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Pediatr Infect Dis J. 2013 Mar;32(3):222-6. doi: 10.1097/INF.0b013e3182769603.

Risk factors for invasive candidiasis in infants >1500 g birth weight.

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1
Department of Pediatrics, Duke University Medical Center, Durham, NC, USA.

Abstract

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).

PMID:
23042050
PMCID:
PMC3578110
DOI:
10.1097/INF.0b013e3182769603
[Indexed for MEDLINE]
Free PMC Article
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