The Incidence, Treatment and Risk Factors of Candidiasis in Very Low Birth Weight Infants
4
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: Candidiasis is an important morbidity among very low birth weight infants (VLBWI). There is a little data on the risk factors in VLBWI. This study was done to describe the incidence, treatment, and risk factors of candidiasis in VLBWI. Methods: From September 2008 to December 2011, medical records of 130 infants with VLBWI in Inje University Ilsan Paik hospital neonatal intensive care unit (NICU) were reviewed retrospectively. Seventeen infants were diagnosed with candidiasis and treated with antifungal agent. Patients were divided into the candidiasis group (CAN, n=17), the bacterial sepsis group (BAC, n=34), and the non-sepsis group (Non-SEP, n=74). Demographic findings and factors associated with candidiasis were compared between these groups. Results: The mean gestational age was significantly low in the CAN group, but birth weight was not significantly different between the groups. The maternal demographic findings were not significantly different between the groups. The incidence of respi- ratory distress syndrome (RDS) is higher in the CAN group compared to these groups (P<0.05). The durations of intubation and central venous line were significantly longer in the CAN group than in the other groups (P<0.05). In the logistic regression analysis, the duration of central venous line is the significant factor for candidiasis (P =0.003, odd ratio: 1.56, 95% confidence interval: 1.39-1.68). Conclusion: The incidence of candidiasis in VLBWI was 13.1 % and the risk factor for candidiasis was longer duration of central venous line in our study.
Abstract
Purpose: Candidiasis is an important morbidity among very low birth weight infants (VLBWI). There is a little data on the risk factors in VLBWI. This study was done to describe the incidence, treatment, and risk factors of candidiasis in VLBWI. Methods: From September 2008 to December 2011, medical records of 130 infants with VLBWI in Inje University Ilsan Paik hospital neonatal intensive care unit (NICU) were reviewed retrospectively. Seventeen infants were diagnosed with candidiasis and treated with antifungal agent. Patients were divided into the candidiasis group (CAN, n=17), the bacterial sepsis group (BAC, n=34), and the non-sepsis group (Non-SEP, n=74). Demographic findings and factors associated with candidiasis were compared between these groups. Results: The mean gestational age was significantly low in the CAN group, but birth weight was not significantly different between the groups. The maternal demographic findings were not significantly different between the groups. The incidence of respi- ratory distress syndrome (RDS) is higher in the CAN group compared to these groups (P<0.05). The durations of intubation and central venous line were significantly longer in the CAN group than in the other groups (P<0.05). In the logistic regression analysis, the duration of central venous line is the significant factor for candidiasis (P =0.003, odd ratio: 1.56, 95% confidence interval: 1.39-1.68). Conclusion: The incidence of candidiasis in VLBWI was 13.1 % and the risk factor for candidiasis was longer duration of central venous line in our study.
참고문헌 (33)
- Shane AL, "Recent developments and current issues in the epidemiology, diagnosis, and management of bacterial and fungal neonatal sepsis", Am J Perinatol, 30, pp.131~141 (2013)
- Shane AL, "Neonatal sepsis: progress towards improved outcomes", J Infect, 68(Suppl 1), pp.S24~S32 (2014)
- 김천수, "극소 미숙아에서 침습 칸디다 감염", Neonatal medicine, 20(3), pp.367~374 (2013), 대한신생아학회
- Frezza S, "Risk factors for pulmonary candidiasis in preterm infants with a birth weight of less than 1250 g", Eur J Pediatr, 164, pp.88~92 (2005)
- Chapman RL, "Invasive neonatal candidiasis: an overview", Semin Perinatol, 27, pp.352~356 (2003)
- Chapman RL, "Candida infections in the neonate", Curr Opin Pediatr, 15, pp.97~102 (2003)
- Barton M, "Invasive candidiasis in low birth weight preterm infants: risk factors, clinical course and outcome in a prospective multicenter study of cases and their matched controls", BMC Infect Dis, 14, pp.327~ (2014)
- Stoll BJ, "Late-onset sepsis in very low birth weight neonates:the experience of the NICHD Neonatal Research Network", Pediatrics, 110, pp.285~291 (2002)
- Makhoul IR, "Epidemiological, clinical, and microbiological characteristics of late-onset sepsis among very low birth weight infants in Israel:a national survey", Pediatrics, 109, pp.34~39 (2002)
- Hammoud MS, "Persistent candidemia in neonatal care units: risk factors and clinical significance", Int J Infect Dis, 17, pp.e624~e628 (2013)
- Wynn JL, "Outcomes following candiduria in extremely low birth weight infants", Clin Infect Dis, 54, pp.331~339 (2012)
- Adams-Chapman I, "Neurodevelopmental outcome of extremely low birth weight infants with Candida infection", J Pediatr, 163, pp.961~967 (2013)
- Kaufman DA, "Strategies to prevent invasive candidal infection in extremely preterm infants", Clin Perinatol, 37, pp.611~628 (2010)
- 심규홍, "Trends in Epidemiology of Neonatal Sepsis in a Tertiary Center in Korea: A 26-Year Longitudinal Analysis, 1980-2005", Journal of Korean Medical Science, 26(2), pp.284~289 (2011), 대한의학회
- Kim DH, "Systemic candidiasis in neonatal intensive care unit: a 8-year experience", J Korean Soc Neonatol, 8, pp.33~45 (2001)
- 이승우, "극소 저체중 출생아에서 전신성 칸디다 감염 : 5년간의 역학적 특성", Neonatal medicine, 16(2), pp.190~196 (2009), 대한신생아학회
- 최익선, "신생아 중환자실에서 캔디다 패혈증의 발생 추이와 위험 인자", Korean Journal of Pediatrics, 45(7), pp.4~846 (2002), 대한소아과학회
- Aliaga S, "Changes in the incidence of candidiasis in neonatal intensive care units", Pediatrics, 133, pp.236~242 (2014)
- Fridkin SK, "Changing incidence of Candida bloodstream infections among NICU patients in the United States: 1995-2004", Pediatrics, 117, pp.1680~1687 (2006)
- Chapman RL, "Prevention and treatment of Candida infections in neonates", Semin Perinatol, 31, pp.39~46 (2007)
- Kaufman DA, "Epidemiology and prevention of neonatal candidiasis:fluconazole for all neonates?", Adv Exp Med Biol, 659, pp.99~119 (2010)
- 김천수, "신생아 집중치료실에서 침습 칸디다 감염의 예방", Pediatric Infection and Vaccine, 18(1), pp.15~22 (2011), 대한소아감염학회
- Clark TA, "Epidemiologic and molecular characterization of an outbreak of Candida parapsilosis bloodstream infections in a community hospital", J Clin Microbiol, 42, pp.4468~4472 (2004)
- Kaufman D, "Clinical microbiology of bacterial and fungal sepsis in very-low-birth-weight infants", Clin Microbiol Rev, 17, pp.638~680 (2004)
- Hundalani S, "Invasive fungal infections in newborns and current management strategies", Expert Rev Anti Infect Ther, 11, pp.709~721 (2013)
- Fernandez M, "Candida meningitis in neonataes: a 10-year Review", Clin Infect Dis, 31, pp.453~463 (2000)
- Benjamin DK Jr, "Neonatal candidiasis: epidemiology, risk factors, and clinical judgment", Pediatrics, 126, pp.e865~e873 (2010)
- 최영륜, "신생아 집중치료실에서 진균감염의 예방", Neonatal medicine, 20(3), pp.359~366 (2013), 대한신생아학회
- Hsieh E, "Neonatal fungal infection:when to treat?", Early Hum Dev, 88(Suppl 2), pp.S6~S10 (2012)
- Manzoni P, "Correct choices for correct treatments:key issues in the management of Candida infections in preterm neonates", Early Hum Dev, 88(Suppl 2), pp.S98~S100 (2012)
- 전가원, "A Comparison of AmBisome(R) to Amphotericin B for Treatment of Systemic Candidiasis in Very Low Birth Weight Infants", Yonsei Medical Journal, 48(4), pp.619~626 (2007), 연세대학교의과대학
- Clerihew L, "Invasive fungal infection in very low birthweight infants: national prospective surveillance study", Arch Dis Child Fetal Neonatal Ed, 91, pp.F188~F192 (2006)
- Robinson JA, "Risk factors for persistent candidemia infection in a neonatal intensive care unit and its effect on mortality and length of hospitalization", J Perinatol, 32, pp.621~625 (2012)