Introduction 
Extremely Low birth Weight (ELBW<1000g) and Very Low Birth Weight (VLBW <1500g) neonates are at high risk of invasive candidiasis. We aim to identify the risk factors and outcomes associated with invasive candidiasis. 

Method- Retrospective review of neonates  <1500 g with positive blood culture for candida over 6 years (2011- 2016). Data was obtained from case notes and electronic database. A universal policy of antifungal prophylaxis for VLBW in NICU admissions was only introduced halfway through the study period.

Results- 12 neonates were identified to have positive blood culture for Candida. 9/12 (75%) were identified to have Candida albicans. Other subtypes were Candida species and Candida parapsilosis.

Median gestational age was 25 weeks (23- 29 weeks). Median birth weight was 750g (600-1460g). Median day of candidiasis was on day 17 of life.

8/12 (67%) were on broad-spectrum antibiotics when identified to have candidiasis.  6/12 (50%) had no antifungal prophylaxis. 9/12 (75%) were colonised prior to positive blood culture. 10 infants (83%) had central lines. 9/12 (75%) had thrombocytopenia (<100 x109/l). C- reactive protein (>40mg/litre) was seen in 7/12 (58%).

6/12 (50%) died. 3/6 deaths occurred during the acute episode of candidiasis and 3/6 later due to other co-morbidities. One neonate with late-onset candidiasis had parenchymal brain lesions. Echocardiography and renal scans were normal in this cohort.

Conclusion – 
Candida albicans was the commonest cause of invasive candidiasis. 92% (11/12) presented as late onset sepsis. Multi-systemic involvement is not commonly seen in invasive candidiasis.

NEONATAL CANDIDIASIS IN ELBW AND VLBW INFANTS IN A UK TERTIARY NICU - 6 YEAR REVIEW