Risk factors for pulmonary candidiasis in preterm infants with a birth weight of less than 1250 g.
To evaluate the epidemiology of pulmonary candidiasis (PC) and to identify risk factors in premature infants during the 1st month of life, all infants with a birth weight <1250 g admitted to our neonatal intensive care unit with PC between January 1994 and December 2001 were retrospectively reviewed. Infants with PC ( n =20) were compared with a control group ( n =20), matched for gestational age and birth weight, with regard to possible perinatal and postnatal risk factors. Among 325 infants with a birth weight <1250 g, 20 out of 233 ventilated infants (8.6%) developed PC. Candida albicans ( n =12) and C. parapsilosis ( n =4) were the predominant isolates. Neonates with PC were significantly different from controls with regard to male prevalence ( P =0.002), rates of preterm premature rupture of membranes (PPROM) ( P =0.02), longer duration of antibiotic therapy ( P =0.01) and of ventilation ( P =0.02). The difference between groups did not attain significance with regard to postnatal dexamethasone administration, duration of central vein catheterisation and duration of parenteral nutrition. Multivariate logistic regression analysis indicated as significant predictors of PC, among perinatal data, the male gender (OR =26.3; 95%CI 2.44 to 284) and PPROM (OR =12.3; 95%CI 1.16 to 130) and, among postnatal data, the duration of ventilation (OR =1.54; 95%CI 1.01 to 2.34).


CONCLUSIONS
The presence of preterm premature rupture of membranes and the duration of ventilation are significant risk factors for developing pulmonary candidiasis and should be considered in the preventive efforts to reduce this disease in infants with a birth weight <1250 g.
Frezza
Simonetta
S
Department of Neonatology, Catholic University of Sacred Heart, Largo A. Gemelli 8, 00168 Rome, Italy. simofrezza@yahoo.it
Maggio
Luca
L
De Carolis
Maria Pia
MP
Gallini
Francesca
F
Puopolo
Maria
M
Polimeni
Valentina
V
Costa
Simonetta
S
Vento
Giovanni
G
Tortorolo
Giuseppe
G
D002177:Candidiasis / Q000175:diagnosis / Q000453:epidemiology*; D016022:Case-Control Studies; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D007558:Italy / Q000453:epidemiology; D008172:Lung Diseases, Fungal / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D015999:Multivariate Analysis; D011247:Pregnancy; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors