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
Observational Study
. 2013 Oct;163(4):961-7.e3.
doi: 10.1016/j.jpeds.2013.04.034. Epub 2013 May 30.

Neurodevelopmental outcome of extremely low birth weight infants with Candida infection

Ira Adams-Chapman  1 , Carla M Bann, Abhik Das, Ronald N Goldberg, Barbara J Stoll, Michele C Walsh, Pablo J Sánchez, Rosemary D Higgins, Seetha Shankaran, Kristi L Watterberg, Shahnaz Duara, Nancy A Miller, Roy J Heyne, Myriam Peralta-Carcelen, Ricki F Goldstein, Jean J Steichen, Charles R Bauer, Susan R Hintz, Patricia W Evans, Michael J Acarregui, Gary J Myers, Betty R Vohr, Deanne E Wilson-Costello, Athina Pappas, Yvonne E Vaucher, Richard A Ehrenkranz, Elisabeth C McGowan, Robert G Dillard, Janell Fuller, Daniel K Benjamin Jr; Eunice Kennedy Shriver National Institutes of Child Health and Human Development Neonatal Research Network
Collaborators, Affiliations
Observational Study

Neurodevelopmental outcome of extremely low birth weight infants with Candida infection

Ira Adams-Chapman et al. J Pediatr. 2013 Oct.

Abstract

Objective: Candida remains an important cause of late-onset infection in preterm infants. Mortality and neurodevelopmental outcome of extremely low birth weight (ELBW) infants enrolled in the Candida study were evaluated based on infection status.

Study design: ELBW infants born at Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network (NRN) centers between March 2004 and July 2007 who were screened for suspected sepsis were eligible for inclusion in the Candida study. Primary outcome data for neurodevelopmental impairment (NDI) or death were available for 1317 of the 1515 infants (87%) enrolled in the Candida study. The Bayley Scales of Infant Development-II or -III was administered at 18 months' adjusted age. A secondary comparison was performed with 864 infants enrolled in the NRN Generic Database during the same cohort who were never screened for sepsis and therefore not eligible for the Candida study.

Results: Among ELBW infants enrolled in the Candida study, 31% with Candida and 31% with late-onset non-Candida sepsis had NDI at 18 months. Infants with Candida sepsis and/or meningitis had an increased risk of death and were more likely to have the composite outcome of death and/or NDI compared with uninfected infants in adjusted analysis. Compared with infants in the NRN registry never screened for sepsis, overall risk for death were similar but those with Candida infection were more likely to have NDI (OR 1.83, 95% CI 1.01-3.33, P = .047).

Conclusions: In this cohort of ELBW infants, those with infection and/or meningitis were at increased risk for death and/or NDI. This risk was highest among those with Candida sepsis and/or meningitis.

Keywords: BSID; Bayley Scales of Infant Development; CLD; CNS; CP; CSF; Central nervous system; Cerebral palsy; Cerebrospinal fluid; Chronic lung disease; ELBW; EOS; Early-onset sepsis; Eunice Kennedy Shriver National Institute of Child Health and Human Development; Extremely low birth weight; GA; GDB; Generic database; Gestational age; IVH; Intraventricular hemorrhage; LOS; Late-onset sepsis; ND; NDI; NEC; NICHD; NRN; Necrotizing enterocolitis; Neonatal Research Network; Neurodevelopmental; Neurodevelopmental impairment; PVL; Periventricular leukomalacia.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1. Candida Study Enrollment
* 2 infants in Candida study were born before 3/04 (birthdates 1/04 and 2/04)
See this image and copyright information in PMC

References

    1. Benjamin DK, Jr, Stoll BJ, Gantz MG, Walsh MC, Sanchez PJ, Das A, et al. Neonatal candidiasis: epidemiology, risk factors, and clinical judgment. Pediatrics. 2010;126(4):e865–73. Epub 2010/09/30. - PMC - PubMed
    1. Benjamin DK, Jr, Ross K, McKinney RE, Jr, Benjamin DK, Auten R, Fisher RG. When to Suspect Fungal Infection in Neonates: A Clinical Comparison of Candida albicans and Candida parapsilosis Fungemia With Coagulase-Negative Staphylococcal Bacteremia. Pediatrics. 2000;106(4):712–8. - PubMed
    1. Stoll BJ, Hansen N, Fanaroff AA, Wright LL, Carlo WA, Ehrenkranz RA, et al. Late-onset sepsis in very low birth weight neonates: the experience of the NICHD Neonatal Research Network. Pediatrics. 2002;110(2 Pt 1):285–91. Epub 2002/08/08. - PubMed
    1. Stoll BJ, Hansen NI, Adams-Chapman I, Fanaroff AA, Hintz SR, Vohr B, et al. Neurodevelopmental and growth impairment among extremely low-birth-weight infants with neonatal infection. JAMA. 2004;292(19):2357–65. Epub 2004/11/18. - PubMed
    1. Vohr BR, Wright LL, Dusick AM, Mele L, Verter J, Steichen JJ, et al. Neurodevelopmental and functional outcomes of extremely low birth weight infants in the National Institute of Child Health and Human Development Neonatal Research Network, 1993–1994. Pediatrics. 2000;105(6):1216–26. Epub 2000/06/02. - PubMed

Publication types