Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Jan-Mar;11(1):71-5.
doi: 10.1590/s1679-45082013000100013.

Invasive candidiasis and oral manifestations in premature newborns

[Article in English, Portuguese]
José Endrigo Tinoco-Araujo  1 , Diana Ferreira Gadelha Araújo, Patrícia Gomes Barbosa, Paulo Sérgio da Silva Santos, Ana Myriam Costa de Medeiros
Affiliations

Invasive candidiasis and oral manifestations in premature newborns

[Article in English, Portuguese]
José Endrigo Tinoco-Araujo et al. Einstein (Sao Paulo). 2013 Jan-Mar.

Abstract
in English, Portuguese

Objective: To investigate prevalence of invasive candidiasis in a Neonatal Intensive Care Unit and to evaluate oral diseases and Candida spp. colonization in low birth weight preterm newborns.

Methods: A descriptive epidemiological study performed in two stages. First, prevalence of candidiasis was analyzed in a database of 295 preterm patients admitted to hospital for over 10 days and birth weight less than 2,000g. In the second stage, oral changes and Candida spp. colonization were assessed in 65 patients weighing less than 2,000g, up to 4 week-old, hospitalized for over 10 days and presenting oral abnormalities compatible with fungal lesions. Swab samples were collected in the mouth to identify fungi.

Results: Prevalence of candidiasis was 5.4% in the database analyzed. It correlated with prolonged hospital length of stay (p<0.001), in average, 31 days, and 85% risk of developing infection in the first 25 days. It correlated with low birth weight (p<0.001), with mean of 1,140g. The most frequent alterations were white soft plaques, detachable, in oral mucosa and tongue. Intense oral colonization by Candida spp was observed (80%).

Conclusions: The frequency of invasive candidiasis was low and correlated with low birth weight and prolonged hospital stay. The most common oral changes were white plaques compatible with pseudomembranous candidiasis and colonization by Candida spp. was above average.

Objetivo:: Investigar a prevalência de candidíase invasiva em Unidade de Terapia Intensiva Neonatal e avaliar alterações bucais e colonização bucal por Candida spp. em recém-nascidos prematuros com baixo peso.

Métodos:: Estudo epidemiológico descritivo em duas etapas. Na primeira, analisou-se prevalência de candidíase invasiva em base de dados de 295 prematuros com tempo de internação superior a 10 dias e peso ao nascer inferior a 2.000g. Na segunda etapa, avaliaram-se alterações bucais e colonização por Candida spp. em 65 pacientes com peso inferior a 2.000g, com até 4 semanas de idade, internados há mais de 10 dias e apresentando alterações bucais compatíveis com lesões fúngicas. Coletaram-se amostras com swab bucal e identificou-se a colonização fúngica.

Resultados:: Na análise da base de dados, constatou-se que a prevalência de candidíase foi de 5,4%. Houve correlação com o tempo prolongado de internação (p<0,001), que foi, em média, de 31 dias, com risco de desenvolver infecção de 85% nos primeiros 25 dias. Houve correlação com o baixo peso ao nascer (p<0,001), com média de 1.410g. No exame dos pacientes, constatou-se que as alterações bucais mais frequentes foram placas brancas, moles, destacáveis localizadas na mucosa jugal e língua. Houve colonização bucal expressiva por Candida spp. (80%).

Conclusão:: A frequência de candidíase invasiva foi baixa e teve correlação com baixo peso ao nascer e tempo de internação prolongado. As alterações bucais mais frequentes foram placas brancas compatíveis com candidíase pseudomembranosa e a colonização por Candida spp. foi acima da média.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: none.

Similar articles

See all similar articles

Cited by

References

    1. Karlowicz MG, Hashimoto LN, Kelly RE, Buescher ES. Should central venous catheters be removed as soon as candidemia is detected in neonates? Pediatrics. 2000;106(5):E63–E63. - PubMed
    1. Brecht M, Clerihew L, McGuire W. Prevention and treatment of invasive fungal infection in very low birthweight infants. Arch Dis Child Fetal Neonatal Ed. 2009;94(1):65–69. - PubMed
    1. Benjamin DK, Jr, Stoll BJ, Gantz MG, Walsh MC, Sánchez PJ, Das A, Shankaran S, Higgins RD, Auten KJ, Miller NA, Walsh TJ, Laptook AR, Carlo WA, Kennedy KA, Finer NN, Duara S, Schibler K, Chapman RL, Van Meurs KP, Frantz ID, 3rd, Phelps DL, Poindexter BB, Bell EF, O'Shea TM, Watterberg KL, Goldberg RN. Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Neonatal candidiasis: epidemiology, risk factors, and clinical judgment. Pediatrics. 2010;126(4):865–873. - PMC - PubMed
    1. Greenberg RG, Benjamin DK, Jr, Gantz MG, Cotten CM, Stoll BJ, Walsh MC, Sánchez PJ, Shankaran S, Das A, Higgins RD, Miller NA, Auten KJ, Walsh TJ, Laptook AR, Carlo WA, Kennedy KA, Finer NN, Duara S, Schibler K, Ehrenkranz RA, Van Meurs KP, Frantz ID, 3rd, Phelps DL, Poindexter BB, Bell EF, O'Shea TM, Watterberg KL, Goldberg RN, Smith PB. Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Empiric Antifungal Therapy and Outcomes in Extremely Low Birth Weight Infants with Invasive Candidiasis. J Pediatr. 2012;161(2):264–269. - PMC - PubMed
    1. Cahan H, Deville JG. Outcomes of Neonatal Candidiasis: The Impact of Delayed Initiation of Antifungal Therapy. Int J Pediatr. 2011;2011:813871–813871. - PMC - PubMed