Menu Close

Risk Factors for Invasive Candidiasis in Infants >1500 g Birth Weight

Citation

Lee, Jan Hau; Hornik, Christoph P.; Benjamin, Daniel K., Jr.; Herring, Amy H.; Clark, Reese H.; Cohen-Wolkowiez, Michael; & Smith, P. Brian (2013). Risk Factors for Invasive Candidiasis in Infants >1500 g Birth Weight. Pediatric Infectious Disease Journal, 32(3), 222-226. PMCID: PMC3578110

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 NICUs in the Pediatrix Medical Group from 2001-2010. Using multivariable logistic regression, we identified risk factors for invasive candidiasis.
RESULTS: Invasive candidiasis occurred in 330/530,162 (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 (OR 25.2; 95% CI 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.

URL

http://dx.doi.org/10.1097/INF.0b013e3182769603

Reference Type

Journal Article

Year Published

2013

Journal Title

Pediatric Infectious Disease Journal

Author(s)

Lee, Jan Hau
Hornik, Christoph P.
Benjamin, Daniel K., Jr.
Herring, Amy H.
Clark, Reese H.
Cohen-Wolkowiez, Michael
Smith, P. Brian

PMCID

PMC3578110