Comparative study of mortality and morbidity in premature infants (birth weight, < 1,250 g) with candidemia or candidal meningitis.
Little information is available on long-term neurodevelopment of premature neonates with invasive candidal infections. We retrospectively studied the outcomes for 25 premature neonates (birth weight, < 1,250 g) with candidemia or candidal meningitis (cases) and compared them with 25 neonates matched for birth weight (+/- 100 g) and gestational age (+/- 1 week) (controls). Durations of antibiotic therapy, artificial ventilation, invasive catheterizations, and hyperalimentation were longer for cases than for controls. Cases had a higher final grade of intraventricular hemorrhage than did controls (median: 3.0 vs. 2.5, respectively; P < .05). Forty-four percent (11 of 25) of cases and 16% (4 of 25) of controls died (P > .05), and 29% (4 of 14) of surviving cases and 14% (3 of 21) of controls were disabled (P > .05). More cases had combined mortality and neurodevelopmental disabilities than did controls (60% vs. 28%, respectively; P < .05). Use of invasive therapies should be minimized for premature neonates at risk for invasive candidal infection that is associated with adverse outcomes.
Lee
B E
BE
Department of Pediatrics, University of Alberta Hospital, Canada.
Cheung
P Y
PY
Robinson
J L
JL
Evanochko
C
C
Robertson
C M
CM
D002175:Candida / Q000302:isolation & purification; D002177:Candidiasis / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality; D016022:Case-Control Studies; D003710:Demography; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality; D019102:Infant, Very Low Birth Weight; D016921:Meningitis, Fungal / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality; D009017:Morbidity; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome