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J Pediatr. 2013 Oct;163(4):961-7.e3. doi: 10.1016/j.jpeds.2013.04.034. Epub 2013 May 30.

Neurodevelopmental outcome of extremely low birth weight infants with Candida infection.

Collaborators (167)

Jobe AH, 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, Hessling J, 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, Minnich HM, 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, Bridge R, Demetrio C, Fuller MG, Henderson C, Rich W, Bell EF, Widness JA, Johnson KJ, Eastman DL, Everett-Thomas R, Worth AM, 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, Rosenfeld CR, Salhab WA, Guzman A, Hensley G, Leps MH, 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.

Author information

Department of Pediatrics, Emory University, Atlanta, GA. Electronic address:



Candida remains an important cause of late-onset infection in preterm infants. Mortality and neurodevelopmental outcome of extremely low birth weight (ELBW) infants enrolled in the Candida study were evaluated based on infection status.


ELBW infants born at Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network (NRN) centers between March 2004 and July 2007 who were screened for suspected sepsis were eligible for inclusion in the Candida study. Primary outcome data for neurodevelopmental impairment (NDI) or death were available for 1317 of the 1515 infants (87%) enrolled in the Candida study. The Bayley Scales of Infant Development-II or -III was administered at 18 months' adjusted age. A secondary comparison was performed with 864 infants enrolled in the NRN Generic Database during the same cohort who were never screened for sepsis and therefore not eligible for the Candida study.


Among ELBW infants enrolled in the Candida study, 31% with Candida and 31% with late-onset non-Candida sepsis had NDI at 18 months. Infants with Candida sepsis and/or meningitis had an increased risk of death and were more likely to have the composite outcome of death and/or NDI compared with uninfected infants in adjusted analysis. Compared with infants in the NRN registry never screened for sepsis, overall risk for death were similar but those with Candida infection were more likely to have NDI (OR 1.83, 95% CI 1.01-3.33, P = .047).


In this cohort of ELBW infants, those with infection and/or meningitis were at increased risk for death and/or NDI. This risk was highest among those with Candida sepsis and/or meningitis.


BSID; Bayley Scales of Infant Development; CLD; CNS; CP; CSF; Central nervous system; Cerebral palsy; Cerebrospinal fluid; Chronic lung disease; ELBW; EOS; Early-onset sepsis; Eunice Kennedy Shriver National Institute of Child Health and Human Development; Extremely low birth weight; GA; GDB; Generic database; Gestational age; IVH; Intraventricular hemorrhage; LOS; Late-onset sepsis; ND; NDI; NEC; NICHD; NRN; Necrotizing enterocolitis; Neonatal Research Network; Neurodevelopmental; Neurodevelopmental impairment; PVL; Periventricular leukomalacia

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