Yeast colonisation & fungaemia in preterm neonates in a tertiary care centre

Seventy consecutive preterm neonates who stayed in the hospital for more th an seven days between March and October 1996, were studied for colonisation at oral, umbilical, groin, and rectal areas and for fungaemia. Overall, 71 .4 per cent of the neonates were colonised and colonisation occurred within 24 h in 38 per cent preterm neonates. Neonates weighing less than 1500 g w ere colonised more frequently at more than one site and had higher load of yeast. Candida albicans (19%), Pichia (Hansenula) anomala (17.5%), C. tropi calis (13.2%), C. parapsilosis (12.3%) and Trichosporon cutaneum (10.0%) we re the predominant colonising yeasts. Fungaemia was detected in 22.8 per ce nt of preterm neonates with predominance of P. anomala fungaemia (62.5 %). Prematurity, male sex, broad spectrum antibiotic therapy, intubation and hi gher colonising rate were identified as significant risk factors for develo pment of fungaemia. Except one strain of C. tropicalis, all yeast strains w ere sensitive to commonly used systemic antifungal agents. Study highlights the importance of routine surveillance of yeast colonisation of preterm ne onates with identifying possible risk factors.