Candidemia in the Neonatal Intensive Care Unit: A Retrospective, Observational Survey and Analysis of Literature Data

Abstract

We evaluated the epidemiology ofCandidabloodstream infections in the neonatal intensive care unit (NICU) of an Italian university hospital during a 9-year period as a means of quantifying the burden of infection and identifying emerging trends. Clinical data were searched for in the microbiological laboratory database. For comparative purposes, we performed a review of NICU candidemia. Forty-one candidemia cases were reviewed (overall incidence, 3.0 per 100 admissions).Candida parapsilosis sensu stricto(58.5%) andC. albicans(34.1%) were the most common species recovered. A variable drift through years was observed; in 2015, 75% of the cases were caused by non-albicansspecies. The duration of NICU hospitalization of patients with non-albicanswas significantly longer than in those withC. albicans(median days, 10 versus 12). Patients with non-albicansspecies were more likely to have parenteral nutrition than those withC. albicans(96.3% versus 71.4%).Candida albicanswas the dominant species in Europe and America (median, 55% and 60%; resp.); non-albicansspecies predominate in Asia (75%). Significant geographic variation is evident among cases of candidemia in different parts of the world, recognizing the importance of epidemiological data to facilitate the treatment.