Information de reference pour ce titreAccession Number: | 00005186-200508000-00007.
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Author: | FEJA, KRISTINA N. MD, MPH; WU, FANN MD, PHD; ROBERTS, KEVIN PHD; LOUGHREY, MAUREEN RN, MS; NESIN, MIRJANA MD; LARSON, ELAINE PHD; DELLA-LATTA, PHYLLIS PHD; HAAS, JANET RN, MS; CIMIOTTI, JEANNIE RN, DNSC; SAIMAN, LISA MD, MPH
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Institution: | Departments of Pediatrics, Biostatistics, Pathology, Epidemiology and School of Nursing, Columbia University Medical Center, New York, New York; and Department of Pediatrics, Cornell University Medical Center, Ithaca, New York; and New York Presbyterian Hospital, New York, New York.
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Title: | |
Source: | Journal of Pediatrics. 147(2):156-160, August 2005.
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Abstract: | Objective: To determine risk factors for late-onset candidemia among infants in the neonatal intensive care unit (NICU).
Study design: We performed a matched case-control study from March 2001 to January 2003 in 2 level III-IV NICUs. Case subjects had candidemia diagnosed more than 48 hours after hospitalization. Control subjects (3 per case) were matched by study site, birth weight, study year, and date of enrollment. Potential risk factors included medical devices, medications, gastrointestinal (GI) pathology (congenital anomalies or necrotizing enterocolitis) and previous bacterial bloodstream infections (BSIs).
Results: Forty-five cases of candidemia occurred during the study period and accounted for 15% of BSIs. C. albicans caused 62% of infections (28/45); C. parapsilosis, 31% (14/45). Multivariate analysis revealed that catheter use (odds ratio [OR] = 1.06 per day of use; 95% confidence interval [CI] = 1.02 to 1.10), previous bacterial BSIs (OR = 8.02; 95% CI = 2.76 to 23.30) and GI pathology (OR = 4.57; 95% CI = 1.62 to 12.92) were significantly associated with candidemia. In all, 26/45 cases (58%) of candidemia occurred in infants who would not have qualified for fluconazole prophylaxis according to the Kaufman criteria.
Conclusions: We confirmed previous risk factors (catheter-days) and identified novel risk factors (previous BSI and GI pathology) for candidemia in critically ill infants that could guide future targeted antifungal prophylaxis strategies.
(C) Mosby-Year Book Inc. 2005. All Rights Reserved.
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Language: | English.
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Document Type: | ORIGINAL ARTICLE.
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Journal Subset: | Clinical Medicine.
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ISSN: | 0022-3476
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NLM Journal Code: | jlz, 0375410
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