THE RESULTS OF ORAL NYSTATIN PROPHYLAXIS TO PREVENT INVASIVE CANDIDIASIS IN NEONATES UNDER 1500 GRAM AT CHILDREN'S HOSPITAL 2

Abstract

Backround: Invasive Candidiasis is a significant cause of sepsis in neonates weighted under 1500 grams, associates with high mortality and prolonged hospital stay. Many studies have shown that gastrointestinal fungal colonization increases the risk of invasive fungal infection. Prophylactic Oral Nystatin may reduce the incidence of gastrointestinal Candida colonization and invasive candidiasis.

Objectives: To determine the incidence of gastrointestinal fungal colonization; the rates of invasive candidiasis, mortality, and length of hospital stay between neonates under 1500 gram not receiving Nystatin and those receiving Nystatin at Children's Hospital No. 2.

Methods: A descriptive study conducted from October 2023 to April 2024, involving neonates weighted under 1500 grams and admitted to Children's Hospital No. 2. All neonates underwent weekly rectal swabs and those with fungi in their stool received Nystatin prophylaxis. l.

Results: Data from 100 neonates under 1500 gram were collected. The prevalence of gastrointestinal fungal colonization was 41% (OR = 1.79). The rates of invasive fungal infection were 15.3% and 24.4% (p = 0.25), mortality rates were 27.1% and 24.4% (p = 0.76), and the lengths of hospital stay were 43 days and 48 days (p = 0.17) in the non-Nystatin and Nystatin groups, respectively.

Conclusions: The rate of gastrointestinal fungal colonization in neonates under 1500 gram was high, increasing the risk of invasive fungal infections. The mortality rate and length of hospital stay for very low birth weight neonates with invasive fungal infections remain concerning. Nystatin plays a role in reducing gastrointestinal fungal colonization, thereby lowering the risk of invasive candidiasis.

Keywords: invasive candidiasis; gastrointestinal fungal colonization; very low birth weight neonates