Emerging Incidence of Candidemia in Neonatal Intensive Care Unit and Sick Newborn Care Unit in a Tertiary Care Hospital in Eastern India

Background: NICUs and SNCUs, especially resource-limited ones, are increasingly concerned about candidemia, a fungal bloodstream infection caused by Candida species. Prematurity, low birth weight, and protracted hospital stays put neonates in danger. Methods: From April 2022 to May 2023, 235 neonates in the NICU and SNCU at Anugrah Narayan Magadh Medical College & Hospital (ANMMCH), Gaya, Bihar, participated in this prospective observational study. Analyses included demographics, clinical risk factors, and test results. Candida species were isolated from blood cultures and tested for antifungal susceptibility. Results: Candidemia affected 19.1% of infants. Key risk factors included low birth weight (<1500 g), preterm birth (<32 weeks), prolonged hospital stay, invasive procedures, and prolonged antibiotic use. The most common species was Candida albicans, followed by C. parapsilosis, tropicalis, and glabrata. Amphotericin B and caspofungin were most effective, however, several isolates were fluconazole-resistant. Conclusion: The high incidence of candidemia highlights the need for targeted antifungal therapies and stringent infection control practices in NICUs and SNCUs. Effective treatment options such as amphotericin B and caspofungin are recommended, given observed resistance patterns.