Candidemia in neonates: a concerning threat in neonatal intensive care units

Neonatal sepsis is a significant health concern. Candida species are the leading cause of invasive fungal infections in neonatal intensive care units, accounting for 9-13% of bloodstream infections in neonates. Candida albicans is the most common causative agent, but nonalbicans candidial septicemia is becoming more common due to the increased use of azole drugs. This study aims to isolate and speciate Candida from suspected cases of neonatal sepsis, perform antifungal susceptibility testing, and demonstrate biofilm formation. The study involved isolation of Candida from neonates with a clinical diagnosis of septicaemia. Gram staining, germ tube test, pigmentation on Chrome Candida differential agar, and Dalmau plate culture were used to identify the organisms. Antifungal susceptibility testing was performed according to the Clinical Laboratory Standards Institute (CLSI) guidelines. Biofilm formation was detected by Microtiter Plate method. Out of 469 samples, 54 (11.51%) cases had isolation of Candida species. The predominant Candida isolates were Candida tropicalis. Among all the drugs tested, sensitivity of Candida isolates was lowest for fluconazole (70.37%), highest for Caspofungin (100%) and micafungin (100%). The Microtiter Plate Method revealed that 57.41% of the Candida isolates had formed biofilms. The study highlights the importance of identifying Candida species in neonatal septicemia.