IMPORTANCE OF ORAL NYSTATIN
PROPHYLAXİS TO PREVENT CANDIDA OUTBREAK IN THE NEONATAL INTENSIVE CARE UNIT
Öztürk MA, Çetin N, Güneş T, Akçakuş M,Kurtoğlu
S, Kuyucu T
Erciyes University, Medical Faculty, Pediatrics Dept.,
Kayseri, Turkey
Objective: Candida specious are
important nosocomial pathogens in Neonatal Intensive Care Units(NICU). The
aim of this study was to assess selective
decontamination of the digestive tract with oral nystatin as a measure to
control Candida outbreak in our neonatal intensive care unit.
Methods: During the first period of study (from January 1999 until
July 2000) 2559 babies
admitted to the admissions to
the NICU and nystatin was not used as prophylactic. All neonates (995
admissions) who were admitted to the NICU between July 2000- February 2001, received oral nystatin
for prophylaxis (100 000 IU/kg/24 hr, div, every 8 hr). There was no difference between invasive attemts ( e.g. ventilator terapy,
parenteral nutrition, central arterial or venous catheters etc.) , the use
of broad spectrum antibiotics,
glucocorticoids and gestational ages between the two groups.
Results: Before selective decontamination
with nystatin, the incidence of candida sepsis was 8.61 % (224 cases). 175
(78.10 %) of contaminated cases were Candida pelliculosa, and 49 ( 21.90 %) were Candida
albicans. These patients were treated with amphotericin B or fluconazole.
After selective decontamination
with nystatin in all patients, the incidence of candida sepsis dropped
below 1,60 %. 9 (56.20%) of these
were Candida
pelliculosa, 7 (43.80 %) of these were Candida albicans.
Conclusion: These data suggested that selective
decontamination with nystatin for control of candida outbreak in the
Neonatal Intensive Care Unit was very effective.