OBJECTIVE: To determine risk factors for late-onset candidemia among infants in the neonatal intensive care unit (NICU). STUDY DESIGN: We performed a matched case-control study from March 2001 to January 2003 in 2 level III-IV NICUs. Case subjects had candidemia diagnosed more than 48 hours after hospitalization. Control subjects (3 per case) were matched by study site, birth weight, study year, and date of enrollment. Potential risk factors included medical devices, medications, gastrointestinal (GI) pathology (congenital anomalies or necrotizing enterocolitis) and previous bacterial bloodstream infections (BSIs). RESULTS: Forty-five cases of candidemia occurred during the study period and accounted for 15% of BSIs. C. albicans caused 62% of infections (28/45); C. parapsilosis, 31% (14/45). Multivariate analysis revealed that catheter use (odds ratio [OR]=1.06 per day of use; 95% confidence interval [CI]=1.02 to 1.10), previous bacterial BSIs (OR=8.02; 95% CI=2.76 to 23.30) and GI pathology (OR=4.57; 95% CI=1.62 to 12.92) were significantly associated with candidemia. In all, 26/45 cases (58%) of candidemia occurred in infants who would not have qualified for fluconazole prophylaxis according to the Kaufman criteria. CONCLUSIONS: We confirmed previous risk factors (catheter-days) and identified novel risk factors (previous BSI and GI pathology) for candidemia in critically ill infants that could guide future targeted antifungal prophylaxis strategies.
OBJECTIVE: To determine risk factors for late-onset candidemia among infants in the neonatal intensive care unit (NICU). STUDY DESIGN: We performed a matched case-control study from March 2001 to January 2003 in 2 level III-IV NICUs. Case subjects had candidemia diagnosed more than 48 hours after hospitalization. Control subjects (3 per case) were matched by study site, birth weight, study year, and date of enrollment. Potential risk factors included medical devices, medications, gastrointestinal (GI) pathology (congenital anomalies or necrotizing enterocolitis) and previous bacterial bloodstream infections (BSIs). RESULTS: Forty-five cases of candidemia occurred during the study period and accounted for 15% of BSIs. C. albicans caused 62% of infections (28/45); C. parapsilosis, 31% (14/45). Multivariate analysis revealed that catheter use (odds ratio [OR]=1.06 per day of use; 95% confidence interval [CI]=1.02 to 1.10), previous bacterial BSIs (OR=8.02; 95% CI=2.76 to 23.30) and GI pathology (OR=4.57; 95% CI=1.62 to 12.92) were significantly associated with candidemia. In all, 26/45 cases (58%) of candidemia occurred in infants who would not have qualified for fluconazole prophylaxis according to the Kaufman criteria. CONCLUSIONS: We confirmed previous risk factors (catheter-days) and identified novel risk factors (previous BSI and GI pathology) for candidemia in critically ill infants that could guide future targeted antifungal prophylaxis strategies.
Authors: L Saiman; E Ludington; J D Dawson; J E Patterson; S Rangel-Frausto; R T Wiblin; H M Blumberg; M Pfaller; M Rinaldi; J E Edwards; R P Wenzel; W Jarvis Journal: Pediatr Infect Dis J Date: 2001-12 Impact factor: 2.129
Authors: Barbara J Stoll; Nellie Hansen; Avroy A Fanaroff; Linda L Wright; Waldemar A Carlo; Richard A Ehrenkranz; James A Lemons; Edward F Donovan; Ann R Stark; Jon E Tyson; William Oh; Charles R Bauer; Sheldon B Korones; Seetha Shankaran; Abbot R Laptook; David K Stevenson; Lu-Ann Papile; W Kenneth Poole Journal: Pediatrics Date: 2002-08 Impact factor: 7.124
Authors: Daniel K Benjamin; Elizabeth R DeLong; William J Steinbach; Charles M Cotton; Thomas J Walsh; Reese H Clark Journal: Pediatrics Date: 2003-09 Impact factor: 7.124
Authors: Ann Smith; Lisa Saiman; Juyan Zhou; Phyllis Della-Latta; Haomiao Jia; Philip L Graham Journal: Pediatr Infect Dis J Date: 2010-09 Impact factor: 2.129
Authors: Amanda B Arsenault; Kearney T W Gunsalus; Sonia S Laforce-Nesbitt; Lynn Przystac; Erik J DeAngelis; Michaela E Hurley; Ethan S Vorel; Richard Tucker; Nirupa R Matthan; Alice H Lichtenstein; Carol A Kumamoto; Joseph M Bliss Journal: Pediatr Infect Dis J Date: 2019-02 Impact factor: 2.129
Authors: David Trofa; Lamia Soghier; Christina Long; Joshua D Nosanchuk; Attila Gacser; David L Goldman Journal: Mycopathologia Date: 2011-06-12 Impact factor: 2.574
Authors: Jan Hau Lee; Christoph P Hornik; Daniel K Benjamin; Amy H Herring; Reese H Clark; Michael Cohen-Wolkowiez; P Brian Smith Journal: Pediatr Infect Dis J Date: 2013-03 Impact factor: 2.129