Invasive fungal infection in very low birthweight infants: national prospective surveillance study
Date
2005-12-06
Authors
Clerihew, L
Lamagni, T. L.
Brocklehurst, P.
McGuire, W.
Journal Title
Journal ISSN
Volume Title
Publisher
BMJ Publishing Group
Abstract
OBJECTIVE To describe the epidemiology of invasive fungal infection in very low birthweight (VLBW: <1500 g) infants in the United Kingdom. DESIGN National prospective surveillance study between February 2003 and February 2004 using the British Paediatric Surveillance Unit reporting system reconciled with cases identified through routine laboratory reporting to the Health Protection Agency (England, Wales, and Northern Ireland), the Scottish Centre for Infection and Environmental Health, and the UK Mycology Reference Laboratory. RESULTS Ninety four confirmed cases of invasive fungal infection were identified during the surveillance period giving an incidence of estimated annual incidence of 10.0 (95% confidence interval (CI) 8.0 to 12.0) cases per 1000 VLBW live births. Eighty one (86%) of the infants were of extremely low birth weight (ELBW: <1000 g), incidence 21.1 (95% CI 16.5 to 25.7) per 1000 ELBW live births. Candida species, predominantly C albicans and C parapsilosis, were isolated in 93% of cases. Most organisms were isolated from the bloodstream and urinary tract. Death occurred in 41% of the infected infants before 37 weeks postconceptional age. CONCLUSIONS The incidence of invasive fungal infection in VLBW and ELBW infants in the United Kingdom is lower than reported in previous studies from tertiary centres in North America and elsewhere. The associated late neonatal and post-neonatal death rates are substantially higher than expected in infants without invasive fungal infection. These data may inform decisions about the evaluation and use of antifungal infection control strategies.
Description
Keywords
antifungal agents, early diagnosis, gestational age, great britain, humans, incidence, infant, infant mortality, infant, newborn, infant, premature, infant, premature, diseases, mycoses, prospective studies, survival analysis, infant, very low birth weight
Citation
Collections
Source
Archives of Disease in Childhood - Fetal and Neonatal Edition
Type
Journal article