Patterns of fungal colonization in preterm infants weighing less than 1000 grams at birth

被引:54
作者
Kaufman, David A.
Gurka, Matthew J.
Hazen, Kevin C.
Boyle, Robert
Robinson, Melinda
Grossman, Leigh B.
机构
[1] Univ Virginia, Sch Med, Dept Publ Hlth Sci, Charlottesville, VA 22908 USA
[2] Univ Virginia, Sch Med, Dept Pathol & Microbiol, Charlottesville, VA 22908 USA
[3] Univ Virginia, Sch Med, Dept Pediat, Charlottesville, VA 22908 USA
关键词
preterm infant; fungi; colonization; neonate; Candida;
D O I
10.1097/01.inf.0000226978.96218.e6
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background: Colonization with Candida spp. is an important risk factor for systemic infection in very low birth weight (VLBW; < 1500 g) and extremely low birth weight (ELBW, < 1000 g) infants. ELBW infants are at a higher risk than VLBW infants for fungal sepsis and its associated mortality, but few studies have examined fungal colonization exclusively in ELBW infants. Methods: Fungal colonization data were analyzed retrospectively in 50 high risk ELBW infants. Weekly surveillance fungal cultures of the skin, gastrointestinal tract, respiratory tract and umbilicus had been performed from birth through the first 6 weeks of life. Colonization was analyzed for time of initial colonization, site, species and spread of Candida from one site to another. Results: Candida was isolated from surveillance cultures in 31 of 50 (62%) infants. Colonization was inversely proportional to gestational age. Initial week of both the fungal colonization of the skin [1 (0-6) week, median (range)] and gastrointestinal tract [2 (0-6)] preceded colonization of the respiratory tract [3 (1-6)] (P = 0.0001). Among infants colonized by only 1 of the species, colonization at 2 or more sites occurred similarly with Candida albicans (77%) and Candida parapsilosis (85%), whereas colonization at 3 or more sites occurred more frequently with C. albicans (69%) compared with C. parapsilosis (23%) (P = 0.047). Conclusions: Fungal colonization occurs on the skin and gastrointestinal tract before the respiratory tract. In addition, C. albicans is more likely than C. parapsilosis to colonize multiple sites.
引用
收藏
页码:733 / 737
页数:5
相关论文
共 47 条
[41]   Reduced pulmonary oxygen diffusion at 36 weeks of postmenstrual age in small-for-gestational-age preterm infants of less than 32 weeks without bronchopulmonary dysplasia [J].
Correani, Alessio ;
Lanciotti, Lucia ;
Giorgetti, Chiara ;
Palazzi, Maria Laura ;
Monachesi, Chiara ;
Antognoli, Luca ;
Burattini, Ilaria ;
Cogo, Paola ;
Carnielli, Virgilio .
PEDIATRIC PULMONOLOGY, 2023, 58 (11) :3054-3062
[42]   Neonatal brain magnetic resonance imaging before discharge is better than serial cranial ultrasound in predicting cerebral palsy in very low birth weight preterm infants [J].
Mirmiran, M ;
Barnes, PD ;
Keller, K ;
Constantinou, JC ;
Fleisher, BE ;
Hintz, SR ;
Ariagno, RL .
PEDIATRICS, 2004, 114 (04) :992-998
[43]   Randomized controlled trial to compare sleep and wake in preterm infants less than 32 weeks of gestation receiving two different modes of non-invasive respiratory support [J].
Collins, C. L. ;
Barfield, C. ;
Davis, P. G. ;
Horne, R. S. C. .
EARLY HUMAN DEVELOPMENT, 2015, 91 (12) :701-704
[44]   High levels of CXCL8 in tracheal aspirate samples taken at birth are associated with adverse respiratory outcome only in preterm infants younger than 28 weeks gestation [J].
De Dooy, Jozef ;
Leven, Margareta ;
Stevens, Wim ;
De Clerck, Luc ;
Mahieu, Ludo .
PEDIATRIC PULMONOLOGY, 2007, 42 (03) :193-203
[45]   Long-Term Course of Hypothyroidism Detected through Neonatal TSH Screening in a Population-Based Cohort of Very Preterm Infants Born at Less Than 32 Weeks of Gestation [J].
Odenwald, Birgit ;
Fischer, Aline ;
Roeschinger, Wulf ;
Liebl, Bernhard ;
Schmidt, Heinrich ;
Nennstiel, Uta .
INTERNATIONAL JOURNAL OF NEONATAL SCREENING, 2021, 7 (04)
[46]   Bi-level Nasal Positive Airway Pressure (BiPAP) versus Nasal Continuous Positive Airway Pressure (CPAP) for Preterm Infants with Birth Weight Less Than 1500 g and Respiratory Distress Syndrome Following INSURE Treatment: A Two-center Randomized Controlled Trial [J].
Pan, Rui ;
Chen, Gao-yan ;
Wang, Jing ;
Zhou, Zhao-xian ;
Zhang, Ping-ying ;
Chang, Li-wen ;
Rong, Zhi-hui .
CURRENT MEDICAL SCIENCE, 2021, 41 (03) :542-547
[47]   Bi-level Nasal Positive Airway Pressure (BiPAP) versus Nasal Continuous Positive Airway Pressure (CPAP) for Preterm Infants with Birth Weight Less Than 1500 g and Respiratory Distress Syndrome Following INSURE Treatment: A Two-center Randomized Controlled Trial [J].
Rui Pan ;
Gao-yan Chen ;
Jing Wang ;
Zhao-xian Zhou ;
Ping-ying Zhang ;
Li-wen Chang ;
Zhi-hui Rong .
Current Medical Science, 2021, 41 :542-547