Abstract

POOLI, Lidia et al. Candidemia en una Unidad de Cuidados Intensivos Neonatales: identificación de factores de riesgo. Arch. argent. pediatr. [online]. 2006, vol.104, n.5, pp.393-398. ISSN 0325-0075.

Introduction. In the last decades, systemic fungal infections have became more frequent as the survival of high risk newborns increased. Our aim was to determine the incidence and mortality of, as well as risk factors for candidemia, and to identify the Candida species involved in patients staying in a neonatal intensive care unit. Population, material and methods. A retrospective study was performed between 1/01/98 and 31/ 12/01 with a cohort of newborns discharged from a NICU, including only those patients who stayed more than three days. A case of candidemia was defined as those patients with at least one blood culture positive for Candida. Results. 872 patients were enrolled with a mean weight of 3,200 g, and a mean gestational age of 38 weeks; 180 required surgery; 189, mechanical ventilatory assistance and 162, total parenteral nutrition. The incidence of candidemia was 4.6% (40/872). Mortality in patients with candidemia was 27.5% (11/40). Multivariate logistic regression analysis showed as independent risk factors: weight at admission (AW) ≤ 1,500 g (OR 33.3; CI 95%= 6.6- 168.8); surgery (OR 4.2; CI 95%= 1.6-10.9); MAV (OR 4.3; CI 95%= 1.5-12.3) and TPN (OR 10.4; CI 95%= 3.3- 32.4). Candida species involved were: albicans (22), parapsilosis (10); tropicalis (7) and guillermondii (1). Conclusions. The incidence of candidemia was 4.6% with a high mortality rate. Species most frequently involved were C. albicans and C. parapsilosis.

Keywords : Candidemia; Risk factors; Neonatal intensive care unit; Incidence.

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