PREVALENCE OF NON-ALBICANS CANDIDA IN CASES OF NEONATAL SEPSIS IN A TERTIARY CARE HOSPITAL

Abstract

Background: Neonatal candidiasis is becoming more common, mostly as a result of the improved survival of low-birth-weight neonates, preterm deliveries, medical advancements, life support systems, a state of relative immunodeficiency, and the widespread use of broad-spectrum antibiotics. The dominance of Candida albicans has gradually given way to non-albicans Candida species during the past few decades. We in this study tried to analyse the prevalence of non-albicans Candida in cases of neonatal sepsis cases.

Methods: Blood samples of 1 – 2ml were done by arterial and venous samples, finger, or heel prick-capillary sampling, as well as newly inserted umbilical catheters. The ready-to-use BacT/ALERT PF Plus culture vials (yellow colour coded for paediatric usage) were injected with around 1 ml of blood and well-shaken. After scanning the bottle's barcode, the culture bottles were inserted into the apparatus and placed in the incubator.

Results: Out of n=23 culture-proven sepsis cases 30.44% (n=07) were bacterial isolates and 69.44%(n=16) were fungal isolates. there was a twofold rise in fungal isolates compared to bacterial isolates in the present study. Among the fungal isolates, C. glabrata 34.78% (n=8) constituted the majority of isolates followed by C. tropicalis 30.43%(n=7) and C. cruzi 4.35%(n=01).  50% of C. glabrata cases demonstrated resistance to commonly used antifungal drugs like fluconazole, C. tropicalis isolates, 42.8% showed resistance to fluconazole, 28.6% exhibited resistance to flucytosine, and 14.2% demonstrated resistance to amphotericin B.

Conclusion: There is a predominance of candida species in neonatal septicemia cases and a shift of strains to non-albicans candida is noted. Therefore, the importance to routinely identifying Candida isolates to the species level and conducting antifungal susceptibility tests to detect resistant strains. Continuous monitoring of candidemia through surveillance is essential to track changes in epidemiological trends, antifungal susceptibility patterns, and to guide the development and evaluation of preventive strategies.