INCIDENCE OF CANDIDA-PARAPSILOSIS COLONIZATION IN AN INTENSIVE-CARE NURSERY POPULATION AND ITS ASSOCIATION WITH INVASIVE FUNGAL DISEASE

We have studied 82 consecutive intensive care nursery admissions to de termine rates of colonization and incidence of fungal sepsis. Cultures were obtained from stool, gastric aspirate and skin at three differen t times. Infants studied ranged in gestational age from 23 to 38 weeks (mean +/- SEM 29+/-0.4 weeks). Nineteen percent of all infants were c olonized with Candida sp.; stools were more frequently culture-positiv e than skin or gastric aspirates. Colonized infants began enteral feed s at a later time compared with noncolonized neonates. Five of the stu dy infants developed fungal sepsis. One had congenital Candida albican s sepsis and died at 10 days of age; the other four had Candida paraps ilosis sepsis and survived. The development of C. parapsilosis sepsis was significantly associated with gastrointestinal colonization. Our r esults suggest that early initiation of enteral feeds decreases gastro intestinal colonization with C. parapsilosis. Gastrointestinal coloniz ation was strongly associated with the subsequent development of C. pa rapsilosis sepsis in this group of high risk neonates.