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Dexamethasone Therapy and Candida Sepsis in Neonates Less Than 1250 Grams

Journal of Perinatology volume 22, pages 204–208 (2002)Cite this article

Abstract

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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Authors and Affiliations

  1. Pediatrics, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA

    Angelina Pera MD, Rama Schwartz MD, Deepak Kumar MD, MRCP & Prabhu Parimi MD

  2. Pediatrics and MetroHealth Foundation, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA

    Angela Byun & Steven Gribar

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  1. Angelina Pera MD
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Pera, A., Byun, A., Gribar, S. et al. Dexamethasone Therapy and Candida Sepsis in Neonates Less Than 1250 Grams. J Perinatol 22, 204–208 (2002). https://doi.org/10.1038/sj.jp.7210699

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