Abstract
Systemic candidiasis, especially candidemia, is an increasing problem among high-risk neonates. Although possible predisposing factors have been suggested, no case-control study has evaluated potential risk factors. By retrospective chart review we identified 19 infants admitted to the NICU between 1976 and 1983 (0.9% of all admissions) who had documented candidemia prior to 4 months of age. 17 of 19 patients could be matched to a control infant selected on the basis of birthweight and date of NICU admission. We compared the duration of exposure to antibiotics, hyperalimentation and central venous and arterial catheters in cases to controls. We found that median duration in days (d) of exposure to several risk factors was significantly longer in patients compared to controls by Wilcoxon signed-rank test: all antibiotics 38 vs 14 d, p< .0004; aminoglycoside therapy 17 vs 7 d, p< .0004; nafcillin or vancomycin therapy 5 vs 0 d, p<.0014; hyperalimentation 19 vs 0 d, p<.0018; intralipid 13 vs 0 d, p< .008; endotracheal tube or tracheostomy 19 vs 1 d, p <.01; central venous catheters 10 vs 0 d, .05<p< .10; and umbilical artery catheters 12 vs 5 d, .05<p<.10. We conclude that in neonates development of candidemia is associated with (and possibly caused by) prolonged exposure to antibiotics, hyperalimentation, intralipid, and tracheal intubation. To the greatest extent possible consistent with good clinical care, exposure to these risk factors should be minimized.
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Weese-Mayer, D., Fondriest, D., Brouillette, R. et al. 1176 RISK FACTORS FOR CANDIDEMIA IN THE NEONATAL INTENSIVE CARE UNIT (NICU): A CASE-CONTROL STUDY. Pediatr Res 19, 306 (1985). https://doi.org/10.1203/00006450-198504000-01206
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DOI: https://doi.org/10.1203/00006450-198504000-01206