Disseminated Candidal Infections and Intravenous Hydrocortisone in Preterm Infants

摘要: Background. Intravenous (IV) hydrocortisone (HC) has been used recently in selected preterm infants for hypotension soon after birth. During the same time period that HC was used, there a marked increase incidence of disseminated candidal infections (DCIs). Objective. To determine whether is an association between DCI first 35 days life and IV infants. Research design. A hospital case-control study comparing exposure with matched without DCI. Setting. tertiary level intensive care nursery major teaching San Francisco, CA. Patients. Seventeen 25 DCI, gestational age younger than 28 weeks birth weight less 1000 g, inborn outborn admitted to January 1992 September 1993. Methods. All diagnosed at were identified using perinatal neonatal database. defined as blood, cerebrospinal fluid, or two urine cultures positive Candida requiring antifungal therapy. control group uninfected risk factors (gestational age, weight, duration intubation, broad-spectrum antibiotics, alimentation, including lipids central venous catheters) during Postmatching comparison performed several other detect any differences groups. Results. The (n = 17) 25) had no statistical difference postmatching comparison. Ten (59%) receiving infection, whereas four (16%) received life. Infants 7.5 times likely (95% confidence interval, 5 11) have before onset fungal infection. Conclusion. We conclude administration significantly increases susceptible age. potentially serious risks should be considered particularly patient selection process HC.