Document Detail


Candidal and bacterial bloodstream infections in premature neonates: a case-control study.
MedLine Citation:
PMID:  11270410     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Nosocomial bloodstream infections (BSI) in premature neonates are an important cause of morbidity and mortality. The early and efficient diagnosis of a neonatal BSI and the differentiation between bacterial and fungal BSI remains a challenging task. We compared the clinical features and blood test results in preterm infants with proven candidal or bacterial BSI in order to identify potential risk factors for developing a candidal BSI. Preterm infants with proven candidal BSI were significantly more prematurely born (mean age of gestation 27.7 vs. 29.8 weeks), had previously received significantly more antibiotics of multiple classes (mean 4.4 vs. 1.2) for significantly longer periods (mean 19.3 vs. 3.2 days), were ventilated more intensively, had a significantly longer stay at the neonatal intensive care unit before the onset of the BSI (mean 26.5 vs. 9.4 days), and had C-reactive protein values even higher than in preterm infants with a bacterial BSI (mean 90 vs. 71 mg l(-1)). The presence of thrombocytopenia ( < 150 x 10(9) cells l(-1)) in all the preterm infants with candidal BSI was a significant difference. No differences were seen with regard to birth-weight, use of central intravascular catheters, total parenteral nutrition, white blood cell count and differentiation. In conclusion, candidal BSI can be strongly expected after the third week of admittance in the most premature neonates on a respirator and treated with multiple classes of antibiotics for a prolonged period of time. The presence of these risk factors in a 'septic' premature infant on antibiotic treatment justifies the empiric use of antifungals.
Authors:
A Warris; B A Semmekrot; A Voss
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Medical mycology     Volume:  39     ISSN:  1369-3786     ISO Abbreviation:  Med. Mycol.     Publication Date:  2001 Feb 
Date Detail:
Created Date:  2001-03-28     Completed Date:  2001-09-06     Revised Date:  2013-12-13    
Medline Journal Info:
Nlm Unique ID:  9815835     Medline TA:  Med Mycol     Country:  England    
Other Details:
Languages:  eng     Pagination:  75-9     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Anti-Bacterial Agents / therapeutic use
Bacteremia / complications,  diagnosis,  etiology*
C-Reactive Protein / analysis
Candidiasis / etiology*,  physiopathology
Case-Control Studies
Cross Infection / etiology*,  microbiology,  physiopathology
Fungemia / complications,  diagnosis,  drug therapy,  etiology*,  physiopathology
Humans
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / etiology*
Risk Factors
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 9007-41-4/C-Reactive Protein

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