Journal article
Risk factors for Candida species colonization of neonatal intensive care unit patients
The Pediatric infectious disease journal, Vol.20(12), pp.1119-1124
12/2001
DOI: 10.1097/00006454-200112000-00005
PMID: 11740316
Abstract
BACKGROUND.Candida spp. are increasingly important pathogens in neonatal intensive care units (NICU). Prior colonization is a major risk factor for candidemia, but few studies have focused on risk factors for colonization, particularly in NICU patients.
METHODS.A prospective, multicenter cohort study was performed in six NICUs to determine risk factors for Candida colonization. Infant gastrointestinal tracts were cultured on admission and weekly until NICU discharge and health care worker hands were cultured monthly for Candida spp.
RESULTS.The prevalence of Candida spp. colonization was 23% (486 of 2157 infants); 299 (14%), 151 (7%) and 74 (3%) were colonized with Candida albicans, Candida parapsilosis and other Candida spp., respectively. Multiple logistic regression analysis adjusting for length of stay, birth weight ≤1000 g and gestational age <32 weeks revealed that use of third generation cephalosporins was associated with either C. albicans (155 incident cases) or C. parapsilosis (104 incident cases) colonization. Use of central venous catheters or intravenous lipids were risk factors for C. albicans, whereas delivery by cesarean section was protective. Use of H2 blockers was an independent risk factor for C. parapsilosis. Of 2989 cultures from health care workers’ hands, 150 (5%) were positive for C. albicans and 575 (19%) for C. parapsilosis, but carriage rates did not correlate with NICU site-specific rates for infant colonization.
CONCLUSIONS.We speculate that NICU patients acquire Candida spp. , particularly C. parapsilosis, from the hands of health care workers. H2 blockers, third generation cephalosporins and delayed enteral feedings alter gastrointestinal tract ecology, thereby facilitating colonization.
Details
- Title: Subtitle
- Risk factors for Candida species colonization of neonatal intensive care unit patients
- Creators
- LISA SAIMAN - From the Department of Pediatrics, Columbia University, New York, NY (LS); the Departments of Biostatistics (EL, JDD), Medicine (SRF, RTW) and Pathology (MP), University of Iowa College of Medicine Iowa City, IA; the Department of Medicine, University of Texas Health Science Center, San Antonio, TX (JEP, MR); the Department of Medicine, Emory University School of Medicine and Grady Memorial Hospital (HMB) and the Hospital Infections Program, Centers for Disease Control and Prevention (WJ), Atlanta, GA; the Department of Medicine, University of California School of Medicine, Los Angeles, CA (JEE); and the Department of Medicine, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA (RPW)ELIZABETH LUDINGTONJEFFREY DAWSONJAN PATTERSONSIGFRIDO RANGEL-FRAUSTOR WIBLINHENRY BLUMBERGMICHAEL PFALLERMICHAEL RINALDIJACK EDWARDSRICHARD WENZELWILLIAM JARVISNatl Epidemiology Mycoses Survey
- Resource Type
- Journal article
- Publication Details
- The Pediatric infectious disease journal, Vol.20(12), pp.1119-1124
- DOI
- 10.1097/00006454-200112000-00005
- PMID
- 11740316
- NLM abbreviation
- Pediatr Infect Dis J
- ISSN
- 0891-3668
- eISSN
- 1532-0987
- Publisher
- Lippincott Williams & Wilkins, Inc
- Language
- English
- Date published
- 12/2001
- Academic Unit
- Public Health Administration; Epidemiology; Pathology; Biostatistics; Internal Medicine
- Record Identifier
- 9983997332102771
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