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Invasive Fungal Infection in Neonatal Intensive Care Units: A Multicenter Survey

Mónica Baptista1, José Nona1, Manuel Ferreira2, Isabel Sampaio3, Margarida Abrantes3, Maria Teresa Tomé1, Maria Teresa Neto4, Rosalina Barroso2, Micaela Serelha4, Daniel Virella5

  1. Neonatology Department, Maternidade Dr. Alfredo da Costa, Centro Hospitalar Lisboa Central, Lisbon, Portugal
  2. Neonatology Department, Hospital Fernando da Fonseca, Lisbon, Portugal
  3. Neonatology Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
  4. Neonatology Department, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, Lisbon, Portugal
  5. Epidemiology and Statistics Office of the Research Unit of Centro Hospitalar de Lisboa Central, Lisbon, Portugal

J Chemother.2014 Nov 3:1973947814Y0000000222. [Epub ahead of print]

This study assesses the epidemiology of invasive fungal infection in Portuguese Neonatal Intensive Care Units and compares the effectiveness and safety of antifungal therapies. A survey concerning the period 2005-2010 was carried out in NICUs of Greater Lisbon. Among 10,473 admitted neonates, 44 cases were identified, 29 among extreme low birth weight neonates (65.9%). Cumulative incidence rate was 0.42% (95%CI 0.309–0.559). A central venous catheter was present before IFI in all cases. Candida albicans and Candida parapsilosis were the most frequent isolates. Fluconazole was the first antifungal treatment in 22 cases and liposomal amphotericin B (L-AmB) in 18. Therapy was switched in 10 patients on fluconazole and 3 on L-AmB. Case fatality rate was 11.4% (95%CI 4.39–23.91). No serious adverse drugs reactions or clinical side effects were observed. The knowledge of the local epidemiology helps to identify adequate prophylactic and treatment strategies.

Keywords: Extreme low birth weight; Fluconazole; Invasive fungal infection, Liposomal amphotericin B; Neonatal Intensive Care Units; Incidence rate; Case fatality rate.