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Dr. Mahmuda Hassan Associate professor Dept. of Pediatrics Ad-din Medical college Hospital, Dhaka E-mail mahmudahasn@yahoo.com Introduction Fungal septicemia is a devastating disease in the neonate, especially in the preterm low birth weight (PTLBW) infant. They are vulnerable to disseminated fungal sepsis due to lack of innate and the acquired immunity. Invasive fungal infection, predominantly due to Candida species, is an increasingly common cause of mortality and morbidity in preterm and sick newborn infants. In the last 25 years the incidence is increasing may be due to the increased survival rates of preterm low birth or very low birth weight (VLBW) and sick neonates. Specially due to the intensive nature of the care with many invasive procedures what these infants receive in the neonatal intensive care unit. Candida species are commensal organisms that colonise the skin, gastrointestinal tract and the female genitourinary tract. The vast majority of fungal infections in preterm neonates are due to Candida species, The early NICU course favors colonization and proliferation of fungi since many VLBW infants have central vascular catheters and are exposed to broad-spectrum antibiotics and parenteral nutrition. Mortality figures can vary between 15%and 59% and Candida species (Candida albicans, C. krusei and C. parapsilosis) are considered the third most common causeof late-onset sepsis in the NICU. Incidence rates have rangedfrom 2.6% to 16.7% among the VLBW infants and from 5.5% to 20% among extremely low birth weight infants (ELBW), with a mortality rate of around 30%. In one study fungal septicemia was demonstrated as a devastating disease in the neonate, in the VLBW premature infant who is especially vulnerable to disseminated fungal sepsis. Invasive fungal infection is defined as positive fungal cultures from blood, cerebrospinal fluid or urine (collected by suprapubic aspiration or bladder catheterisation). Invasive fungal infection is usually nosocomially acquired. It accounts for approximately 10% of all first episodes of late onset sepsis in VLBW babies. The incidence peaks between 2-6 weeks of age and in the UK the median age at diagnosis is 14 days.

Fungal sepsis and Indications of antifungal prophylaxis and treatment in neonatal intensive care units : A review