title: Mortality and risk factors for invasive fungal infections after the implementation of a fluconazole prophylaxis protocol in very low birth weight infants.
abstract: Fungal infections are a common cause of late-onset sepsis in very low birth weight infants and can impact mortality and morbidity. The purpose of this study is to determine the impact of systemic fluconazole prophylaxis in the prevalence of fungemia.
  
  
  METHODS
  Subjects included 402 very low birth weight premature infants with birth weights between 500 and 1,250 grams admitted to the University Pediatric Hospital NICU over a six year period. The period before and after prophylaxis was retrospectively compared
  
  
  RESULTS
  There was a marginal decrease in fungemia in the prophylaxis group (2.6% vs. 6.7%, p = 0.0525). Factors associated to fungemia were chorioamnionitis (p = 0.0240), H2-receptor inhibitors use (p = 0.0109), mechanical ventilati (p = 0.0049), prolonged antibiotic t py (p = 0.0015), and parenteral nutriti (p = 0.0048). Infants with fungemia had longer lengths of stay (p = 0.0143) and lower survival (p = 0.002).
  
  
  CONCLUSIONS
  Prophylaxis with fluconazole decreases mortality and morbidity in an environment with a high incidence of late onset fungal infections. Early identification and prevention of risk factors must be reinforced.
authors.forename: Alessandro M
authors.initials: AM
authors.lastname: Acosta
authors.forename: Inés
authors.initials: I
authors.lastname: García-García
authors.forename: Lourdes
authors.initials: L
authors.lastname: García-Fragoso
authors.forename: Gloria
authors.initials: G
authors.lastname: Reyes
authors.forename: Juan
authors.initials: J
authors.lastname: Rivera
authors.forename: Marta
authors.initials: M
authors.lastname: Valcárcel
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use*; D002985:Clinical Protocols; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D009181:Mycoses / Q000401:mortality* / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000935:Antifungal Agents; D015725:Fluconazole