Candida Colonization in Low Birth Weight and Very Low Birth Weight Infants in a Neonatal Intensive Care Unit

Abstract

Background: Candida colonization is a major risk factor for invasive candidiasis in premature infants in the neonatal intensive care unit (NICU). Objectives: The purpose of this study was to determine the rate, risk factors, and sources of colonization in low birth weight (LBW) and very low birth weight (VLBW) infants in an NICU. Patients and Methods: All cases were classified in to 1 of 2 groups: LBW and VLBW. A questionnaire that collected demographic data was completed for each case. Swabs were obtained from the ear, umbilicus, and rectum, as well as catheters, tracheal tubes, and nasogastric tubes. Samples were cultured on Sabouraud dextrose agar. The data were analyzed using SPSS software. A P value < 0.05 was considered significant. Results: A total of 102 cases were examined in this study. The mean weight of the infants was 1720 ± 474 gr (range 850 - 2500 gr). Positive Candida cultures were isolated in 19 (31.7%) cases in the LBW group and 20 (47.6%) cases in the VLBW group. In addition, 36 (35.3%) cases showed signs of sepsis. The mortality rate was 1.7% (n = 1). The umbilicus and rectum were the most common sites for Candida colonization in both groups. The analysis also indicated that the duration of hospitalization, prolonged use of corticosteroids, central venous catheters, total parenteral nutrition, and mechanical ventilation were associated with candidiasis infection in VLBW infants while prolonged use of corticosteroids and central venous catheters were major risk factors associated with candidiasis infection in LBW infants. Conclusions: These results show that maturity and birth weight are related to a decrease in the risk of developing a candidiasis infection.