title: Invasive Candidiasis in preterm neonates in China: a retrospective study from 11 NICUS during 2009-2011.
abstract: BACKGROUND
  Candida species is an important cause of nosocomial infection in neonatal intensive care units (NICUs). However, most reports in China have been limited to single institutions. The aim of this study is to investigate the epidemiology of invasive candidiasis in multiple NICUs across China.
  
  
  METHODS
  We retrospectively collected demographic data, clinical characteristics, microbiological results and outcome of preterm infants with invasive candidiasis discharged from 11 academic tertiary NICUs during January 2009 to December 2011.
  
  
  RESULTS
  There were 30,045 preterm infants discharged from 11 NICUs during the study period. We detected 223 infants with invasive candidiasis, resulting in an incidence of 0.74 cases per 100 preterm discharges from NICUs. In very low birth weight infants, the incidence was 3.42 cases per 100 very low birth weight discharges. Mean gestational age of infected infants was 31.4 weeks and median birth weight was 1410 gram. Among the cohort of infants with invasive candidiasis, 214 (96.0%) infants had positive blood culture for fungus, 5 infants had positive urine culture, 3 from cerebrospinal fluid and 1 from articular effusion in the shoulder joint. Among the cohort of infants with candidemia, 48 (22.4%) infants had fungal meningitis. Candida albicans accounted for 57.4% of total positive cultures. Overall mortality attributable to invasive candidiasis was 19.3%.
  
  
  CONCLUSIONS
  Invasive candidiasis is a common problem among preterm neonates in China, especially among very low birth weight infants and it is associated with a high mortality. The preponderance of infections was due to Candida albicans.
authors.affiliation: From the *Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai; †First Hospital of Jilin University, Changchun; ‡Hubei Maternity and Child Health Hospital, Hubei; §Shenzhen Maternity Hospital, Guangdong; ¶Children's Hospital of Fudan University, Shanghai; ‖Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai; **Guangzhou Women and Children's Medical Center, Guangdong; ††International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai; ‡‡Shenzhen Bao'an Maternity Hospital, Guangdong; §§Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai;and ¶¶Nanjing Children's Hospital, Nanjing Medical University, Nanjing, China.
authors.forename: Hongping
authors.initials: H
authors.lastname: Xia
authors.forename: Hui
authors.initials: H
authors.lastname: Wu
authors.forename: Shiwen
authors.initials: S
authors.lastname: Xia
authors.forename: Xiaoyu
authors.initials: X
authors.lastname: Zhu
authors.forename: Chao
authors.initials: C
authors.lastname: Chen
authors.forename: Gang
authors.initials: G
authors.lastname: Qiu
authors.forename: Wei
authors.initials: W
authors.lastname: Zhou
authors.forename: Yingying
authors.initials: Y
authors.lastname: Shi
authors.forename: Liya
authors.initials: L
authors.lastname: Ma
authors.forename: Jianhua
authors.initials: J
authors.lastname: Sun
authors.forename: Xiaoyu
authors.initials: X
authors.lastname: Zhou
authors.forename: Jianxing
authors.initials: J
authors.lastname: Zhu
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D001724:Birth Weight; D058365:Candidiasis, Invasive / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality; D002681:China / Q000453:epidemiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008297:Male; D012189:Retrospective Studies
chemical_list: D000935:Antifungal Agents