الفهرس 
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Abstract
In our study, we found that smaller gestational age, lower birth weight and greater postnatal age as well as male gender and CS delivery were significantly associated with invasive fungal infections in neonates included.We also observed an association between low birth weight, prolonged hospitalization (>3 weeks),indwelling central venous catheters and mechanical ventilation or CPAP (>1 week) with increased risk of invasive candidiasis. No significant differences were found regarding prolonged use of antibiotic therapy, surgical interventionor total parenteral nutrition administration amongthe three studied groups.we found that white blood cells count was significantly higher,platelets count was significantly lower andCRP was significantly higher in Definite fungaemia group when compared to theother two groups.we found that the most common pathogens responsible for late onset sepsis wereGram negative bacteria in which Klebsiella spp and E coli were the leading microorganisms followed by Gram positive bacteria in which Coagulase negative Staphylococci and Staphylococcus aureus were the most often isolated pathogens. Fungi constituted 20.3% of themicroorganismsisolated where Candida albicans was the only isolated fungal growth. In our study, the sensitivity, specificity PPV,NPP and accuracy of the BD glucan assay at the best obtained cut-off value of 99pg/ml were 63.6%, 95.1%, 77.8%, 90.7% and88.5% respectively with a good AUC (0.837), good diagnostic accuracy (88.%) and 95% CI between 0.689-0.985. we found a significant negative correlation between BG concentration and gestational age as well as a significant positive correlation between BG concentration and CRP level in Definite fungaemia group when compared to the other two groups included. from our study, we can conclude that the best cut-off value of the BG assay used to detect fungaemia in neonates is 99 pg/mL with a good AUC and good accuracy. In addition, BG assay carries ahigh specificityand a low sensitivity that might allow its use as an adjunct in the early diagnosis of IFIs in neonates. Its excellent specificity and high negative predictive value suggest that BG assay could be useful for exclusion of IFI in suspected neonates based on a negative result. Accurate diagnosis and therapeutic decisions should be based on combining BG assay with other clinical, radiological and microbiological findings due to its limited sensitivity. Further studies are required to evaluate the influence of concurrent bacteremia on BG diagnostic performance, its optimal cut-off value and the change in the assay level in response to antifungal therapy in neonates. We acknowledge some limitations of our study including small sample size, heterogenous cohort of newborn infants included, two different centers manipulating the blood samples and the use of blood culture as a gold standard for diagnosis of neonatal fungaemia while it is only positive in 50% of IFI case.