Characterisation and Speciation of Fungal Isolates in Neonatal Sepsis in a Tertiary Care Hospital

Lakshmana Kumar, V (2015) Characterisation and Speciation of Fungal Isolates in Neonatal Sepsis in a Tertiary Care Hospital. Masters thesis, Madurai Medical College, Madurai.


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INTRODUCTION: Sepsis is the most common cause of neonatal mortality. Sepsis caused by fungal infections are a serious problem. This study is aimed to estimate the incidence of fungal sepsis, evaluate the risk factors and isolate the common fungal pathogen in neonatal intensive care unit (NICU) in a tertiary care hospital. MATERIALS AND METHODS: 200 neonates were selected from NICU and blood, CSF or urine sample were collected for fungal culture. Fungal pathogens were isolated by conventional culture method, identification by microscopic and macroscopic observation of growth. Speciation of Candida was done by germ tube test, corn meal agar morphology, CHROME agar color, urea hydrolysis, sugar fermentation and sugar assimilation tests. Antifungal susceptibility testing was done by broth dilution, agar dilution and disc diffusion methods. RESULTS: From 200 samples, 13 fungal growth were isolated. The incidence of fungal sepsis was 6.5%. All the isolates were Candida species and non albicans Candida were predominent (77%). C.albicans (23%) and C.gullermondii (23%) were the most common species. There was male preponderance (54%) and outborn babies (62%) had more sepsis. The major risk factors were preterm (77%) and very low birth weight (VLBW) (69%) and the associated risk factors were prolonged hospital stay more than 7 days (54%), administration of broad spectrum antibiotics for more than 5 days (61%) and mechanical ventilation (46%). The isolated candida species showed more resistance to fluconazole (30%) and amphotericin B (23%). CONCLUSIONS: The incidence of fungal sepsis in NICU was increased. Candida species were the common cause for fungal infection in neonates. Preterm and very low birth weight, prolong hospital stay, administration of broad spectrum antibiotics and mechanical ventilation were the major risk factors. Nosocomial infection was considered as a major contributor. Routine screening and evaluation can be recommended for prevention and control of fungal sepsis in NICU.

Item Type: Thesis (Masters)
Uncontrolled Keywords: NICU ; fungal sepsis ; VLBW neonates ; Candida species.
Subjects: MEDICAL > Microbiology
Depositing User: Punitha K
Date Deposited: 23 May 2018 03:08
Last Modified: 27 May 2018 06:02

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