Prevalence of Candida species in umbilical catheters implanted in newborns in Natal, Brazil

English. All the newborns with umbilical venous catheters, hospitalized in the neonatal intensive care unit at Januário Cicco Maternity Hospital in Natal, Brazil, between January, 2003 and December, 2004 were studied. The prevalence of Candida species in the tips of intra-venous catheters was assessed, as well as the coexisting exposures that the patients were subjected to. Catheter tips were cultivated in blood agar and when yeast culture occurred, the colony was subcultivated for species identification through morphologic and biochemical assays. From a total of 240 catheters, 41 were positive for yeasts, and 34 were submitted to identification. The following agents were isolated: 13 C. albicans (38%), 10 Candida parapsilosis (29%), 8 C. tropicalis (20%), one C. guilliermondii (3%), one C. famata (3%) and one Trichosporon spp. (3%). Three patients among those with positive catheter tip fungal cultures were also hemoculture positive, with the same fungal species at both sites. Among the coexisting exposures, it should be pointed out that all the patients underwent broad spectrum antibiotic therapy, used a nasogastric probe, in addition to undergoing other invasive procedures such as mechanical ventilation and umbilical catheter implantation.

Portuguese. Foram estudados, entre janeiro de 2003 a dezembro de 2004, todos os recém-nascidos internados na UTI neonatal da Maternidade Escola Januário Cicco, portadores de cateter venoso umbilical. Avaliou-se a prevalência de espécies de Candida nas pontas de cateteres intra-venosos dos neonatos, e os fatores associados a que os pacientes estavam submetidos. As pontas de cateter foram cultivadas em ágar sangue, e, quando houve crescimento de colônia leveduriforme, esta foi subcultivada para a realização de provas morfológicas e bioquímicas para identificar a espécie. Do total de 240 cateteres analisados, 41 apresentaram crescimento de leveduras, sendo 34 encaminhados para identificação, observando-se os seguintes agentes: 13 C. albicans (38%), 10 Candida parapsilosis (29%), 8 C. tropicalis (20%), 1 C. guilliermondii (3%), 1 C. famata (3%) e 1 Trichosporon spp. (3%). Dos pacientes que apresentaram cultura de ponta de cateter positiva para fungos, três tiveram hemocultura positiva com a mesma espécie em ambos os sítios. Entre os fatores de risco destaca-se que todos os pacientes faziam uso de antibioticoterapia de amplo espectro, portavam sonda nasogástrica, além de outros procedimentos invasivos, como ventilação mecânica e cateter umbilical.