Candidaemia in special care nurseries: Comparison of Albicans and Parapsilosis infection

Objectives: Candidaemia caused by Candida parapsilosis (CP) is being increa singly reported among infants in neonatal intensive care units (NICU). To a ssess relative severity clinical manifestations of candidaemia caused by C. albicans (CA) and CP in a NICU were compared. Methods: Between January 1994 and July 1997, episodes of candidaemia occurr ing among infants hospitalized in the NICU were identified in a children's hospital. The demographic characteristics, associated risk factors, clinica l manifestations and outcome of the infants with CP fungaemia were collecte d and compared with those of the infants with CA fungaemia. Results: Twenty-four episodes caused by CA and 22 episodes caused by CP wer e included in this study, No significant differences were found between the two groups for gestational age, birth weight, male gender. post-natal age at onset of candidaemia, frequency of antecedent neonatal events, prior dur ation of antibiotic therapy and hyperalimentation, as well as presence of c entral vt:nous catheter (CVC), Infants with CA fungaemia were significantly more likely than those with CP fungaemia to present with hypoxaemia, brady cardia and respiratory distress requiring intubation, and have a longer pri or duration of indwelling CVC and a higher dissemination rate. The eradicat ion rate of candidaemia and overall case fatality race were comparable in b oth groups, but CP fungaemia did not appear to cause acute lethal events. Conclusions: The presenting, signs of CP fungaemia are relatively not so se vere, but CP fungaemia, which is relatively difficult to eradicate, increas es the morbidity and mortality of the infants. (C) 2000 The British Infecti on Society.