FEATURES OF NEONATES TREATED WITH MICAFUNGIN FOR THE SUSPICION OF HAVING INVASIVE CANDIDA INFECTION IN THE DEPARTMENT OF PEDIATRICS OF THE UNIVERSITY HOSPITAL CENTRE SPLIT

Abstract

Cilj istraživanja: Procijeniti sigurnost mikafungina u liječenju suspektne invazivne kandidoze novorođenčadi te odrediti učestalost čimbenika rizika za razvoj iste. Materijali i metode: Retrospektivna analiza medicinske dokumentacije 28 novorođenčadi hospitalizirane u Klinici za dječje bolesti KBC Split u razdoblju od rujna 2014. do prosinca 2016. godine koji su liječeni mikafunginom zbog sumnje na invazivnu Candida infekciju. Prikupljeni podaci su uneseni u elektroničke tablice podataka i analizirani pomoću računalnog programa Microsoft Office Excel 2007. Rezultati: Terapija mikafunginom u novorođenčadi sa suspektnom invazivnom kandidozom nije uzrokovala nuspojave kao ni poremećaje u laboratorijskim nalazima. Od prisutnih čimbenika rizika za razvoj invazivne kandidoze najčešći promjenjivi je bio primjena antibiotika širokog spektra, a nepromjenjivi izrazito niska porođajna masa (ELBW). Simptomi i rizični čimbenici koji su upućivali na invazivnu kandidozu bili su češći u muške novorođenčadi (71.43 %) te se muški spol pokazao kao dodatni čimbenik rizika za razvoj ove infekcije u populaciji novorođenčadi. Zaključak: Istraživanje je opravdalo primjenu mikafungina kao jedinog ehinokandina odobrenog za populaciju novorođenčadi. Također, potvrđeno je da rano prepoznavanje čimbenika rizika i ordiniranje terapije znači i bolji ishod za novorođenčad.Objectives: to evaluate a safety of micafungin in the treatment of suspected neonate invasive candidiasis and to determine a frequency of risk factors for the development of invasive candidasis. Materials and methodes: A retrospective analysis of medical records of 28 neonates hospitalized in the Department of Pediatrics of the University Hospital Centre in the period from september 2014 to december 2016 who were treated with micafungin for the suspected invasive Candida infection. Collected data were taken in electronic data tables and analyzed by computer program Microsoft Office Excel 2007. Results: Micafungin treatment in neonates with suspected invasive candidiasis did not cause any adverse effects and there were no changes in laboratory values related to micafungin. Among the present risk factors for the development of invasive candidiasis, the most common modifiable risk factor were use of broad spectrum antibiotics, and the most commmon unmodifiable risk factor were extremly low birth weight (ELBW). Simptoms and risk factors referred to invasive candidiasis were more common in male neonates (71.43%) and male gender was shown to be an additional risk factor for this infection in the neonatal population. Conclusion: The study justified use of micafungin as only echinocandin for neonatal use. Also, is confirmed that early recognition of risk factors and early therapy results with a better ultimate outcome for neonates