Abstract
Background Candida is a common cause of invasive fungal infection, which increases the risk of morbidity and mortality in neonates. The prevalence of neonatal candidemia has been reported in some regions; however, there is a dearth of studies on the prevalence, risk factors, and outcomes of neonatal candidemia in Arab countries. Therefore, we conducted this study to determine the prevalence, etiology, risk factors, and adverse outcomes of neonatal candidiasis in Saudi Arabian neonatal populations. Methods This was a retrospective cohort study of neonates admitted to the intensive neonatal care unit of our institution between January 2010 and December 2020. A standard questionnaire was used to collect data on sociodemographic and clinical factors, clinical course, and survival. Multivariate logistic regression analysis was performed to determine the adjusted effects of the risk factors for neonatal candidiasis, as well as its clinical course and outcomes. Results A total of 80 neonates were analyzed in this study. Approximately 30% of the neonates had positive Candida cultures, with Candida albicans being the predominant species (72.4%). Regarding the clinical course, 41.4% of the neonates were stable, whereas 58.9% died during treatment. Neonatal birth weight (odds ratio, OR = 0.16; 95% confidence interval, CI: 0.023-0.89), length of hospital stay before candidiasis diagnosis (OR = 1.16; 95% CI: 1.03-1.31), and total length of hospital stay (OR = 0.93; 95% CI: 0.88-0.97) were significant risk factors for mortality. Total length of hospital stay was the only demographic risk factor associated with the clinical course of neonatal candidiasis (OR = 0.97; 95% CI: 0.94-1.00); however, the association was marginally significant. Conclusion The results of this study suggest that the prevalence of neonatal candidiasis in Saudi Arabia is high, and that greater attention needs to be paid to low-birth-weight babies with a prolonged hospital stay. The results of this study can facilitate the development of a framework or treatment protocol specifically designed for neonates susceptible to candidiasis.