A retrospective analysis of the incidence of invasive candidiasis in the extreme - and very low birth weight neonates admitted to the neonatal ICU and high care unit in Universitas Academic Hospital over a 2 year period from January 2016 to December 2017 to determine if the unit will qualify for the use of fluconazole prophylaxis

De Klerk, Leandri

A retrospective analysis of the incidence of invasive candidiasis in the extreme - and very low birth weight neonates admitted to the neonatal ICU and high care unit in Universitas Academic Hospital over a 2 year period from January 2016 to December 2017 to determine if the unit will qualify for the use of fluconazole prophylaxis

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DeKlerkL.pdf (2.41 MB)

Date

2020-06

Authors

De Klerk, Leandri

Publisher

University of the Free State

Abstract

Background: Invasive Candida infection is a leading cause of mortality and morbidity during the neonatal period, specifically in premature neonates admitted to intensive care units. Fluconazole prophylaxis has been proven to effectively reduce the incidence of invasive candidiasis in neonates admitted to high care facilities. Methods: A retrospective, descriptive, cross-sectional, non-experimental study was conducted. Data was collected from the Meditech and National Health Laboratory Service databases. Positive culture results on sterile body fluids were analyzed to determine the incidence of invasive candidemia in the neonatal unit at Universitas Academic Hospital. Sterile body fluids included blood, urine and cerebrospinal fluid. Results: The results revealed an incidence of 13.5% of invasive candidiasis in the extremely- and very low birth weight neonates admitted to the neonatal unit at Universitas Academic Hospital. These results included all the positive cultures done on urine, cerebrospinal fluid and blood. The study population was 324 neonates admitted to the neonatal unit of Universitas Academic Hospital with a birth weight of less than 1.5 kg for the years 2016 and 2017. The population group included 183 female neonates (56%) and 141 male neonates (44%). The median gestational age was 29 weeks and the median birth weight was 1110g. The positive Candida culture results included 43 blood cultures, 5 urine cultures and zero cerebrospinal fluid cultures. Conclusion: The incidence rate for invasive candidiasis in very low birth weight and extremely low birth weight neonates at Universitas Academic Hospital was 13.5% during the study period. Previous research studies concluded that an incidence rate higher than ten percent of invasive Candida infection is significant and a neonatal unit will benefit from the use of fluconazole prophylaxis. Decreasing the incidence will have a direct effect on the morbidity associated with neonatal invasive Candida infection. The recommendation following the findings of the study would be to include the use of fluconazole prophylaxis as standard of care in the neonatal unit at Universitas Academic Hospital and to adapt policies and protocols accordingly.

Keywords

Dissertation (M.Med. (Paediatrics and Child Health))--University of the Free State, 2020, Neonate, Fluconazole, Prematurity, Prophylaxis, Incidence, Extremely low birth weight, Very low birth weight, Invasive candidiasis, Meditech