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Clinical characteristics and response to prophylactic fluconazole of preterm VLBW neonates with baseline and acquired fungal colonisation in NICU: data from a multicentre RCT.

Publication ,  Journal Article
Manzoni, P; Mostert, M; Latino, MA; Pugni, L; Stolfi, I; Decembrino, L; Vagnarelli, F; Corona, G; Tridapalli, E; Vetrano, G; Memo, L; Gallo, E ...
Published in: Early Hum Dev
May 2012

BACKGROUND: Fungal colonisation by Candida spp. affects a high proportion of VLBW neonates in NICU. However, few data are available on the clinical characteristics of colonisation in preterm infants who are colonised at baseline via vertical transmission, compared to preterms who become colonised during their stay in NICU via horizontal transmission. MATERIAL AND METHODS: We reviewed the database of a multicentre, randomised trial of prophylactic fluconazole in VLBW neonates conducted in 8 Italian NICUs in the years 2004 and 2005 (Manzoni et al., NEJM 2007;356(24):2483-95). Per the protocol, all enrolled infants underwent weekly surveillance cultures from birth till discharge. We investigated the frequency of the two different modalities of Candida colonisation in this population, as well as the clinical and outcome characteristics possibly related to them. RESULTS: Overall, Candida colonisation affected 54 of 336 infants (16.1%). Baseline (i.e., detected <3(rd) day of life) colonisation affected 16 (4.7%), and acquired 38 (11.4%), of the 54 colonised preterms. Infants with baseline colonisation had significantly higher birth weight (1229 ± 28 g vs. 1047 g ± 29, p = 0.01) and gestational age (30.2 wks ± 2.7 vs. 28.5 wks ± 2.6, p = 0.01), and were significantly more likely to limit progression from colonisation to invasive Candida infection when fluconazole prophylaxis was instituted (21.6% vs. 42.7%, p = 0.009). Isolation of C. parapsilosis was significantly more frequent in infants with acquired colonisation. CONCLUSIONS: Infants with baseline and acquired colonisation differ for demographics characteristics and for their response to fluconazole prophylaxis. This information may be useful for targeting more accurate management strategies for these two different groups of colonised preterms in NICU.

Duke Scholars

Published In

Early Hum Dev

DOI

EISSN

1872-6232

Publication Date

May 2012

Volume

88 Suppl 2

Start / End Page

S60 / S64

Location

Ireland

Related Subject Headings

  • Premature Birth
  • Pediatrics
  • Male
  • Intensive Care Units, Neonatal
  • Infectious Disease Transmission, Vertical
  • Infant, Very Low Birth Weight
  • Infant, Premature, Diseases
  • Infant, Premature
  • Infant, Newborn
  • Infant
 

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Manzoni, P., Mostert, M., Latino, M. A., Pugni, L., Stolfi, I., Decembrino, L., … Italian Task Force for the Study and Prevention of Neonatal Fungal Infections; Italian Society of Neonatology, . (2012). Clinical characteristics and response to prophylactic fluconazole of preterm VLBW neonates with baseline and acquired fungal colonisation in NICU: data from a multicentre RCT. Early Hum Dev, 88 Suppl 2, S60–S64. https://doi.org/10.1016/S0378-3782(12)70017-8
Manzoni, P., M. Mostert, M. A. Latino, L. Pugni, I. Stolfi, L. Decembrino, F. Vagnarelli, et al. “Clinical characteristics and response to prophylactic fluconazole of preterm VLBW neonates with baseline and acquired fungal colonisation in NICU: data from a multicentre RCT.Early Hum Dev 88 Suppl 2 (May 2012): S60–64. https://doi.org/10.1016/S0378-3782(12)70017-8.
Manzoni P, Mostert M, Latino MA, Pugni L, Stolfi I, Decembrino L, et al. Clinical characteristics and response to prophylactic fluconazole of preterm VLBW neonates with baseline and acquired fungal colonisation in NICU: data from a multicentre RCT. Early Hum Dev. 2012 May;88 Suppl 2:S60–4.
Manzoni, P., et al. “Clinical characteristics and response to prophylactic fluconazole of preterm VLBW neonates with baseline and acquired fungal colonisation in NICU: data from a multicentre RCT.Early Hum Dev, vol. 88 Suppl 2, May 2012, pp. S60–64. Pubmed, doi:10.1016/S0378-3782(12)70017-8.
Manzoni P, Mostert M, Latino MA, Pugni L, Stolfi I, Decembrino L, Vagnarelli F, Corona G, Tridapalli E, Vetrano G, Memo L, Priolo C, Galletto P, Giovannozzi C, Gallo E, Pedicino R, Barberi I, Faldella G, Mosca F, Saia OS, Bollani L, Maragliano R, Ruffinazzi G, Tzialla C, Stronati M, Rizzollo S, Farina D, Benjamin DK, Smith PB, Jacqz-Aigrain E, Kaguelidou F, Cohen-Wolkowiez M, Italian Task Force for the Study and Prevention of Neonatal Fungal Infections; Italian Society of Neonatology. Clinical characteristics and response to prophylactic fluconazole of preterm VLBW neonates with baseline and acquired fungal colonisation in NICU: data from a multicentre RCT. Early Hum Dev. 2012 May;88 Suppl 2:S60–S64.
Journal cover image

Published In

Early Hum Dev

DOI

EISSN

1872-6232

Publication Date

May 2012

Volume

88 Suppl 2

Start / End Page

S60 / S64

Location

Ireland

Related Subject Headings

  • Premature Birth
  • Pediatrics
  • Male
  • Intensive Care Units, Neonatal
  • Infectious Disease Transmission, Vertical
  • Infant, Very Low Birth Weight
  • Infant, Premature, Diseases
  • Infant, Premature
  • Infant, Newborn
  • Infant