A research report submitted to Faculty of Health Sciences, as a requirement for completion of
Masters of Medicine in Paediatrics, University of the Witwatersrand, Johannesburg, 2018 / Background.
Candidemia is a significant cause of morbidity and mortality in infants. The mortality rate ranges between 21% and 76%. Non-albicans candida (NAC) is increasing in incidence and resistance to azoles.
Very low birth weight (VLBW) infants have numerous risk factors which predispose them as a group to invasive candidemia.
Methods.
A retrospective case control study of candidemia in VLBW infants admitted to the neonatal unit at Charlotte Maxeke Johannesburg Hospital (CMJAH) between 01 January 2015 to 31 December 2017 was undertaken.
Clinical and demographic characteristics of VLBW infants who developed candidemia, commonest Candida species, antifungal susceptibility profiles and outcomes defined as death were identified.
71 infants with confirmed positive blood cultures for candidemia from the NHLS database were selected and each case was allocated 3 controls; the final sample comprised 284 infants.
Results.
Bacterial sepsis, chronic lung disease (CLD), necrotising enterocolitis (NEC) and NEC surgery, other surgery, anaemia and ventilation, all showed a strong association with development of candidemia in the infants.
The most common isolate was Candida parapsilosis (59.1%), followed by Candida albicans (30.9%). The cases of candidemia overall and NAC isolates increased over the study years. Resistance to azoles by NAC was demonstrated.
Mortality was 31.2% and 28.2% in controls and cases respectively. The difference in death between the two groups was not statistically significant.
7
A research report submitted to Faculty of Health Sciences WITS, as a requirement for completion of
Masters of Medicine; Paediatrics. Johannesburg, South Africa 2018.
Conclusions.
The study demonstrated a predominance of NAC isolates, increasing rate of candidemia and increased resistance to azoles. Stricter infection control measures and medical intervention strategies should be implemented / GR 2020
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/28979 |
| Date | January 2020 |
| Creators | Malunga, Carol Jacobeth |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | Online resource (36 leaves), application/pdf |
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