur Anbessa University Hospital, Ethiopia. Ethiop Med J. 2010;48(1): 11-21.
  • 4. Kelly MS, Benjamin DK, Smith PB. The epidemiology and diagnosis of invasive candidiasis among prematüre infants. Clin Perinatol. 2015;42(1):105-117.
  • 5. Uslu S, Bolat F, Can E, Comert S, Nuhoğlu A. Yenidoğan yoğun bakım ünitelerinde hastane enfeksiyonlarını önleme çalışmaları. Med J Bakirkoy. 2010;6(1):1-7.
  • 6. Garzillo C, Bagattini M, Bogdanović L, Di Popolo A, Iula VD, Catania MR. Risk factors for Candida parapsilosis bloodstream infection in a neonatal intensive care unit: a case-control study. Ital J Pediatr. 2017;19(43):1
  • 7. Lupetti A, Tavanti A, Davini P, Ghelardi E, Corsini V, Merusi I. Horizontal transmission of Candida parapsilosis candidemia in a neonatal intensive care unit. J. Clin. Microbiol. 2002;40(7):2363-2369.
  • 8. Benjamin DK, Ross K, McKinney RE, Auten R, Fisher RG. When to suspect fungal infection in neonates: a clinical comparison of Candida albicans and Candida parapsilosis fungemia with coagulase-negative staphylococcal bacteremia. Pediatrics. 2000;106(4):712-718.
  • 9. V. Krcmery, M. Huttova, F. Mateicka, et al. Breakthrough fungaemia in neonates and infants caused by Candida albicans and Candida parapsilosis susceptible to fluconazole in vitro. J Antimicrob Chemother. 2001;48(4):521-525.
  • 10. B. Almirante, D. Rodriguez, M. Cuenca Estrella, et al. Epidemiology and predictors of mortality in cases of Candida bloodstream infection: results from population-based surveillance, Barcelona, Spain, from 2002 to 2003. J Clin Microbiol. 2005; 43(4):1829-1835.
  • 11. Zaoutis T. Candidemia in children. Curr Med Res Opin. 2010;26(7):1761-1768.
  • 12. Steinbach WJ, Roilides E, Berman D, Hoffman J.A, Groll AH, Bin-Hussain İ. Results from a prospective, international, epidemiologic study of invasive candidiasis in children and neonates. Pediatr Infect Dis J. 2012;31(12):1252-1257.
  • 13. Brissaud O, Guichoux J, Harambat J, Tandonnet O, Zaoutis T. Invasive fungal disease in PICU: epidemiology and risk factors. Ann Intensive Care. 2012;2(1):1-8.
  • 14. Hofer N, Zacharias E, Müller W, Resch B. An update on the use of C-reactive protein in early-onset neonatal sepsis: current insights and new tasks. Neonatology. 2012;102(1):25-36.
  • 15. Pappas PG, Kauffman CA, Andes D, et al. Infectious Diseases Society of America. Clinical practice guidelines forthe management of candidiasis: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis. 2009;48(5):503-535.
  • 16. Weinstein MP, Patel JB, Bobenchik AM, et al. Performance Standards for Antimicrobial Susceptibility Testing. 29. Ed. Wayne, PA: Clinical and Laboratory Standards Institute;2019:32
  • 17. Bhat S, Naik S, Rafiq W, Tariq A. Incidence of thrombocytopenia and changes in various platelet parameters, in blood culture positive neonatal sepsis. Int J Pediatr. 2015;3(4.1):757-766.
  • 18. MY Lai, MH Tsai, CW Lee, et al. Characteristics of neonates with culture-proven bloodstream infection who have low levels of C-reactive protein (≦ 10 mg/L). BMC Infect. Dis. 2015;15(320):1-10.
  • 19. Nosocomial Infections Study Group. Nosocomial infections in neonatal units in Turkey: epidemiology, problems, unit policies and opinions of healthcare workers. Turk J Pediatr. 2010;52(1): 50-57.
  • 20. Gümüş H, Kazanasmaz H. Kültür Kanıtlı Geç Neonatal Sepsis Olgularında Sıklık, İzole Edilen Mikroorganizmalar ve Antibiyotik Direncinin Araştırılması. KSÜ Tıp Fak Der. 2018;13(3):88-91.
  • 21. Gülmez D, Gür D. Hacettepe Üniversitesi İhsan Doğramacı Çocuk Hastanesi’nde 2000 - 2011 yılları arasında kan kültürlerinden izole edilen mikroorganizmalar: 12 yıllık değerlendirme. J Pediatr Inf. 2012;6(13):679-683.
  • 22. Çopur Çiçek A, Şentürk Köksal Z, Ertürk A, Köksal E. Rize 82. Yıl Devlet Hastanesi’nde bir yıllık sürede kan kültürlerinden izole edilen mikroorganizmalar ve antibiyotiklere duyarlılıkları. Turk Hij Den Biyol Derg. 2011;68(4):175-184.
  • 23. Akova F, İlçe Z, Köksal F, Celayir S. The evaluation of septicemia in the surgical newborn intensive care unit. Cerrahpaşa Med J. 2001;32(4):214-220.
  • 24. Makhoul IR, Kassis I, Smolkin T, Tamir A, Sujov P. Review of 49 neonates with acquired fungal sepsis: Further characterization. Pediatrics. 2001;107(1):61-66.
  • 25. Acar A, Öncül O, Küçükardalı Y, Ozyurt M, Haznedaroğlu T, Cavuşlu S. Epidemiological features of Candida infections detected in intensive care units and risk factors affecting mortality. Mikrobiyol Bul. 2008;42(3):451-461.
  • 26. Taşbakan SM, Çeviker Y, Metin D, et al Candida pneumonia cases. 11. Annual TTS Congress, 2009, Antalya.
There are 26 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Original Articles
Authors

Mehmet Reşat Ceylan 0000-0001-8063-4836

Hüseyin Gümüş 0000-0002-9326-2194

Abdullah Solmaz 0000-0002-9479-8679

Publication Date December 12, 2020
Published in Issue Year 2020 Volume: 4 Issue: 3

Cite

APA Ceylan, M. R., Gümüş, H., & Solmaz, A. (2020). Yenidoğan Kandida Sepsisli Olguların Retrospektif Değerlendirilmesi. Ahi Evran Medical Journal, 4(3), 72-76. https://doi.org/10.46332/aemj.748413
AMA Ceylan MR, Gümüş H, Solmaz A. Yenidoğan Kandida Sepsisli Olguların Retrospektif Değerlendirilmesi. Ahi Evran Med J. December 2020;4(3):72-76. doi:10.46332/aemj.748413
Chicago Ceylan, Mehmet Reşat, Hüseyin Gümüş, and Abdullah Solmaz. “Yenidoğan Kandida Sepsisli Olguların Retrospektif Değerlendirilmesi”. Ahi Evran Medical Journal 4, no. 3 (December 2020): 72-76. https://doi.org/10.46332/aemj.748413.
EndNote Ceylan MR, Gümüş H, Solmaz A (December 1, 2020) Yenidoğan Kandida Sepsisli Olguların Retrospektif Değerlendirilmesi. Ahi Evran Medical Journal 4 3 72–76.
IEEE M. R. Ceylan, H. Gümüş, and A. Solmaz, “Yenidoğan Kandida Sepsisli Olguların Retrospektif Değerlendirilmesi”, Ahi Evran Med J, vol. 4, no. 3, pp. 72–76, 2020, doi: 10.46332/aemj.748413.
ISNAD Ceylan, Mehmet Reşat et al. “Yenidoğan Kandida Sepsisli Olguların Retrospektif Değerlendirilmesi”. Ahi Evran Medical Journal 4/3 (December 2020), 72-76. https://doi.org/10.46332/aemj.748413.
JAMA Ceylan MR, Gümüş H, Solmaz A. Yenidoğan Kandida Sepsisli Olguların Retrospektif Değerlendirilmesi. Ahi Evran Med J. 2020;4:72–76.
MLA Ceylan, Mehmet Reşat et al. “Yenidoğan Kandida Sepsisli Olguların Retrospektif Değerlendirilmesi”. Ahi Evran Medical Journal, vol. 4, no. 3, 2020, pp. 72-76, doi:10.46332/aemj.748413.
Vancouver Ceylan MR, Gümüş H, Solmaz A. Yenidoğan Kandida Sepsisli Olguların Retrospektif Değerlendirilmesi. Ahi Evran Med J. 2020;4(3):72-6.

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