Risk factors for Candida infections in a neonatal intensive care unit in Costa Rica

• Published in: International journal of infectious diseases 2005-03, Vol.9 (2), p.90-95
• Main Authors: Avila-Aguero, María L., Canas-Coto, Alejandro, Ulloa-Gutierrez, Rolando, Caro, Marco A., Alfaro, Braulio, Paris, María M.
• Format: Article
• Language: English
• Subjects: Amphotericin B - therapeutic use; Antifungal Agents - therapeutic use; Antifungal drugs; Biological and medical sciences; Candidemia; Candidiasis - drug therapy; Candidiasis - epidemiology; Costa Rica - epidemiology; Fluconazole - therapeutic use; Flucytosine - therapeutic use; Human mycoses; Humans; Infant, Newborn; Infectious diseases; Intensive Care Units, Neonatal; Medical sciences; Mycoses; Mycotic sepsis; Neonatal intensive care unit; Newborn; Nosocomial infection; Retrospective Studies; Risk Factors
• ISSN: 1201-9712; 1878-3511
• DOI: 10.1016/j.ijid.2004.05.007

To identify potential risk factors associated with Candida infections and compare these risk factors between patients who both died and survived. A group of patients with positive Candida spp. blood cultures admitted to a neonatal intensive care unit (NICU) in Costa Rica between January 1994 and December 1998. Cases were identified through a computerized search of the microbiology laboratory's database on blood cultures. One hundred and ten newborns were identified. Sixty-six patients (60%) were male; 46 (62%) were preterm infants. Thirty-seven (34%) patients died. Twenty (54%) of them died within three days of the candidemia diagnosis and 17 had disseminated Candida infection on autopsy. Candida albicans and Candida tropicalis were isolated in 90% and 10% of blood cultures, respectively. Mean ± SD (range) number of days from admission to NICU to the initial positive blood culture were 13.5 ± 8.5 (1–30) days. Most patients had at least two positive blood cultures (range 1–8). Median (range) days for the sterilization of blood culture were four (1–25) days. Significant differences in survival were identified in patients with axillary-inguinal lesions, apnea and seizures. Invasive fungal infections are frequent in NICU. Future case-control prospective studies should be carried out to confirm the findings from this report.