Dexamethasone therapy and Candida sepsis in neonates less than 1250 grams

被引:34
作者
Pera A. [1 ]
Byun A. [1 ,2 ]
Gribar S. [1 ,2 ]
Schwartz R. [1 ]
Kumar D. [1 ]
Parimi P. [1 ]
机构
[1] MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH
[2] Pediatrics and MetroHealth Foundation, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH
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D O I
10.1038/sj.jp.7210699
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学科分类号
摘要
Objective: To determine whether dexamethasone use increases the risk for Candida sepsis (CS) in very low birth weight premature infants (< 1250 g). Design: Retrospective chart review of all infants with a birth weight < 1250 g, admitted to the neonatal intensive care unit of the MetroHealth Medical Center, Cleveland, Ohio between January 1, 1996 and December 31, 1999. Infant groups with (n=65) and without (n=229) CS were compared. Results: Two hundred and ninety four infants with a birth weight < 1250 g were identified. CS was diagnosed at a median age of 18 days, and 6 of 65 (10%) infants died directly from Candida-related complications. Candida albicans (n=30, 60%) and Candida parapsilosis (n=14, 25%) were the predominant isolates. Use of dexamethasone in infants at risk for chronic lung disease before 14 days of age (p=0.001), duration of antibiotics (p=0.001), and total duration of parenteral nutrition and intralipid (p=0.0001) were all significantly greater in infants who developed CS. Regression analysis showed that duration of antibiotics before the diagnosis of Candida infection (r2=0.69, p=0.0002) and duration of dexamethasone (r2=0.93, p=0.0002) correlated with Candida infection. Early dexamethasone use was also related to the age at diagnosis of Candida infection (r2=0.51, p=0.01). Conclusions: Dexamethasone therapy and prolonged duration of antibiotics are associated with Candida infection in premature infants.
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页码:204 / 208
页数:4
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共 27 条
[1]  
Johnson D.E., Thompson T.R., Green T.P., Ferrari P., Systemic Candidiasis in very low birth weight infants (< 1500 grams), Pediatrics, 73, pp. 138-143, (1984)
[2]  
Baley J.E., Kliegman R.M., Boxerbaum B., Fanaroff A.A., Fungal colonization in the very low birth weight infant, Pediatrics, 78, pp. 225-232, (1986)
[3]  
Baley J.E., Kliegman R.M., Fanaroff A.A., Disseminated fungal infections in very low birth weight infants: Clinical manifestations and epidemiology, Pediatrics, 73, pp. 144-152, (1984)
[4]  
Faix R.G., Kovarik S.M., Shaw T.R., Johnson R.V., Mucocutaneous and invasive Candidiasis among very low birth weight (< 1500 grams) infants in intensive care nurseries: A prospective study, Pediatrics, 83, pp. 101-107, (1989)
[5]  
Huang Y.C., Li C.C., Lin T.Y., Lien A., Et al., Association of fungal colonization and invasive disease in very low birth weight infants, Pediatr. Infect. Dis. J, 17, pp. 819-822, (1998)
[6]  
Kossoff E.H., Buescher E.S., Karlowicz M.G., Candidiasis in a neonatal intensive care unit: Trends during fifteen years and clinical features of 111 cases, Pediatr. Infect. Dis. J, 17, pp. 504-508, (1998)
[7]  
Bektas S., Decreased adherence, chemotaxis and phagocytic activities of neutrophils from preterm neonates, Acta Pediatr. Scand, 79, (1990)
[8]  
Blaschke-Hellmessen R., Vertical transmission of Candida and its consequences, Mycoses, 41, 2, pp. 31-36, (1998)
[9]  
Stark A.R., Carlo W.A., Tyson J.E., Et al., Adverse effects of early dexamethasone in extremely-low-birth-weight infant, N. Engl. J. Med, 344, 2, pp. 95-101, (2001)
[10]  
Stoll B.J., Temprosa M., Tyson J.E., Et al., Dexamethasone therapy increases infection in very low birth weight infant, Pediatrics, 104, 5, (1999)