Neurodevelopmental outcome of extremely low birth weight infants with Candida infection

Ira Adams-Chapman, 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. AcarreguiGary 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

Research output: Contribution to journalArticlepeer-review

85 Scopus citations

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.

Original languageEnglish
Pages (from-to)961-967.e3
JournalJournal of Pediatrics
Volume163
Issue number4
DOIs
StatePublished - Oct 2013

Bibliographical note

Funding Information:
Supported by grants from the National Institutes of Health and the Eunice Kennedy Shriver NICHD for the Neonatal Research Network’s Candidiasis Study ( Appendix ). D.B. received support from the Thrasher Research Fund and NICHD . The funding agencies provided overall oversight for study conduct, but all data analyses and interpretation were independent of the funding agencies. Data collected at participating sites of the NICHD Neonatal Research Network were transmitted to RTI International, the data coordinating center for the network, which stored, managed, and analyzed the data for this study. The authors declare no conflicts of interest.

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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