Document Detail

Risk factors for invasive candidiasis in infants >1500 g birth weight.
MedLine Citation:
PMID:  23042050     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: We describe the incidence, risk factors and outcomes of invasive candidiasis in infants >1500 g birth weight.
METHODS: We conducted a retrospective cohort study of infants >1500 g birth weight discharged from 305 neonatal intensive care units in the Pediatrix Medical Group from 2001 to 2010. Using multivariable logistic regression, we identified risk factors for invasive candidiasis.
RESULTS: Invasive candidiasis occurred in 330 of the 530,162 (0.06%) infants. These were documented from positive cultures from ≥1 of these sources: blood (n = 323), cerebrospinal fluid (n = 6) or urine from catheterization (n = 19). Risk factors included day of life >7 (odds ratio [OR]: 25.2; 95% confidence interval: 14.6-43.3), vaginal birth (OR: 1.6 [1.2-2.3]), exposure to broad-spectrum antibiotics (OR: 1.6 [1.1-2.4]), central venous line (OR: 1.8 [1.3-2.6]) and platelet count <50,000/mm (OR: 3.7 [2.1-6.7]). All risk factors had poor sensitivities, low positive likelihood ratios and low positive predictive values. The combination of broad-spectrum antibiotics and low platelet count had the highest positive likelihood ratio (46.2), but the sensitivity of this combination was only 4%. Infants with invasive candidiasis had increased mortality (OR: 2.2 [1.3-3.6]).
CONCLUSIONS: Invasive candidiasis is uncommon in infants >1500 g birth weight. Infants at greatest risk are those exposed to broad-spectrum antibiotics and with platelet counts of <50,000/mm(3).
Jan Hau Lee; Christoph P Hornik; Daniel K Benjamin; Amy H Herring; Reese H Clark; Michael Cohen-Wolkowiez; P Brian Smith
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Pediatric infectious disease journal     Volume:  32     ISSN:  1532-0987     ISO Abbreviation:  Pediatr. Infect. Dis. J.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-04-05     Completed Date:  2013-09-19     Revised Date:  2014-03-09    
Medline Journal Info:
Nlm Unique ID:  8701858     Medline TA:  Pediatr Infect Dis J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  222-6     Citation Subset:  IM    
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MeSH Terms
Anti-Bacterial Agents / adverse effects,  therapeutic use
Birth Weight
Blood / microbiology
Candidiasis, Invasive / epidemiology*,  mortality
Cerebrospinal Fluid / microbiology
Infant, Newborn
Risk Factors
Treatment Outcome
Urine / microbiology
Grant Support
1K23HD060040-01/HD/NICHD NIH HHS; 1K23HD064814-01/HD/NICHD NIH HHS; 1K24HD058735-01/HD/NICHD NIH HHS; 1R01FD003519-01/FD/FDA HHS; 1R01HD057956-02/HD/NICHD NIH HHS; 1U10-HD45962-06/HD/NICHD NIH HHS; DHHS-1R18AE000028-01/AE/ASPE HHS; HHSN267200700051C/HD/NICHD NIH HHS; HHSN267200700051C//PHS HHS; HHSN275201000002I//PHS HHS; HHSN275201000003I/HD/NICHD NIH HHS; K23 HD060040/HD/NICHD NIH HHS; K23 HD064814/HD/NICHD NIH HHS; K24 HD058735/HD/NICHD NIH HHS; R01 HD057956/HD/NICHD NIH HHS; U10 HD045962/HD/NICHD NIH HHS
Reg. No./Substance:
0/Anti-Bacterial Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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