Document Detail


Trends in Candida central line-associated bloodstream infections among NICUs, 1999-2009.
MedLine Citation:
PMID:  22711720     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To assess trends in incidence of Candida spp. central line-associated bloodstream infections (CLABSIs) in US NICUs, 1999-2009.
METHODS: Data from NICUs participating in the National Nosocomial Infections Surveillance (1999-2004) and National Healthcare Safety Network (2006-2009) were analyzed. Overall and birth weight-specific incidence rates of Candida spp. CLABSIs per 1000 central line-days were calculated. Trends in incidence were assessed by using Poisson regression, and trends in proportion of CLABSIs identified as Candida albicans were assessed by using weighted-linear regression.
RESULTS: Overall, 398 NICUs reported 1407 Candida spp. CLABSIs (706 due to C albicans) among 1400 neonates. Of the 1400 neonates, 963 (69%) were ≤ 1000 g at the time of birth, and 182 (13%) died. From 1999 to 2009, the overall incidence decreased significantly for CLABSIs due to Candida spp. (0.92 vs 0.2), C albicans (0.53 vs 0.09), and non-albicans Candida spp. (0.39 vs 0.1). Birth weight-specific incidence significantly decreased across all birth weight categories for C albicans. For CLABSIs due to non-albicans Candida spp., significant decreases were detected among all birth weight categories, except among neonates 1501 to 2500 g. The proportion of Candida spp. CLABSIs due to C albicans did not significantly change over time, remaining at ~50%.
CONCLUSIONS: Incidence of Candida spp. CLABSIs decreased substantially among NICU patients, regardless of birth weight. Decreases in incidence across all birth weight categories, and not only among neonates ≤ 1000 g in whom antifungal prophylaxis may be more common, suggest that multiple factors contributed to the declining incidence.
Authors:
Amit S Chitnis; Shelley S Magill; Jonathan R Edwards; Tom M Chiller; Scott K Fridkin; Fernanda C Lessa
Publication Detail:
Type:  Journal Article     Date:  2012-06-18
Journal Detail:
Title:  Pediatrics     Volume:  130     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-07-03     Completed Date:  2012-09-10     Revised Date:  2014-03-13    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e46-52     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Birth Weight
Candida albicans
Candidemia / epidemiology*,  etiology,  prevention & control
Catheter-Related Infections / epidemiology*,  prevention & control
Catheterization, Central Venous / adverse effects*,  trends,  utilization
Cross Infection / epidemiology*,  etiology,  prevention & control
Humans
Incidence
Infant, Newborn
Infection Control
Intensive Care Units, Neonatal / statistics & numerical data*,  trends
Linear Models
Poisson Distribution
Population Surveillance
Regression Analysis
United States / epidemiology
Comments/Corrections
Comment In:
Rev Chilena Infectol. 2012 Aug;29(4):479   [PMID:  23096557 ]

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


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