Cook, A;
Ferreras-Antolin, L;
Adhisivam, B;
Ballot, D;
Berkley, JA;
Bernaschi, P;
Carvalheiro, CG;
Chaikittisuk, N;
Chen, Y;
Chibabhai, V;
et al.
Cook, A; Ferreras-Antolin, L; Adhisivam, B; Ballot, D; Berkley, JA; Bernaschi, P; Carvalheiro, CG; Chaikittisuk, N; Chen, Y; Chibabhai, V; Chitkara, S; Chiurchiu, S; Chorafa, E; Dien, TM; Dramowski, A; de Matos, SF; Feng, J; Jarovsky, D; Kaur, R; Khamjakkaew, W; Laoyookhong, P; Machanja, E; Mussi-Pinhata, MM; Namiiro, F; Natraj, G; Naziat, H; Ngoc, HTB; Ondongo-Ezhet, C; Preedisripipat, K; Rahman, H; Riddell, A; Roilides, E; Russell, N; Sastry, AS; Tasimwa, HB; Tongzhen, J; Wadula, J; Wang, Y; Whitelaw, A; Wu, D; Yadav, V; Yang, G; Stohr, W; Bielicki, JA; Ellis, S; Warris, A; Heath, PT; Sharland, M
(2023)
Neonatal invasive candidiasis in low- and middle-income countries: Data from the NeoOBS study.
Med Mycol, 61 (3).
myad010.
ISSN 1460-2709
https://doi.org/10.1093/mmy/myad010
SGUL Authors: Cook, Aislinn Jane
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Abstract
Neonatal invasive candidiasis (NIC) has significant morbidity and mortality. Reports have shown a different profile of those neonates affected with NIC and of fluconazole-resistant Candida spp. isolates in low- and middle-income countries (LMICs) compared to high-income countries (HICs). We describe the epidemiology, Candida spp. distribution, treatment, and outcomes of neonates with NIC from LMICs enrolled in a global, prospective, longitudinal, observational cohort study (NeoOBS) of hospitalized infants <60 days postnatal age with sepsis (August 2018-February 2021). A total of 127 neonates from 14 hospitals in 8 countries with Candida spp. isolated from blood culture were included. Median gestational age of affected neonates was 30 weeks (IQR: 28-34), and median birth weight was 1270 gr (interquartile range [IQR]: 990-1692). Only a minority had high-risk criteria, such as being born <28 weeks, 19% (24/127), or birth weight <1000 gr, 27% (34/127). The most common Candida species were C. albicans (n = 45, 35%), C. parapsilosis (n = 38, 30%), and Candida auris (n = 18, 14%). The majority of C. albicans isolates were fluconazole susceptible, whereas 59% of C. parapsilosis isolates were fluconazole-resistant. Amphotericin B was the most common antifungal used [74% (78/105)], followed by fluconazole [22% (23/105)]. Death by day 28 post-enrollment was 22% (28/127). To our knowledge, this is the largest multi-country cohort of NIC in LMICs. Most of the neonates would not have been considered at high risk for NIC in HICs. A substantial proportion of isolates was resistant to first choice fluconazole. Understanding the burden of NIC in LMIC is essential to guide future research and treatment guidelines.
Item Type: | Article | |||||||||
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Additional Information: | © The Author(s) 2023. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. | |||||||||
Keywords: | Candida auris, Candida parapsilosis, candidiasis, low- and middle-income countries, neonatal candidemia, Antifungal Agents, Birth Weight, Candida, Candida albicans, Candida parapsilosis, Candidiasis, Invasive, Developing Countries, Drug Resistance, Fungal, Fluconazole, Microbial Sensitivity Tests, Prospective Studies, Humans, Infant, Newborn, Infant, Humans, Candida, Candida albicans, Birth Weight, Fluconazole, Antifungal Agents, Microbial Sensitivity Tests, Prospective Studies, Drug Resistance, Fungal, Developing Countries, Infant, Infant, Newborn, Candidiasis, Invasive, Candida parapsilosis, neonatal candidemia, low- and middle-income countries, Candida parapsilosis, candidiasis, Candida auris, 1108 Medical Microbiology, Microbiology | |||||||||
SGUL Research Institute / Research Centre: | Academic Structure > Infection and Immunity Research Institute (INII) | |||||||||
Journal or Publication Title: | Med Mycol | |||||||||
ISSN: | 1460-2709 | |||||||||
Language: | eng | |||||||||
Dates: |
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Publisher License: | Creative Commons: Attribution 4.0 | |||||||||
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PubMed ID: | 36881725 | |||||||||
Web of Science ID: | WOS:000951212800001 | |||||||||
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URI: | https://openaccess.sgul.ac.uk/id/eprint/115334 | |||||||||
Publisher's version: | https://doi.org/10.1093/mmy/myad010 |
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