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Neurodevelopmental outcome of extremely low birth weight infants with Candida infection

Ira Adams-Chapman1, Carla M Bann, Abhik Das

  • 1Department of Pediatrics, Emory University, Atlanta, GA.

The Journal of Pediatrics
|June 4, 2013
PubMed

Insights

Candida infections in extremely low birth weight (ELBW) infants increase the risk of death and neurodevelopmental impairment (NDI). This risk is highest for infants with Candida sepsis or meningitis.

Area of Science:

  • Neonatal Research
  • Infectious Diseases
  • Pediatric Neurology

Background:

  • Candida infections pose a significant threat to preterm infants, particularly those with extremely low birth weight (ELBW).
  • Late-onset sepsis in ELBW infants is associated with adverse outcomes, including mortality and neurodevelopmental impairment (NDI).

Purpose of the Study:

  • To evaluate the mortality and neurodevelopmental outcomes of ELBW infants based on their infection status in the Candida study.
  • To compare outcomes between infected and uninfected ELBW infants and with a control group not screened for sepsis.

Main Methods:

  • Retrospective analysis of ELBW infants (born 2004-2007) enrolled in the Neonatal Research Network (NRN) Candida study.
  • Neurodevelopmental impairment assessed at 18 months using Bayley Scales of Infant Development-II or -III.
  • Comparison with a control group from the NRN Generic Database not screened for sepsis.

Main Results:

  • Among ELBW infants in the Candida study, 31% with Candida sepsis and 31% with non-Candida sepsis experienced NDI.
  • Candida sepsis or meningitis increased the risk of death and the composite outcome of death and/or NDI.
  • Candida infection was associated with a higher likelihood of NDI compared to infants never screened for sepsis (OR 1.83).

Conclusions:

  • ELBW infants with any sepsis or meningitis face elevated risks of death and NDI.
  • Candida sepsis and/or meningitis present the highest risk for adverse outcomes in this vulnerable population.
Abstract

Keywords:
BSIDBayley Scales of Infant DevelopmentCLDCNSCPCSFCentral nervous systemCerebral palsyCerebrospinal fluidChronic lung diseaseELBWEOSEarly-onset sepsisEunice Kennedy Shriver National Institute of Child Health and Human DevelopmentExtremely low birth weightGAGDBGeneric databaseGestational ageIVHIntraventricular hemorrhageLOSLate-onset sepsisNDNDINECNICHDNRNNecrotizing enterocolitisNeonatal Research NetworkNeurodevelopmentalNeurodevelopmental impairmentPVLPeriventricular leukomalacia

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