The changing incidence of neonatal candida bloodstream infections among high risk nurseries in the United States, 1995-2004.

Fridkin S 1, Edwards J 2, Shetty S 1, Austin J 1, Fan K 1, *Horan T 2

Author address: 

1 Division of Bacterial and Mycotic Diseases, NCID, CDC, Atlanta USA, 2 Division of Healthcare Quality Promotion, NCID, CDC, Atlanta USA

Abstract: 

Background: Bloodstream infections caused by the yeast Candida (Candida BSI) are the 3rd leading cause of late-onset sepsis in the neonatal ICU population. As antifungal prophylaxis with azoles is adopted, characterizing the epidemiology of neonatal Candida BSIs is needed to determine the role of species commonly resistant to these agents (C. glabrata and C. kruseii) and identify subpopulations for targeting prophylaxis strategies. Objectives: Determine trends in invasive candidasis (IC) among high risk neonates in the U.S. Methods: We analyzed data on IC among neonates from hospitals participating in the High Risk Nursery (HRN) component of the National Nosocomial Infections Surveillance system (NNIS) during January 1995—December 2004. Using NNIS definitions, IC was defined as primary BSI (i.e., no other body site identified as the primary source of infection) or secondary BSI (i.e., another body site is the primary source of infection). Incidence (no. Candida BSI per 100 patients admitted) and the risk adjusted incidence density (no. of Candida BSI/1000 central vascular catheter (CVC) days) was determined for each HRN, by year and pooled to determine overall incidence, and incidence by species and birth weight category (BWC). Differences in incidence density were compared by binomial test; differences in incidence, BWC and species, by chi-square (categorical variables), trends over time by chi-square for trend. Results: 129 HRNs reported 1,632 months of data which included 130,523 patients, 1997 (1.5%) of whom had IC; 1709 IC (86%) were classified as primary Candida BSI. IC varied by species: 58% C. albicans, 34% C. parapsilosis, 4% C. glabrata, 2% C. tropicalis, 2% C. lusitaniae, 0.2% C. krusei. 1472 (74%) of all IC occurred in the 2500=1.4, p
2005

abstract No: 

41

Full conference title: 

15th Annual Focus on Fungal Infections
    • FFI 15th (2005)