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Clin Infect Dis. 2012 Feb 1;54(3):331-9. doi: 10.1093/cid/cir800. Epub 2011 Dec 5.

Outcomes following candiduria in extremely low birth weight infants.

Collaborators (170)

Jobe A, Caplan MS, Oh W, Laptook AR, Hensman AM, Leach TM, Noel L, Stephens BE, Andrews D, Angela K, Fanaroff AA, Newman NS, Friedman HG, Siner BS, Schibler K, Donovan EF, Yolton K, Alexander B, Bridges K, Gratton TL, Grisby C, JodyHessling, Mincey HL, Cotten C, Auten KJ, Fisher KA, Foy KA, Grimes S, Gustafson KE, Lohmeyer MB, Wang YF, Hale EC, Blackwelder A, Carlton DP, LaRossa MM, Carter S, Smikle G, Archer SW, Frantz ID 3rd, MacKinnon BL, Nylen E, Furey A, Sibley C, Brussa A, Poindexter BB, Lemons JA, Cook AB, Hamer F, Herron DE, Lytle C, Miller LC, Stahlke CL, Wilson LD, Poole W, Wallace D, Auman JO, Cunningham M, Gantz M, Irene AR, Hastings BK, McClure EM, Newman JE, Huitema CM, Pickett JW 2nd, Schaefer SE, Zaterka-Baxter KM, Van Meurs KP, Stevenson DK, Ball M, DeBattista AM, Davis AS, Kohn JG, Bentley B, Brudos GK, Pyle RP, Carlo WA, Ambalavanan N, Collins MV, Cosby SS, Biasini FJ, Johnston KC, Nelson KG, Patterson CS, Phillips VA, Rector RV, Whitley S, Finer NN, Rasmussen MR, Kaegi D, Arnell K, Demetrio C, Fuller MG, Henderson C, Rich W, Bell EF, Widness JA, Johnson KJ, Eastman DL, Duara S, Everett-Thomas R, MurWorth A, Calejo M, Diaz AN, Eguaras SM, Gideon YC, Hiriart-Fajardo S, Londono A, Mathews EO, Stroerger A, Ohls RK, Lacy CB, Phelps DL, Reubens LJ, Burnell E, Hust D, Jensen RL, Johnson JB, Kushner E, Yost K, Zwetsch L, Merzbach J, Sănchez PJ, Rosenfeld CR, Salhab WA, Miller NA, Guzman A, Hensley G, Leps MH, Heyne RJ, Morgan JS, Torres LE, Boatman CT, Adams SS, Heyne E, Madden LA, Kennedy KA, Tyson JE, Jiminez M, Morris BH, Siddiki S, Akpa EG, Alaniz NI, Dieterich S, Harris BF, Green C, Lis AE, Martin S, McDavid GE, Tate PL, Poundstone ML, Reddoch S, Simmons MC, Wright SL, O'Shea T, Peters NJ, Chiu K, Allred DE, Goldstein DJ, Peterson C, Waldrep EL, Washburn LK, Jackson BG, Bara R, Goldston L, Gettner P, Konstantino M, Poulsen J, Romano E, Taft J, Williams J.

Author information

Department of Pediatrics, Duke University, Durham, NC 27715, USA.



Candidiasis carries a significant risk of death or neurodevelopmental impairment (NDI) in extremely low birth weight infants (ELBW; <1000 g). We sought to determine the impact of candiduria in ELBW preterm infants.


Our study was a secondary analysis of the Neonatal Research Network study Early Diagnosis of Nosocomial Candidiasis. Follow-up assessments included Bayley Scales of Infant Development examinations at 18-22 months of corrected age. Risk factors were compared between groups using exact tests and general linear modeling. Death, NDI, and death or NDI were compared using generalized linear mixed modeling.


Of 1515 infants enrolled, 34 (2.2%) had candiduria only. Candida was isolated from blood only (69 of 1515 [4.6%]), cerebrospinal fluid (CSF) only (2 of 1515 [0.1%]), other sterile site only (not urine, blood, or CSF; 4 of 1515 [0.3%]), or multiple sources (28 of 1515 [2%]). Eleven infants had the same Candida species isolated in blood and urine within 3 days; 3 (27%) had a positive urine culture result first. Most urine isolates were Candida albicans (21 of 34 [62%]) or Candida parapsilosis (7 of 34 [29%]). Rate of death or NDI was greater among those with candiduria (50%) than among those with suspected but not proven infection (32%; odds ratio, 2.5 [95% confidence interval, 1.2-5.3]) after adjustment. No difference in death and death or NDI was noted between infants with candiduria and those with candidemia.


These findings provide compelling evidence that ELBW infants with candiduria are at substantial risk of death or NDI. Candiduria in ELBW preterm infants should prompt a systemic evaluation (blood, CSF, and abdominal ultrasound) for disseminated Candida infection and warrants treatment.

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