Risk Factors for Candidemia in Critically Ill Infants: A Matched Case-control Study

摘要: Objective To determine risk factors for late-onset candidemia among infants in the neonatal intensive care unit (NICU). Study design We performed a matched case-control study from March 2001 to January 2003 2 level III-IV NICUs. Case subjects had diagnosed more than 48 hours after hospitalization. Control (3 per case) were by site, birth weight, year, and date of enrollment. Potential included medical devices, medications, gastrointestinal (GI) pathology (congenital anomalies or necrotizing enterocolitis) previous bacterial bloodstream infections (BSIs). Results Forty-five cases occurred during period accounted 15% BSIs. C. albicans caused 62% (28/45); parapsilosis, 31% (14/45). Multivariate analysis revealed that catheter use (odds ratio [OR] = 1.06 day use; 95% confidence interval [CI] = 1.02 1.10), BSIs (OR = 8.02; CI = 2.76 23.30) GI (OR = 4.57; CI = 1.62 12.92) significantly associated with candidemia. In all, 26/45 (58%) who would not have qualified fluconazole prophylaxis according Kaufman criteria. Conclusions confirmed (catheter-days) identified novel (previous BSI pathology) critically ill could guide future targeted antifungal strategies.