INTRODUCTION: During the past years invasive fungal infections (IFIs) have become an increasingly important problem in infants hospitalized in the Neonatal Intensive Care Unit (NICU). Candida species is the third most-common agent of late-onset infections in critically ill neonates, with an estimated incidence of 2.6-10% in very low birth weight and 5.5-20% in extremely low birth weight infants. The aim of this observational study is to evaluate the epidemiology of IFIs among infants admitted to NICUs of one Italian region by a multicenter surveillance (Aurora Project). METHODS: The IFIs surveillance was carried out prospectively in Apulia (Southern Italy) between February 2007 and August 2008. This report focuses on the results from 6 enrolled NICUs. RESULTS: Twenty-one neonates developed IFIs: the overall incidence was 1.3% and crude mortality was 23.8%. Infants weighing < or = 1500 g (4.3%) showed a significantly higher incidence than those > or = 2500 g (0.2%). C. parapsilosis (61.9%) was the most frequent isolated species. The main potential risk factors were having a central venous catheter placed, length of stay in NICU > 7 days and total parenteral nutrition for > 5 days. The (1,3)-beta-D glucan (BDG), mannan antigens and anti-Candida antibodies' evaluation was performed in 7 neonates. All neonates were positive to the BDG; the mannan antigen result was positive in 5 newborns, the anti-mannan antibodies were always negative. All isolates were amphotericin B and fluconazole-susceptible. DISCUSSION: This first prospective study on neonatal fungal infection in one Italian region gives evidence of a preponderance of non-albicans Candida spp and indicates potential utility of BDG as an adjunct diagnostic test.
INTRODUCTION: During the past years invasive fungal infections (IFIs) have become an increasingly important problem in infants hospitalized in the Neonatal Intensive Care Unit (NICU). Candida species is the third most-common agent of late-onset infections in critically ill neonates, with an estimated incidence of 2.6-10% in very low birth weight and 5.5-20% in extremely low birth weight infants. The aim of this observational study is to evaluate the epidemiology of IFIs among infants admitted to NICUs of one Italian region by a multicenter surveillance (Aurora Project). METHODS: The IFIs surveillance was carried out prospectively in Apulia (Southern Italy) between February 2007 and August 2008. This report focuses on the results from 6 enrolled NICUs. RESULTS: Twenty-one neonates developed IFIs: the overall incidence was 1.3% and crude mortality was 23.8%. Infants weighing < or = 1500 g (4.3%) showed a significantly higher incidence than those > or = 2500 g (0.2%). C. parapsilosis (61.9%) was the most frequent isolated species. The main potential risk factors were having a central venous catheter placed, length of stay in NICU > 7 days and total parenteral nutrition for > 5 days. The (1,3)-beta-D glucan (BDG), mannan antigens and anti-Candida antibodies' evaluation was performed in 7 neonates. All neonates were positive to the BDG; the mannan antigen result was positive in 5 newborns, the anti-mannan antibodies were always negative. All isolates were amphotericin B and fluconazole-susceptible. DISCUSSION: This first prospective study on neonatal fungal infection in one Italian region gives evidence of a preponderance of non-albicans Candida spp and indicates potential utility of BDG as an adjunct diagnostic test.
Authors: Anna R Huppler; Brian T Fisher; Thomas Lehrnbecher; Thomas J Walsh; William J Steinbach Journal: J Pediatric Infect Dis Soc Date: 2017-09-01 Impact factor: 3.164
Authors: Giuseppina Caggiano; Francesca Apollonio; Mila Consiglio; Valentina Gasparre; Paolo Trerotoli; Giusy Diella; Marco Lopuzzo; Francesco Triggiano; Stefania Stolfa; Adriana Mosca; Maria Teresa Montagna Journal: Int J Environ Res Public Health Date: 2022-06-09 Impact factor: 4.614
Authors: M T Montagna; G Caggiano; G Lovero; O De Giglio; C Coretti; T Cuna; R Iatta; M Giglio; L Dalfino; F Bruno; F Puntillo Journal: Infection Date: 2013-03-06 Impact factor: 3.553