Abdallah Yaser, Kaddu-Mulindwa Deogratias, Nankunda Jolly, Musoke Philippa M
Department of Paediatrics and Child Health, Makerere University College of Health Sciences.
Department of Microbiology, Makerere University College of Health Sciences.
Afr Health Sci. 2015 Mar;15(1):197-205. doi: 10.4314/ahs.v15i1.26.
Candida species is the third commonest cause of sepsis among neonates. Colonization by Candida is a predictor for candidemia among preterm neonates.
To determine prevalence of early Candida colonization and early outcome among colonized preterm neonates admitted to Mulago hospital Special Care Unit.
A prospective observational cohort was conducted between December 2008 and April 2009. Preterm neonates aged >72 hours and less than one week were screened for Candida colonization of the groin, oral pharynx and rectum using CHROMagar. Colonized neonates were followed up for 14 days. Blood cultures were done for those with signs of septicaemia. The Fisher's exact tests and logistic regression were conducted for factors associated with colonization and mortality among colonized neonates. P values of < 0.05 were considered significant and confidence interval of 95% was used.
Candida colonization occurred in 50/213 (23.5%) neonates. Gestational age ≤ 30 weeks was the only factor independently associated with colonization (p = 0.005). Of the colonized 14/46 (30.4%) died and 13/46 (28.3%) developed mucocutaneous candidiasis. No candidemia was identified. Multiple site colonization was independently associated with mortality (p=0.035).
The consequence of high colonization observed in this study needs to be further elucidated in Uganda.
念珠菌属是新生儿败血症第三大常见病因。念珠菌定植是早产新生儿发生念珠菌血症的一个预测指标。
确定入住穆拉戈医院特殊护理病房的定植早产新生儿中早期念珠菌定植情况及早期转归。
于2008年12月至2009年4月进行了一项前瞻性观察队列研究。对年龄大于72小时且小于1周的早产新生儿使用科玛嘉显色培养基筛查腹股沟、口腔咽部和直肠的念珠菌定植情况。对定植新生儿进行14天的随访。对有败血症体征的患儿进行血培养。对定植新生儿中与定植和死亡相关的因素进行费舍尔精确检验和逻辑回归分析。P值<0.05被认为具有统计学意义，并采用95%置信区间。
213例新生儿中有50例（23.5%）发生念珠菌定植。胎龄≤30周是唯一与定植独立相关的因素（p = 0.005）。在定植患儿中，14/46（30.4%）死亡，13/46（28.3%）发生黏膜皮肤念珠菌病。未发现念珠菌血症。多部位定植与死亡率独立相关（p = 0.035）。
本研究中观察到的高定植率的后果在乌干达需要进一步阐明。
