Amit K Rai, Ragini Tilak, Punit Tiwari, Pooja Meena, Ashok Kumar, Atul K Tiwari, Munesh K Gupta
{"title":"印度北部一家三级医疗中心出现了导致新生儿败血症的罕见和不常见的酵母样病原体。","authors":"Amit K Rai, Ragini Tilak, Punit Tiwari, Pooja Meena, Ashok Kumar, Atul K Tiwari, Munesh K Gupta","doi":"10.18683/germs.2024.1414","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Neonatal candidemia is a life-threatening event in babies requiring ICU admission. Prompt diagnosis and appropriate treatment reduce mortality and morbidity. Worldwide, there is an emergence of drug-resistant rare <i>Candida</i> species causing neonatal sepsis that necessitates antifungal susceptibility testing in each case.</p><p><strong>Methods: </strong>We did a prospective study to isolate <i>Candida</i> species causing neonatal sepsis and to determine the predisposing risk factors and time to positivity for flagged positivity. We also determined fluconazole, itraconazole and amphotericin B minimum inhibitory concentration (MIC) against isolated <i>Candida</i> species by broth microdilution method using CLSI M27-A3 guidelines.</p><p><strong>Results: </strong>A total of 107 neonatal candidemia events were noted. Prematurity was the most common predisposing risk factor. Most isolates were non-<i>albicans Candida</i>. <i>Candida utilis</i>, <i>C. pelliculosa, C. tropicalis</i> and <i>K. ohmeri</i> were the predominant fungi causing neonatal candidemia. A varied antifungal MIC against isolated <i>Candida</i> species was noted. However, 90% of the isolated <i>Candida</i> strains had <8 µg/mL fluconazole MIC. Moreover, ≥8 and ≥2 µg/mL MIC for fluconazole and amphotericin B respectively were also noted.</p><p><strong>Conclusions: </strong>Rare <i>Candida</i> species having varied fluconazole and amphotericin B MIC cause neonatal candidemia. Therefore, culture isolation and antifungal susceptibility testing should be done in each case of neonatal candidemia.</p>","PeriodicalId":45107,"journal":{"name":"GERMS","volume":null,"pages":null},"PeriodicalIF":1.7000,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11333843/pdf/","citationCount":"0","resultStr":"{\"title\":\"Emergence of rare and uncommon yeast-like pathogens causing neonatal sepsis at a tertiary care center, North India.\",\"authors\":\"Amit K Rai, Ragini Tilak, Punit Tiwari, Pooja Meena, Ashok Kumar, Atul K Tiwari, Munesh K Gupta\",\"doi\":\"10.18683/germs.2024.1414\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Neonatal candidemia is a life-threatening event in babies requiring ICU admission. Prompt diagnosis and appropriate treatment reduce mortality and morbidity. Worldwide, there is an emergence of drug-resistant rare <i>Candida</i> species causing neonatal sepsis that necessitates antifungal susceptibility testing in each case.</p><p><strong>Methods: </strong>We did a prospective study to isolate <i>Candida</i> species causing neonatal sepsis and to determine the predisposing risk factors and time to positivity for flagged positivity. We also determined fluconazole, itraconazole and amphotericin B minimum inhibitory concentration (MIC) against isolated <i>Candida</i> species by broth microdilution method using CLSI M27-A3 guidelines.</p><p><strong>Results: </strong>A total of 107 neonatal candidemia events were noted. Prematurity was the most common predisposing risk factor. Most isolates were non-<i>albicans Candida</i>. <i>Candida utilis</i>, <i>C. pelliculosa, C. tropicalis</i> and <i>K. ohmeri</i> were the predominant fungi causing neonatal candidemia. A varied antifungal MIC against isolated <i>Candida</i> species was noted. However, 90% of the isolated <i>Candida</i> strains had <8 µg/mL fluconazole MIC. Moreover, ≥8 and ≥2 µg/mL MIC for fluconazole and amphotericin B respectively were also noted.</p><p><strong>Conclusions: </strong>Rare <i>Candida</i> species having varied fluconazole and amphotericin B MIC cause neonatal candidemia. Therefore, culture isolation and antifungal susceptibility testing should be done in each case of neonatal candidemia.</p>\",\"PeriodicalId\":45107,\"journal\":{\"name\":\"GERMS\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2024-03-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11333843/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"GERMS\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.18683/germs.2024.1414\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/3/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"GERMS","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.18683/germs.2024.1414","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/3/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0
摘要
简介新生儿念珠菌血症对需要入住重症监护室的婴儿来说是一种威胁生命的疾病。及时诊断和适当治疗可降低死亡率和发病率。在全球范围内,引起新生儿败血症的罕见念珠菌出现了耐药性,因此有必要对每个病例进行抗真菌药敏试验:我们进行了一项前瞻性研究,以分离导致新生儿败血症的念珠菌菌种,并确定标记阳性的易感危险因素和阳性时间。我们还根据 CLSI M27-A3 指南,采用肉汤微稀释法测定了氟康唑、伊曲康唑和两性霉素 B 对分离念珠菌的最低抑菌浓度(MIC):结果:共发现 107 例新生儿念珠菌血症。早产是最常见的诱发风险因素。大多数分离株为非白色念珠菌。引起新生儿念珠菌血症的主要真菌是白色念珠菌(Candida utilis)、白色念珠菌(C. pelliculosa)、热带念珠菌(C. tropicalis)和白色念珠菌(K. ohmeri)。针对分离出的念珠菌的抗真菌 MIC 值各不相同。然而,90%的分离念珠菌菌株都有结论:罕见的念珠菌菌株具有不同的氟康唑和两性霉素 B MIC,可导致新生儿念珠菌血症。因此,应针对每例新生儿念珠菌病进行培养分离和抗真菌药敏试验。
Emergence of rare and uncommon yeast-like pathogens causing neonatal sepsis at a tertiary care center, North India.
Introduction: Neonatal candidemia is a life-threatening event in babies requiring ICU admission. Prompt diagnosis and appropriate treatment reduce mortality and morbidity. Worldwide, there is an emergence of drug-resistant rare Candida species causing neonatal sepsis that necessitates antifungal susceptibility testing in each case.
Methods: We did a prospective study to isolate Candida species causing neonatal sepsis and to determine the predisposing risk factors and time to positivity for flagged positivity. We also determined fluconazole, itraconazole and amphotericin B minimum inhibitory concentration (MIC) against isolated Candida species by broth microdilution method using CLSI M27-A3 guidelines.
Results: A total of 107 neonatal candidemia events were noted. Prematurity was the most common predisposing risk factor. Most isolates were non-albicans Candida. Candida utilis, C. pelliculosa, C. tropicalis and K. ohmeri were the predominant fungi causing neonatal candidemia. A varied antifungal MIC against isolated Candida species was noted. However, 90% of the isolated Candida strains had <8 µg/mL fluconazole MIC. Moreover, ≥8 and ≥2 µg/mL MIC for fluconazole and amphotericin B respectively were also noted.
Conclusions: Rare Candida species having varied fluconazole and amphotericin B MIC cause neonatal candidemia. Therefore, culture isolation and antifungal susceptibility testing should be done in each case of neonatal candidemia.