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

Journal Article

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 >1500g birth weight discharged from 305 neonatal intensive care units in the Pedia-trix 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/mm3 (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 >1500g birth weight. Infants at greatest risk are those exposed to broad-spectrum antibiotics and with platelet counts of <50,000/mm3. Copyright © 2013 by Lippincott Williams & Wilkins.

Full Text

Duke Authors

Cited Authors

  • Lee, JH; Hornik, CP; Jr, DKB; Herring, AH; Clark, RH; Cohen-Wolkowiez, M; Smith, PB

Published Date

  • 2013

Published In

Volume / Issue

  • 32 / 3

Start / End Page

  • 222 - 226

International Standard Serial Number (ISSN)

  • 0891-3668

Digital Object Identifier (DOI)

  • 10.1097/INF.0b013e3182769603