کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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3362793 | 1592083 | 2013 | 5 صفحه PDF | دانلود رایگان |
SummaryObjectivesThe prevalence and clinical significance of persistent candidemia among neonates are poorly understood. This study aimed to describe the rate and the clinical relevance of persistent candidemia over a 4-year period in Kuwait.MethodsA retrospective chart review of infants admitted to the Neonatal Care Unit of the Maternity Hospital in Kuwait between January 2007 and December 2010, who had a positive blood culture for Candida species, was conducted. Persistent candidemia was defined as the isolation of the same Candida species more than 6 days after the initiation of antifungal therapy, or death due to candidemia within 6 days of antifungal treatment. Stepwise logistic regression was used to investigate factors associated with persistent candidemia.ResultsOf 89 neonates with a Candida infection, 54 (60.7%, 95% confidence interval 49.7–70.9%) had persistent candidemia. The case-fatality rate was 54% among those with persistent candidemia and 3% among those with non-persistent candidemia (p < 0.001). Neonates with persistent candidemia were more likely to be female, have a central vascular catheter at diagnosis, and have a low platelet count. All isolated Candida species were susceptible to antifungal agents.ConclusionsPersistent candidemia is common among neonates with a Candida infection and is associated with an increased risk of mortality. Drug resistance is unlikely to explain the persistent candidemia; host-related factors seem to be more important and hence could be used to identify those at risk in order to institute appropriate preventive and treatment measures.
Journal: International Journal of Infectious Diseases - Volume 17, Issue 8, August 2013, Pages e624–e628