Abstract :
Latar belakang: Spesies Candida merupakan patogen yang
didapat di rumah sakit yang penting terutama pada bayi yang
masuk perawatan intensif neonatus (NICU). Penelitian ini
dilakukan di NICU Rumah Sakit Arab Saudi, Riyadh, KSA untuk
menganalisis pola kolonisasi Candida pada neonatus beserta
menentukan faktor risiko potensial.
Metode: Kultur jamur surveilans mingguan dilakukan pada
daerah anus, rongga mulut, umbilikus, dan liang telinga pada
neontaus dilakukan saat lahir sampai pasien dipulangkan dari
rumah sakit. Kolonisasi dianalisis berdasarkan waktu, tempat,
spesies, berat lahir, dan usia gestasi. Sumber lingkungan
potensial dan tangan dari petugas kesehatan juga dilakukan
kultur jamur setiap bulan. Uji kepekaan antijamur juga
dilakukan.
Hasil: 100 subjek diajak untuk penelitian ini. Jumlah kolonisasi
secara keseluruhan 51%. Kolonisasi awal didapatkan pada 27
neonatus (27%) sedangkan 24 neonatus (24%) didapatkan
pada saat akhir perawatan di NICU. Daerah perianal dan rongga
mulut merupakan daerah kolonisasi tersering. C. albicans
merupakan spesies isolat terbanyak (56,8% dilanjutkan C.
tropicalis (17,6%), C. glabrata (15,6%), dan C. krusei (2%).
Dari 51 isolat Candida, 68,6% sensitif terhadap flukonazol,
80% terhadap itrakonazol, dan 64,7% terhadap ketokonazol,
sedangkan hanya 33% yang sensitif terhadap amfoterisin B.
Kesimpulan: Candida merupakan penyebab umum infeksi pada
bayi yang masuk ke NICU dan C. albicans merupakan spesies
Candida tersering. Infeksi neonatus yang disebabkan spesies nonalbicans
timbul pada usia yang lebih lanjut selama dirawat di
NICU. Background: Candida species are important hospitalacquired
pathogens in infants admitted to the neonatal
intensive care unit (NICU). This study was performed in
the NICU of Saudi Arabian Hospital, Riyadh region, KSA to
analyze patterns of neonatal Candida colonization as well as
to determine the potential risk factors.
Methods: Weekly surveillance fungal cultures of anal
area, oral cavity, umbilicus and ear canal of neonates
were performed from birth until their discharge from the
hospital. Colonization was analyzed for timing, site, species,
birth weight and gestational age. Potential environmental
reservoirs and hands of health care workers (HCWs) were
also cultured monthly for fungi. Antifungal susceptibility of
the identified isolates was also determined.
Results: One hundred subjects have been recruited in
this study. The overall colonization rate was 51%. Early
colonization was found in 27 (27%) neonates whereas 24
(24%) neonates were lately colonized during their stay in
NICU. Colonization was more in preterm neonates than in
full and post term. Perianal area and oral cavity were the
most frequent colonized sites. C. albicans was the main spp.
(58.8%) isolated from the neonates followed by C. tropicalis
(17.6%), C. glabrata (15.6%), and C. krusei (2%). Of the 51
isolated Candida spp., 68.6% were sensitive to fluconazole,
80% to itraconazole and 64.7% to ketoconazole, while only
33% were sensitive to amphotericin B.
Conclusion: Candida has emerged as a common cause of
infections in infants admitted to NICU, and C. albicans is
the most commonly isolated candidal species. Neonatal
infections caused by non- albicans species occur at a later
age during their stay in NICU.
