European Journal of Cardiovascular Medicine

Background:  Fungal infections have emerged as a critical problem in neonatal intensive care units. The vast majority of fungal infections in neonates are due to Candida species, with a small number being due to Malassezia, Aspergillus and other rare fungi. Candida has become an increasingly significant neonatal pathogen to cause late onset sepsis and compete with bacteria as one of the leading causes of nosocomial infections. We conducted a prospective study for a period of 1 year to know the incidence and course of fungal sepsis in a tertiary care NICU. Methods: This prospective study was conducted in a Neonatal Intensive Care unit of a tertiary care hospital from December 2016 to December 2017. Neonates admitted to K R Hospital NICU suspected / already diagnosed to have fungal sepsis were studied. The hospital has 23 bedded NICU with an average of 400 to 500 admissions each year. Informed parental consent was taken. A standardized case report form was developed to collect data on demographic, clinical, diagnostic, treatment and outcome of all these cases. Neonates admitted to tertiary care NICU were screened for fungal sepsis using standardized proforma developed to collect data and followed up. Results: Out of 15 neonatal cases of fungal sepsis, 11 (73.3%) were females and 4 (26.7%) were males. In the observed study, 7 cases (46.7%) were between 27-32 wks, 3(20%) were between 33-36 wks and 5(33.3%) were above 37 wks of gestational age. In the present study, 5 neonates (33.3%) were below 1.5 kg, 5 neonates (33.3%) between 1.5 to2.5 kg and remaining 5 neonates (33.3%) had birth weight between 2.5 to 3.5 kg. In the present study, 12 cases (80%) were outborn and remaining 3(20%) were inborn cases. Out of 15 cases, 8 cases (53.3%) had early onset fungal sepsis within seven days of hospitalization and remaining 7 cases (46.7%) developed late onset fungal sepsis (>7 days after hospitalization).  Conclusion: Fungal sepsis is one of the emerging problem in NICU and high index of suspicion is necessary for early diagnosis and treatment and good outcome.