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. 2017 Jan 19;43(1):10.
doi: 10.1186/s13052-017-0332-5.

Risk factors for Candida parapsilosis bloodstream infection in a neonatal intensive care unit: a case-control study

Carmine Garzillo  1 , Maria Bagattini  1 , Lidija Bogdanović  1 , Anna Di Popolo  1 , Vita Dora Iula  2 , Maria Rosaria Catania  2 , Francesco Raimondi  3 , Maria Triassi  1 , Raffaele Zarrilli  4
Affiliations

Risk factors for Candida parapsilosis bloodstream infection in a neonatal intensive care unit: a case-control study

Carmine Garzillo et al. Ital J Pediatr. .

Abstract

Background: Candida parapsilosis is increasingly responsible for invasive candidiasis in neonates. This study investigates phenotypic and genotypic features of C. parapsilosis microbial isolates and underlying clinical conditions associated with acquisition of C. parapsilosis in a neonatal intensive care unit (NICU) in Italy.

Methods: Identification of C. parapsilosis was performed by VITEK® 2 and MALDI TOF and confirmed by analysis of internal transcribed spacer ribosomal DNA sequences. Genotyping was performed by PCR fingerprinting. Antifungal susceptibility of strains was evaluated by microdilution. A case-control study was designed to identify risk factors for C. parapsilosis bloodstream infection.

Results: During the study period (April 2009- April 2012), C. parapsilosis was responsible for 6 umbilical catheter and 11 central catheter-associated bloodstream infection in 17 neonates in the NICU. Molecular typing identified identical fingerprinting profile in all C. parapsilosis isolates from neonates. Fifteen of 17 C. parapsilosis isolates were susceptible to all antifungal drugs, two isolates were resistant to fluconazole and intermediate susceptible to itraconazole. Low birthweight, gestational age and time to exposure to assisted ventilation were risk factors for C. parapsilosis infection in neonates in the NICU at univariate and multivariate analysis.

Conclusion: C. parapsilosis bloodstream infections in the NICU were caused by a single epidemic clone. Low birthweight, gestational age and time to exposure to invasive devices, with predominance of assisted ventilation, were the clinical conditions associated with C. parapsilosis bloodstream infection in the NICU.

Keywords: Candida parapsilosis; Healthcare-associated infections; Low birth weight; Neonatal intensive care unit; Risk factor analysis.

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Figures

Fig. 1
Fig. 1
Boxplots for covariates counts in each group. Group 1 represents the cases, groups 2–10 represent the controls. The circles that lie above the top whiskers are the outliers
Fig. 2
Fig. 2
Histograms of variable distributions. Sampling distributions are not normally distributed
See this image and copyright information in PMC

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Supplementary concepts