Abdelhadi Basem, Al Ajmi Mujtaba, Al Hashami Hilal, Al Rawahi Manal
Child Health Department, Royal Hospital, Muscat, Sultanate of Oman.
Child Health Department, Pediatric Infectious Diseases Consultant, Royal Hospital, Muscat, Sultanate of Oman.
Ital J Pediatr. 2025 May 22;51(1):153. doi: 10.1186/s13052-025-01952-6.
One of the well-known causes of morbidity and mortality in the neonatal population is invasive candidiasis. In neonatal critical care units, candida sepsis is now the third most frequent cause of late-onset sepsis. The objective of this research was to determine the prevalence of related risk factors, clinical traits, and results related to invasive candidiasis in the neonatal intensive care unit (NICU) at the Royal Hospital in Oman.
A case-control retrospective analysis of 20 newborns admitted between January 2006 and December 2020 to the neonatal intensive care unit at Royal Hospital. In terms of gestational age, birth weight, and date of birth, cases and controls were matched.
There were 60 infants in all- 20 cases and 40 controls. The two groups'demographics, including age, sex, and weight, were comparable. The case group compared to the control group had a mean gestational age of 32.2 ± 6.1 weeks against 32.2 ± 5.7 weeks and a mean birth weight of 1978 ± 1202 grammes against 1930 ± 1040 grammes, respectively. A total of 14,820 newborns were admitted to the NICU during the study period, with 20 cases of candidemia, representing an incidence of approximately 1.3 per 1000 admissions. Seventy-five percent of the isolated species were Candida albicans. Sixty-five percent of the instances happened in the second and third week of life. Compared to the control group, the case group's mean NICU stay was longer. Several risk factors, including young maternal age, the presence of a central line, invasive mechanical ventilation, total parenteral nutrition, prolonged hospital stay, necrotizing enterocolitis, abdominal surgeries for congenial intestinal malformations and cardiac surgeries for congenital heart diseases, were found to be related with an elevated risk for invasive candidiasis using univariate analysis. In the case group, the overall mortality rate was 45%, but in the control group, there was no death in the cohort.
The following factors were linked to an elevated risk of invasive candidiasis in this case series: total parenteral nutrition, prolonged hospital stay, central line presence, prematurity, abdominal and cardiac surgeries. Those with risk characteristics should be highly suspected for neonatal candidiasis, particularly if their stay in the NICU is longer than seven days. Antifungal prophylaxis should be taken into consideration for these newborns, and presumed antifungal medication should be started as soon as possible.
侵袭性念珠菌病是新生儿发病和死亡的常见原因之一。在新生儿重症监护病房，念珠菌败血症现已成为晚发性败血症的第三大常见原因。本研究的目的是确定阿曼皇家医院新生儿重症监护病房（NICU）中侵袭性念珠菌病相关危险因素、临床特征及结果的患病率。
对2006年1月至2020年12月期间入住皇家医院新生儿重症监护病房的20名新生儿进行病例对照回顾性分析。在胎龄、出生体重和出生日期方面，病例组和对照组进行了匹配。
总共60名婴儿——20例病例和40例对照。两组的人口统计学特征，包括年龄、性别和体重，具有可比性。病例组与对照组相比，平均胎龄分别为32.2±6.1周和32.2±5.7周，平均出生体重分别为1978±1202克和1930±1040克。在研究期间，共有14820名新生儿入住NICU，其中20例念珠菌血症，发病率约为每1000例入院1.3例。分离出的菌种中75%为白色念珠菌。65%的病例发生在出生后的第二和第三周。与对照组相比，病例组在NICU的平均住院时间更长。单因素分析发现，包括产妇年龄小、存在中心静脉导管、有创机械通气、全胃肠外营养、住院时间延长、坏死性小肠结肠炎、先天性肠道畸形的腹部手术和先天性心脏病的心脏手术等几个危险因素与侵袭性念珠菌病风险升高有关。病例组的总死亡率为45%，而对照组在该队列中无死亡病例。
在本病例系列中，以下因素与侵袭性念珠菌病风险升高有关：全胃肠外营养、住院时间延长、中心静脉导管存在、早产、腹部和心脏手术。具有风险特征的新生儿应高度怀疑患有新生儿念珠菌病，特别是如果他们在NICU的住院时间超过7天。对于这些新生儿应考虑进行抗真菌预防，并且应尽快开始经验性抗真菌治疗。
