Abstract:
BACKGROUND: Candida infections have been on rise in ICU settings in recent trends , Candida cifferrii is very rare and emerging pathogen, with only few cases reported worldwide. Its identification has been challenging due to frequent misidentification and misclassification and much variable antifungal susceptibility, particularly resistance to azoles. Early recognition plays essential role in neonates, who are very vulnerable to invasive fungal infections.
METHODS: We describe a case series of three neonates admitted to our tertiary-level NICU in South India in whom Candida ciferrii was identified over a 6-month period. Clinical presentation, laboratory findings, risk factors, source of isolation, antifungal susceptibility, treatment and outcomes were analysed.
RESULTS: Candida ciferrii was identified in three newborns in tertiary level NICU , of which two had bloodstream infection and one had urinary tract infection. All neonates had identifiable risk factors, which included broad-spectrum antibiotic exposure and indwelling devices. The isolates demonstrated reduced susceptibility to fluconazole. Treatment response was favorable; neonates responded to treatment and showed negative follow up cultures and no recurrence was noted.
CONCLUSION : This case series highlights one of the very few documented neonatal clusters of Candida ciferrii. Given the organism’s rarity, potential for misidentification, and azole resistance, early species-level diagnosis and susceptibility-guided therapy are crucial for improving outcomes. Reporting such cases contributes to the growing recognition of this emerging yeast in neonatal care and supports the need for global understanding and management of the emerging pathogen in NICU.
Biography:
Dr. Aarushi Lall is a postgraduate trainee in Pediatrics with a special interest in neonatal infectious diseases and clinical research. She has worked in the NICU, especially focusing on rare fungal infections and the role of early diagnostics in improving outcomes. Her research experience includes area focussing on neonatal sepsis, respiratory disorders, and the application of AI in pediatric and neonatal care. She aims to contribute to evidence-based neonatal medicine through rigorous clinical research and international collaboration and contribute in development of neonatology across the world.Dr. Aarushi Lall is a postgraduate trainee in Pediatrics with a special interest in neonatal infectious diseases and clinical research. She has worked in the NICU, especially focusing on rare fungal infections and the role of early diagnostics in improving outcomes. Her research experience includes area focussing on neonatal sepsis, respiratory disorders, and the application of AI in pediatric and neonatal care. She aims to contribute to evidence-based neonatal medicine through rigorous clinical research and international collaboration and contribute in development of neonatology across the world.
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