CANDIDA SEPSIS IN THE VERY LOW BIRTH-WEIGHT INFANT. † 1758

Abstract

We reviewed records of 167 infants < 1500 g to identify risk factors and determine if changes in obstetrical and neonatal care from 1989 to 1995 affected the incidence of candida sepsis (CS). All available charts of infants who lived ≥ 7d were reviwed. Data were analyzed using chi square, t-test and multiple logistic regression. Mean birth weight (BW), gestational age (GA) and other demographics were similar in 1989-90 & 1994-95. Pneumothorax, necrotizing enterocolitis and severe IVH were less common in 1994-95, likely due to increased use of AS. Postnatal Abx use and feeding practices did not differ in the two epochs. Infants with CS were smaller (826±250 v. 1066±285g), more premature (25.9±2.3 v. 28.5 ±2.5wk), required longer ventilator support (36.4±27 v. 12.2 ±19d), received more Abx (35.3±18 v. 15.2±13d), had more CVLs 91% v. 50% for longer periods (26.5±19 v. 11.6±18d) and higher mortality (35% v. 9%) than those without CS (all p<0.001). Only GA or BW and use of CVL were independent predictors of CS. AS use did not correlate with CS. Maternal Abx had a weak positive correlation (p=0.1). CS incidence tended to increase from 89 to 95 perhaps due to increased use of CVLs. More data are needed to clarify a possible relationship of maternal Abx and CS.Table