Abstract
Systemic candidiasis occurs in 3 to 10% of high risk neonates, but the incidence and significance of fungal colonization in these patients is unknown. We studied colonization and evaluated surveillance cultures for the early detection of systemic fungal infections. Infants older than two weeks who were begun on antimicrobials and those with central venous catheters had weekly throat, stool, and urine cultures. 28 patients were enrolled at a median age of 28 days and followed for a mean of 9 weeks. 70 of 786 (8.9%) specimens grew Candida sp. (12.5% urine, 9.2% throat, 5.0% of stool cultures). 12 of 28 infants became colonized at a median age of 48 days; 6 in the throat, 7 in stool, and 7 in urine. Among 7 patients with positive bagged urine cultures, only 2 had positive catheterized cultures and both had systemic disease. 3 of the 28 patients died, 2 with systemic fungal infections. Risk factors in the 12 colonized versus 16 noncolonized were: birth weight 1140 vs 1530 g*, arterial catheters 11 vs 15, central venous catheters 2 vs 3, hyperalimentation 11 vs 14, asphyxia 7 vs 12, NEC 3 vs 6, bowel surgery 0 vs 3, prenatal steriods 2 vs 3, theophylline 11 vs 8*, days on antibiotics 44 vs 20*, respectively (*p<0.05). In summary, 42.9% of selected infants became colonized with Candida sp. and 7.2% developed systemic candidiasis. Surveillance with urine cultures, but not throat and stool, detected incipient systemic fungal infections.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Swingle, H., Abramson, J., Block, S. et al. 1539 PROSPECTIVE SURVEY OF FUNGAL COLONIZATION IN HIGH RISK INFANTS. Pediatr Res 19, 367 (1985). https://doi.org/10.1203/00006450-198504000-01563
Issue Date:
DOI: https://doi.org/10.1203/00006450-198504000-01563