Invasive fungal infection in preterm infants under 32 weeks: Clinical characteristics, laboratory findings, and treatment outcomes
Main Article Content
Abstract
Invasive candidemia is a major cause of morbidity and mortality, particularly in preterm infants with low birth weight. This study aims to evaluate the incidence of candidemia and antifungal resistance rates in preterm infants under 32 weeks of gestation. Among 102 neonates with positive fungal blood cultures, the mean gestational age was 29 ± 2.3 weeks old, and the mean birth weight was 1307 ± 357 grams. The most common initial diagnoses were neonatal sepsis (50%) and respiratory distress syndrome (25.5%). Notably, thrombocytopenia (< 150 G/L) was observed in 74.5% of cases. The predominant fungal species was Candida (97.1%), with C. albicans (54%) and C. parapsilosis (16.7%). Two cases presented co-infections with C. krusei/ C. guilliermondii and C. albicans/ C. krusei. Additionally, Kodamaea ohmeri was identified in three patients (2.9%). Antifungal resistance was found in 8.5% of cases for fluconazole, and one case showed intermediate susceptibility to amphotericin B and caspofungin. The overall mortality rate was 27.5%, with the highest mortality observed in cases of dual fungal infections (100%), followed by K. ohmeri infections (66.7%). The increasing incidence of candidemia and antifungal resistance in preterm infants under 32 weeks gestation is a critical concern. Early and appropriate interventions are essential to minimize drug resistance and reduce clinical mortality risks.
Article Details
Keywords
Candidemia, preterm birth, neonate, antifungal resistance
References
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