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

Publication ,  Journal Article
Lee, JH; Hornik, CP; Benjamin, DK; Herring, AH; Clark, RH; Cohen-Wolkowiez, M; Smith, PB
Published in: Pediatr Infect Dis J
March 2013

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).

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Published In

Pediatr Infect Dis J

DOI

EISSN

1532-0987

Publication Date

March 2013

Volume

32

Issue

3

Start / End Page

222 / 226

Location

United States

Related Subject Headings

  • Urine
  • Treatment Outcome
  • Risk Factors
  • Pediatrics
  • Male
  • Infant, Newborn
  • Infant
  • Incidence
  • Humans
  • Female
 

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Lee, J. H., Hornik, C. P., Benjamin, D. K., Herring, A. H., Clark, R. H., Cohen-Wolkowiez, M., & Smith, P. B. (2013). Risk factors for invasive candidiasis in infants >1500 g birth weight. Pediatr Infect Dis J, 32(3), 222–226. https://doi.org/10.1097/INF.0b013e3182769603
Lee, Jan Hau, Christoph P. Hornik, Daniel K. Benjamin, Amy H. Herring, Reese H. Clark, Michael Cohen-Wolkowiez, and P Brian Smith. “Risk factors for invasive candidiasis in infants >1500 g birth weight.Pediatr Infect Dis J 32, no. 3 (March 2013): 222–26. https://doi.org/10.1097/INF.0b013e3182769603.
Lee JH, Hornik CP, Benjamin DK, Herring AH, Clark RH, Cohen-Wolkowiez M, et al. Risk factors for invasive candidiasis in infants >1500 g birth weight. Pediatr Infect Dis J. 2013 Mar;32(3):222–6.
Lee, Jan Hau, et al. “Risk factors for invasive candidiasis in infants >1500 g birth weight.Pediatr Infect Dis J, vol. 32, no. 3, Mar. 2013, pp. 222–26. Pubmed, doi:10.1097/INF.0b013e3182769603.
Lee JH, Hornik CP, Benjamin DK, Herring AH, Clark RH, Cohen-Wolkowiez M, Smith PB. Risk factors for invasive candidiasis in infants >1500 g birth weight. Pediatr Infect Dis J. 2013 Mar;32(3):222–226.

Published In

Pediatr Infect Dis J

DOI

EISSN

1532-0987

Publication Date

March 2013

Volume

32

Issue

3

Start / End Page

222 / 226

Location

United States

Related Subject Headings

  • Urine
  • Treatment Outcome
  • Risk Factors
  • Pediatrics
  • Male
  • Infant, Newborn
  • Infant
  • Incidence
  • Humans
  • Female