| Persistent candidemia in neonatal care units: risk factors and clinical significance. | |
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MedLine Citation:
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PMID: 23276488 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVES: The prevalence and clinical significance of persistent candidemia among neonates are poorly understood. This study aimed to describe the rate and the clinical relevance of persistent candidemia over a 4-year period in Kuwait. METHODS: A retrospective chart review of infants admitted to the Neonatal Care Unit of the Maternity Hospital in Kuwait between January 2007 and December 2010, who had a positive blood culture for Candida species, was conducted. Persistent candidemia was defined as the isolation of the same Candida species more than 6 days after the initiation of antifungal therapy, or death due to candidemia within 6 days of antifungal treatment. Stepwise logistic regression was used to investigate factors associated with persistent candidemia. RESULTS: Of 89 neonates with a Candida infection, 54 (60.7%, 95% confidence interval 49.7-70.9%) had persistent candidemia. The case-fatality rate was 54% among those with persistent candidemia and 3% among those with non-persistent candidemia (p<0.001). Neonates with persistent candidemia were more likely to be female, have a central vascular catheter at diagnosis, and have a low platelet count. All isolated Candida species were susceptible to antifungal agents. CONCLUSIONS: Persistent candidemia is common among neonates with a Candida infection and is associated with an increased risk of mortality. Drug resistance is unlikely to explain the persistent candidemia; host-related factors seem to be more important and hence could be used to identify those at risk in order to institute appropriate preventive and treatment measures. |
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Authors:
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Majeda S Hammoud; Abdullah Al-Taiar; Mervat Fouad; Aditiya Raina; Ziauddin Khan |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-12-28 |
Journal Detail:
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Title: International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases Volume: - ISSN: 1878-3511 ISO Abbreviation: Int. J. Infect. Dis. Publication Date: 2012 Dec |
Date Detail:
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Created Date: 2013-1-1 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9610933 Medline TA: Int J Infect Dis Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012. Published by Elsevier Ltd. |
Affiliation:
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Department of Paediatrics, Faculty of Medicine, Kuwait University, PO Box 24923, Safat, Kuwait 13110. Electronic address: m.hammoud@hsc.edu.kw. |
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