title: Integrated measures for prevention of invasive Candida infections in preterm infants in a Chinese neonatal intensive care unit.
abstract: BACKGROUND
  The increasing incidence of invasive Candida infections (ICIs) in preterm infants in the neonatal intensive care unit (NICU) of Xinhua Hospital aroused our concern. We undertook a retrospective study to evaluate the efficacy of different preventive measures for ICI in preterm infants.
  
  
  METHODS
  Preterm infants with gestational age (GA) <33 weeks admitted between 2010 and 2013 were divided into 3 groups according to the preventive measures applied in different periods: the control group (CG), fluconazole group (FG), and integrated measures group (IMG). We analyzed the incidence of ICI and distribution of fungal pathogens in these 3 groups, and also evaluated the efficiency of various measures in preventing ICIs in preterm infants.
  
  
  RESULTS
  The study sample comprised 261 preterm infants born at <33 weeks GA, including 94 in the CG, 99 in the FG, and 68 in the IMG. The differences among the groups were not significant at baseline. ICI developed in 41 of the 261 infants (15.7%). The incidence of ICI varied significantly among the groups: 22.3% in the CG (21/94), 18.2% in the FG (18/99), and only 2.9% in the IMG (2/68) (P = .003). ICI was less frequent in the IMG compared with the CG (P <.001) and the FG (P = .003).
  
  
  CONCLUSIONS
  The integrated measures approach is meaningful for the prevention of ICIs in preterm infants in NICUs with many patients but inadequate medical resources in some developing countries.
authors.affiliation: Neonatology Department, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Jiahui
authors.initials: J
authors.lastname: Chen
authors.affiliation: MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Xiaodan
authors.initials: X
authors.lastname: Yu
authors.affiliation: Neonatology Department, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Yijun
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Neonatology Department, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Yongjun
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Neonatology Department, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Jianxing
authors.initials: J
authors.lastname: Zhu
authors.affiliation: Neonatology Department, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Lijuan
authors.initials: L
authors.lastname: Xie
authors.affiliation: Neonatology Department, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Jihong
authors.initials: J
authors.lastname: Qian
authors.affiliation: Neonatology Department, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Qingnan
authors.initials: Q
authors.lastname: Yang
authors.affiliation: Neonatology Department, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Hongping
authors.initials: H
authors.lastname: Xia
authors.affiliation: Neonatology Department, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Tianwen
authors.initials: T
authors.lastname: Zhu
authors.affiliation: Neonatology Department, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Yonghong
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Neonatology Department, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Neonatology Department, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Dongying
authors.initials: D
authors.lastname: Zhao
authors.affiliation: Neonatology Department, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Institute for Pediatric Research, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address: hezhenjuan@sjtu.edu.cn.
authors.forename: Zhenjuan
authors.initials: Z
authors.lastname: He
mesh_terms: D000328:Adult; D058365:Candidiasis, Invasive / Q000517:prevention & control*; D002681:China; D003428:Cross Infection / Q000517:prevention & control*; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature; D017053:Infection Control / Q000379:methods* / Q000458:organization & administration*; D007363:Intensive Care Units, Neonatal; D008297:Male; D012189:Retrospective Studies; D055815:Young Adult
keywords: Fluconazole; Hand hygiene; Invasive Candida infection; Preterm infant; Prophylaxis