EPIDEMIOLOGY OF SYSTEMIC CANDIDIASIS IN A TERTIARY CARE NEONATAL UNIT

143 neonates were diagnosed to have acquired systemic candidiasis out of a total 4530 admissions (3.2 per cent) to the neonatal intensive ca re unit (NICU) during a period of 6 1/2 years from January 1990 to Jun e 1996, Mean age at onset was 10.4 days, mean birth weight 1454 g, and mean gestation was 31.7 weeks, Ninety-four per cent were premature, 9 5 per cent low birth weight (LBW), and all had undergone peripheral ve in catheterization and had received broad spectrum antibiotics, except one, prior to the diagnosis. Fifty-eight per cent were ventilated and 15 per cent received parenteral nutrition. Persistent/recurrent pneum onia, apnoea, lethargy, high gastric aspirates, and abdominal distensi on were the common clinical manifestations. Candida tropicalis, C. alb icans, and C. guillermondii were the most common isolates. Blood and u rine were the predominant sites for isolation of Candida, Fluconazole was the most used antifungal agent, with 24 per cent resistance agains t it. Fifty per cent of babies died due to all causes. Of all the deat hs, two-thirds were Candida related. Candida-attributable deaths occur red in 24 cases (17 per cent).