Risk Factors and Clinical Analysis for Invasive Fungal Infection in Neonatal Intensive Care Unit Patients

Abstract

Objective In this study, we seek to determine independent risk factors of invasive fungal infection (IFI) in neonatal infants.

Study Design The medical charts of 5135 neonatal intensive care unit admissions in the past 7 years between January 2004 and December 2010 were reviewed and 45 neonates were found with IFI. Two controls, matched by gestational age, birth weight category, admission date, ward, hospital stay, and admission age, were selected for each case.

Results Candida parapsilosis was the leading causative pathogen of IFI and was isolated in 33.3% of the patients. The mortality rate of the case group was 8.9% versus 1.1% in controls (p < 0.05). Multivariable logistic regression modeling defined intubation > 6 days (71.1%), use of peripherally inserted central venous catheter (68.8%), use of third-generation cephalosporin (53.3%), any prior abdominal surgeries (20.0%), and neutropenia during first week of life < 1.5 · 10⁹/L (20.0%) as exposures significantly associated with case status.

Conclusions The predominant factors identified with IFI were third-generation cephalosporin use, peripherally inserted central venous catheter use, intubation > 6 days, any prior abdominal surgery, and neutropenia during first week of life < 1.5 · 10⁹/L.

Keywords

neonatal intensive care unit - invasive fungal infection - Candida - independent risk factors

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