Incidence of Candida parapsilosis colonization in an intensive care nursery population and its association with invasive fungal disease

We have studied 82 consecutive intensive care nursery admissions to determine rates of colonization and incidence of fungal sepsis. Cultures were obtained from stool, gastric aspirate and skin at three different times. Infants studied ranged in gestational age from 23 to 38 weeks (mean +/- SEM 29 +/...

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Bibliographic Details
Published in:	The Pediatric infectious disease journal Vol. 13; no. 6; p. 520
Main Authors:	el-Mohandes, A E, Johnson-Robbins, L, Keiser, J F, Simmens, S J, Aure, M V
Format:	Journal Article
Language:	English
Published:	United States 01-06-1994
Subjects:	Candida - isolation & purification Candidiasis - epidemiology Candidiasis - microbiology Candidiasis - physiopathology Colony Count, Microbial Enteral Nutrition Feces - microbiology Female Fungemia - epidemiology Fungemia - microbiology Fungemia - physiopathology Gastric Juice - microbiology Humans Incidence Infant Infant, Low Birth Weight Infant, Newborn Infant, Premature Infant, Premature, Diseases - epidemiology Infant, Premature, Diseases - microbiology Infant, Premature, Diseases - physiopathology Intensive Care Units, Neonatal - statistics & numerical data Male Skin - microbiology
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Summary:	We have studied 82 consecutive intensive care nursery admissions to determine rates of colonization and incidence of fungal sepsis. Cultures were obtained from stool, gastric aspirate and skin at three different times. Infants studied ranged in gestational age from 23 to 38 weeks (mean +/- SEM 29 +/- 0.4 weeks). Nineteen percent of all infants were colonized with Candida sp.; stools were more frequently culture-positive than skin or gastric aspirates. Colonized infants began enteral feeds at a later time compared with noncolonized neonates. Five of the study infants developed fungal sepsis. One had congenital Candida albicans sepsis and died at 10 days of age; the other four had Candida parapsilosis sepsis and survived. The development of C. parapsilosis sepsis was significantly associated with gastrointestinal colonization. Our results suggest that early initiation of enteral feeds decreases gastrointestinal colonization with C. parapsilosis. Gastrointestinal colonization was strongly associated with the subsequent development of C. parapsilosis sepsis in this group of high risk neonates.
ISSN:	0891-3668
DOI:	10.1097/00006454-199406000-00011