Prevalence of Candidemia in High-Risk Neonates of Neonatal Intensive Care Unit – A One-Year Cross Sectional Study

Background:
Fungal sepsis in neonates is third most common
blood stream infections in ICUs. The changing
epidemiology to non-albicans Candida is grossly evident.
Azole resistance is on rise, next alternative are
Echinocandins.Objective:
To study the prevalence of Candidemia in high-risk
neonates of NICU and to study Caspofungin
(Echinocandin) antifungal susceptibility in Fluconazole
resistant Candida isolates by E test / MIC test strip
method.Material and Methods:
The blood sample collected from all high-risk
neonates admitted during the study period in NICU of
Dr. Prabhakar kore charitable hospital, Belagavi during
study period, were included in the study. All the samples
were processed according to the standard operating
procedures of Mycology, conventionally.Results:
A total of 230 Blood samples collected from NICU
from the high-risk neonates with suspected sepsis, who
were admitted in the study period and were processed
and were evaluated.53.97 (n= 34) isolates are resistant to
Fluconazole and 76.19 (n=48) are resistant to
Voriconazole. By E-strip method 20.63 (n=13) were
resistant to Caspofungin.Conclusion:
Prophylactic usage of Fluconazole as an antifungal
drug is now questionable as Fluconazole resistance is on
rise. Echinocandins are the only next alternative. Strict
infection control strategies, appropriate preventive, and
therapeutic measures should be implemented.