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Candidemia in Neonatal Intensive Care Units: Barcelona, Spain

Rodriguez, Dolors MD*; Almirante, Benito MD*; Park, Benjamin J. MD†; Cuenca-Estrella, Manuel MD‡; Planes, Ana M. MD§; Sanchez, Ferran MD∥; Gene, Amadeu MD¶; Xercavins, Mariona MD#; Fontanals, Dionisia MD**; Rodriguez-Tudela, Juan L. MD‡; Warnock, David W. PhD†; Pahissa, Albert MD*; on behalf of the Barcelona Candidemia Project Study Group

Pediatric Infectious Disease Journal: March 2006 - Volume 25 - Issue 3 - pp 224-229
doi: 10.1097/01.inf.0000202127.43695.06
Original Studies

Background: Candida spp. are increasingly important hospital-acquired pathogens in neonatal intensive care units (NICU) and cause considerable mortality in preterm infants. Most studies have been limited to a single institution. The aim of this study was to determine the epidemiology of candidemia in all Barcelona NICUs.

Methods: We conducted prospective population-based surveillance for candidemia in Barcelona, Spain, during 2002–2003. This report focuses on the results from 5 participating hospitals with NICUs.

Results: We detected 24 cases, resulting in an annual incidence of 32.6 cases per 100,000 live births and 1.1 cases per 100 NICU discharges. Median gestational age was 27.5 weeks (range, 24–40.5), and there were 21 cases among very low birth weight infants. Among the 20 (83%) cases evaluated for the presence of end organ infection, endophthalmitis occurred in 2 cases, and endocarditis, meningitis and peritonitis occurred in 1 case each. Candida parapsilosis was the most frequent species isolated (67%). All isolates were fluconazole-susceptible. Crude mortality was 21%.

Conclusions: The preponderance of C. parapsilosis candidemias observed in Barcelona NICUs is similar to reports from the literature. Morbidity and mortality associated with neonatal candidemia remain high.

From the *Infectious Diseases Department, Medicine Department, Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain; the †Mycotic Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Diseases Control and Prevention, Atlanta, GA; the ‡Mycology Reference Laboratory, Instituto de Salud Carlos III, Madrid, Spain; the §Microbiology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain; the ∥Microbiology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; the ¶Microbiology Department, Hospital St Joan de Deu, Esplugues de Llobregat, Barcelona, Spain; #Microbiology Department, Hospital Mutua de Terrassa, Terrassa, Barcelona, Spain; and the **Microbiology Department, Hospital Parc Tauli Sabadell, Barcelona, Spain.

Accepted for publication September 23, 2005.

Supported by research grants from Pfizer, Inc. and Gilead Sciences.

Presented in part at the 44th Interscience Conference on Antimicrobial Agents and Chemotherapy, Washington DC, October 30–November 2, 2004.44

E-mail dolorodriguez@vhebron.net. Reprints not available.

© 2006 Lippincott Williams & Wilkins, Inc.