[Clinical characteristics of Candida septicemia seen in a neonatal intensive care unit: analysis of 9 cases]

Abstract

Objective: To analyze the clinical characteristics of Candida septicemia occurred in neonatal intensive care unit (NICU).

Methods: The clinical characteristics of 9 confirmed cases with septicemia caused by Candida species yeasts were analyzed and summarized.

Results: All the 9 cases were preterm infants, including 6 cases of very low birth weight infants. All these cases were treated with broad-spectrum antibiotics and parenteral nutrition before fungal infections occurred. Eight cases had percutaneous inserted central catheter (PICC). Three cases had been on ventilator. The symptoms of fungal infection were presented at 8 to 22 days of age. Apnea, poor perfusion and lethargy were common symptoms of these cases with fungal infection. Seven of the 9 cases developed thrombocytopenia. C reactive protein was elevated in 7 cases. Blood culture showed C. albicans in 1 case, C. parapsilosis in 2 cases, and C. guilliermondii in 6 cases. In 5 cases PICC culture showed the same fungus as blood culture revealed at the same time. All the 9 patients received antifungal therapy. Six patients were cured, two died and in one patient the treatments were given up by the parents.

Conclusions: The high risk factors of Candida septicemia in newborn infants include preterm, PICC, broad-spectrum antibiotic therapy and mechanical ventilation. The clinical presentations are always nonspecific. Thrombocytopenia and elevated C reactive protein are common in Candida septicemia patients. Early-started antifungal therapy can improve the prognosis.