Background: Infants who develop candidemia in the Neonatal Intensive Care Unit (NICU) experience increased morbidity and mortality. Identifying infants at risk allows targeted prevention.
Methods: A retrospective cohort study on all infants admitted to the NICU in five U.S. children’s hospitals between 1994 and 1998 was conducted to determine if gestational age and birthweight are risk factors for developing candidemia.
Results: Data was available on 11,571 infants and 287,220 NICU-days of follow-up. There were 186 cases of candidemia. The incidence density (ID) of candidemia for infants under 30 weeks gestational age was 11 cases/10,000 NICU-days while ID in infants over 30 weeks gestational age was 2 cases/10,000 NICU-days. The ID for infants under 1500 grams at birth was 9 cases/10,000 NICU-days as compared to 2 cases/10,000 baby days for larger infants. Regression modeling showed that neither gestational age [IDR=0.998, 05% CI: 0.891, 1.119] nor birthweight [IDR=0.988, 95% CI: 0.943, 1.036] is predictive of candidemia for infants with a gestational age of at least 30 weeks. However, infants with a gestational age less than 30 weeks had a 13% decrease in risk for candidemia for every 100-gram increase in birthweight [IDR=0.874, 95% CI: 0.789, 0.968] and a 29% decrease in risk for every one-week increase in gestational age [IDR=0.709, 95% CI: 0.622, 0.808]. Males were 1.7 times more likely to develop candidemia.
Conclusions: Very low birthweight and prematurity are risk factors for developing candidemia. Increased birthweight decreases the risk of candidemia for infants with a gestational age less than 30 weeks.
Learning Objectives: At the conclusion of the session, the participant learner) in this session will be able to discuss the roles of gestational age and birthweight in the development of fungal blood stream infections in neonates.
Keywords: Low Birthweight, Risk Factors
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.