Rafael Galván-Contreras, Unidad de Enfermedades Infecciosas y Epidemiología, Instituto Nacional de Perinatología, Ciudad de México, México
Ana K. Camarena-Abrego, Unidad de Enfermedades Infecciosas y Epidemiología, Instituto Nacional de Perinatología, Ciudad de México, México
Angélica Pedraza-Amador, Departamento de Infectología e Inmunología, Instituto Nacional de Perinatología, Ciudad de México, México
Agustín Del Prado-Palomares, Departamento de Infectología e Inmunología, Instituto Nacional de Perinatología, Ciudad de México, México
Background: Invasive candidiasis is a high-impact pathology in the neonatal intensive care unit (NICU). Objective: To evaluate risk factors for invasive candidiasis in a referral center in Mexico City. Material and methods: Observational casecontrol study. Neonates diagnosed with invasive candidiasis were included, matched 1:3 with controls hospitalized in the NICU of the National Institute of Perinatology in Mexico City between 2011 and 2021. Risk factors for invasive candidiasis were explored using logistic regression. Results: Among 2640 patients hospitalized in the NICU, we identified 51 cases of invasive candidiasis, with a prevalence of 1.95% (95%CI: 1.44-2.53). Invasive candidiasis cases were premature with low birth weight and higher exposure to antimicrobials compared to controls (n = 153). The most frequently isolated pathogens of invasive candidiasis were Candida albicans (62.7%), Candida parapsilosis (25.5%) and Nakaseomyces glabratus (5.9%). In multivariate analysis, gestational age at birth < 28 weeks (OR: 2.79; 95%CI: 1.05-7.43) and use of three or more antimicrobials prior to blood culture positivity (OR: 2.83; 95%CI: 1.22-6.59) were identified as risk factors for the development of invasive candidiasis compared to controls. Conclusions: Prematurity and higher exposure to multiple antimicrobial regimens increased the risk of invasive candidiasis in the NICU.
Keywords: Invasive candidiasis. Neonates. Risk factors. Broad-spectrum antimicrobials.