Incidence and Characteristics of Candida Sepsis in Very Low Birth Weight Infants

Science Center, Bent Corridor

The objective of this study was to describe the incidence and risk factors for Candida sepsis (CS) in very low birth weight (<1500 >g) premature infants and compare these factors with earlier data. We conducted a retrospective chart review case-control study of 94 infants with a BW <1500 g admitted to the NICU>(MetroHealth Medical Center, Cleveland, Ohio) between January 1, 2000 and December 31, 2015. Infant groups with (n = 47) and without (n = 47) CS were compared. Forty seven infants with CS confirmed by positive blood culture were identified. Controls without CS were matched using BW, gestational age, and date of birth. The overall incidence of CS was 2.6% in infants <1500 g and CS was diagnosed at a median age of 21 days. Candida albicans>(n = 24, 51%) and Candida parapsilosis (n = 21, 45%) were most common. Overall incidence of CS in <1250 g babies was>3.5%, compared to 19% in same center historical cases (1996-1999). Examined risk factors were not associated with CS. Postnatal Candida colonization was associated with CS (p = 0.00125). For unexplained reasons, infants with CS versus controls had lower mortality. Mortality among cases (BW <1250) fell from 30% to 11% when historical cases (1996-1999) were compared to current cases (2000-2015) (p = 0.0183). The incidence and mortality rate of Candida sepsis in infants <1500 g admitted to the MHMC NICU have decreased significantly from late the 1990s onwards with the lowest incidence noted since 2010.