[Colonization by Candida in a neonatal intensive care unit].

BACKGROUND: Candida infections have increased in the last few decades. Previous colonization is the most important risk factor for the development of fungemia. Understanding local epidemiology is necessary in order to select the optimal anti-fungal treatment. The purpose of this study was to establish colonization by Candida in patients, staff and medical devices in a neonatal intensive care unit.

METHODS: A prospective cohort study was conducted. Cultures were obtained from different anatomic sites, from medical devices and from the hands of healthcare staff at admission and every 7 days until discharge of the unit. Identification and susceptibility tests to amphotericin B, fluconazole, itraconazole, voriconazole and caspofungin were performed.

RESULTS: Out of 98 patients, 24 % were already colonized at admission, 15 % became colonized during their stay at the hospital. Out of 738 samples obtained from devices, 2 % were positive. Out of 89 cultures obtained from hands, 55 % were positive. A total of 124 Candida strains were retrieved; Candida parapsilosis was the most common species (59 %), followed by Candida albicans (26 %). Resistance to itraconazole was only found in 13 %.

CONCLUSIONS: Colonization in neonatal intensive care-admitted patients was 40 %, and it was a common event in the hands of the healthcare staff. Candida parapsilosis was the predominant species. Resistance was found only to itraconazole.