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Published on: August 24, 2011

Hyperglycaemia as a possible marker of invasive fungal infection in preterm neonates

Paolo Manzoni1, Elio Castagnola, Michael Mostert

  • 1Neonatology Unit and Hospital NICU, Ospedale S. Anna, Turin, Italy. paolomanzoni@hotmail.com

Acta Paediatrica (Oslo, Norway : 1992)
|May 25, 2006
PubMed
Abstract

Insights

Hyperglycaemia, a sign of glucose intolerance, is more common in preterm newborns with invasive fungal infections. This finding suggests monitoring for fungal infections in vulnerable neonates presenting with carbohydrate intolerance.

Area of Science:

  • Neonatal Medicine
  • Infectious Diseases
  • Metabolic Disorders

Background:

  • Invasive fungal infections (IFIs) pose a growing threat to preterm newborns.
  • Diagnosing IFIs is challenging due to non-specific clinical signs and poor microbiological data.
  • Differentiating fungal from bacterial infections in neonates is difficult.

Purpose of the Study:

  • To investigate if glucose intolerance, specifically hyperglycemia, can serve as a predictive marker for IFIs in preterm neonates.
  • To evaluate the temporal relationship between hyperglycemia and the onset of IFIs.

Main Methods:

  • A case-control study was conducted on 383 neonates (birthweight < 1250 g).
  • Cases (n=45) had IFIs; controls (n=46) had bacterial late-onset sepsis.
  • Hyperglycemia (serum glycaemia > 215 mg/dl) occurrence and timing relative to sepsis were analyzed.

Main Results:

  • Hyperglycemia was significantly more frequent in neonates with IFIs (46.6%) compared to bacterial sepsis (23.9%).
  • In 90.4% of IFI cases with hyperglycemia, it preceded infection by approximately 72 hours.
  • No such temporal relationship was observed in bacterial sepsis cases.

Conclusions:

  • Hyperglycemia is a significant indicator preceding invasive fungal infections in preterm neonates by about 3 days.
  • Preterm neonates (<1250 g) with signs of carbohydrate intolerance warrant careful evaluation for systemic fungal infection.

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