Clinical Outcomes of Very Low Birth Weight Infants with Candidemia

Abstract

The aim of this study is to compare the clinical outcomes of very low birth weight (VLBW, birth weight＜1500 g) infants with and without candidemia. From January 1995 through December 2003, VLBW infants with Candida species isolated from a blood culture obtained at or after 3 days of age were identified as the study cases. Each study case was matched to two control infants with similar birth weights, gestational ages, and dates of admission. The short term morbidity and the long term neurodevelopmental up to two years of corrected age were recorded. During the study period, a total of 28 cases of candidemia were found in our neonatal intensive care unit (NICU). Among them, 19 cases occurred in VLBW infants. The short term clinical outcome seemed grave in the group of VLBW infants who had candidemia. More cases of chronic lung disease (CLD), periventricular leukomalacia (PVL), and severe retinopathy of prematurity (ROP stage 3 or greater) were noted in this group than in the control group. However, neurodevelopment up to two years of corrected age as assessed by the Bailey Scales of Infant Development II was not significantly different in the two groups. Candida sepsis remains a serious problem in the NICU, especially among VLBW infants. Through a case-control study, we concluded that candidemia in VLBW infants is associated with an increased incidence of short term morbidity from complications such as CLD, threshold ROP, and PVL.