Invasive Candidiasis in Newborns Report of Cases and Review of Literature Diagnosis, Treatment and Prevention

Introduction: Neonatal invasive candidiasis is associated with significant morbidity and mortality, currently there is greater survival of critically ill newborn patients predominantly premature newborns, and then it has increased invasive fungal infections reports, being a common problem present in the neonatal intensive care units (NICU). Objective: This review proposes to carry out actions to prevent, give treatment and monitor invasive candidiasis in the newborn infant. by reviewing the cases reported in the HMI GV Edo de Mex. And in that way determine the modalities in which this condition occurs. Consequently, make an effective and timely management Methods: The review of the documented cases of critically ill patients diagnosed with Invasive Candidiasis, Hospitalized in the NICU area from October 2016 to February 2019, was carried out retrospectively, identifying as factors of risk those previously described being the main ones, prematurity, use of central vascular lines, exposure to broad spectrum antibiotics, as well as forms of presentation, gestational age, sex and weight of affected patients. Results: In this Institution during the year 2018 there were a total of 3585 births of which 8.89% (n = 319) required hospitalization for different causes, the main one being: Prematurity, In this article the incidence of invasive candidiasis in the same time span of the sample, adding a total of 29 patients (n = 29) 8 of these hospitalized in the year 2018, corresponding to a 0.22% of the income, of the total of patients (n = 29) the gestational ages were report between week 29 to 40 of gestation, and weights from 1000 g 2800 grams. In relation to the sex of the patients, it predominated in the masculine in 62.06% (n = 18) and feminine in 37.9% (n = 11). The largest number of affected patients presented between week 30 34. The whole of the sample cited 100% (n = 29) course with invasive Candidiasis = Neonatal Sepsis, In addition some patients attended with invasion to other devices and systems, causing endocarditis (n = 2) (6.8%), neuroinfection: (n = 1) (3.4%), hepatic colonization (n = 1) (3.4%) and Urosepsis n = 1 (3.4%), discarding in all of them intraocular injury. They were treated with antifungal schemes according to clinical practice practices in Mexico: fluconazole, amphotericin, B dexosicolate, Caspofungin and finally Voriconazole in patients with Candida spp. Resistant to the previously mentioned medications. The above according to the form of presentation and prior consent of the parents. The final decrease in n = 3 cases unfortunately and given the seriousness and acuteness with which the disease was presented was the death of patients, otherwise high at home with respective references for follow-up in the third level of health care. Conclusions: Neonatal Sepsis secondary to Candida spp in the Newborn is an important cause of morbidity and mortality in the NICU. In a newborn with risk factors and suspected infection, it is recommended to initiate an intentional search, with study and tracking of all the diana organs, when confirming the presence by blood culture and other indicators, specific antifungal treatment should be provided according to location or systems affected and the central vascular access lines should be removed within 24 hours to avoid colonization of the fungus. with the implementation of Essential Actions of patient safety, as a method for the prevention of nosocomial infections. Those patients who had repercussions to other target organs, were directed to their exit to Hospitals that have the medical elements to continue treatment (at Cardiovascular and Neurological level). As soon as its impact exists in Neurodevelopment, it is necessary to initiate a long-term surveillance scheme. Besides that, more studies are needed to evaluate the toxicity of Voriconazole in the newborn. It is working jointly with the authorities, both health and government, to carry out care in an effective and timely way, as well as insisting totally in the culture of prevention of premature birth.