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 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, Alan H Jobe, Michael S Caplan, William Oh, Abbot R Laptook, Angelita M Hensman, Theresa M Leach, Lucy Noel, Bonnie E Stephens, Dawn Andrews, Kristen Angela, Avroy A Fanaroff, Nancy S Newman, Harriet G Friedman, Bonnie S Siner, Kurt Schibler, Edward F Donovan, Kimberly Yolton, Barbara Alexander, Kate Bridges, Teresa L Gratton, Cathy Grisby, Jody Hessling, Holly L Mincey, C Michael Cotten, Kathy J Auten, Kimberley A Fisher, Katherine A Foy, Sandra Grimes, Kathryn E Gustafson, Melody B Lohmeyer, Yun F Wang, Ellen C Hale, Ann Blackwelder, David P Carlton, Maureen Mulligan LaRossa, Sheena Carter, Gloria Smikle, Stephanie Wilson Archer, Ivan D Frantz 3rd, Brenda L MacKinnon, Ellen Nylen, Anne Furey, Cecelia Sibley, Ana Brussa, Brenda B Poindexter, James A Lemons, Ann B Cook, Faithe Hamer, Dianne E Herron, Carolyn Lytle, Lucy C Miller, Heike M Minnich, Cassandra L Stahlke, Leslie Dawn Wilson, W Kenneth Poole, Dennis Wallace, Jeanette O'Donnell Auman, Margaret Cunningham, Marie Gantz, Amanda R Irene, Betty K Hastings, Elizabeth M McClure, Jamie E Newman, Carolyn M Petrie Huitema, James W Pickett 2nd, Scott E Schaefer, Kristin M Zaterka-Baxter, Krisa P Van Meurs, David K Stevenson, M Bethany Ball, Anne M DeBattista, Alexis S Davis, Jean G Kohn, Barbara Bentley, Ginger K Brudos, Renee P Pyle, Waldemar A Carlo, Namasivayam Ambalavanan, Monica V Collins, Shirley S Cosby, Fred J Biasini, Kristen C Johnston, Kathleen G Nelson, Cryshelle S Patterson, Vivien A Phillips, Richard V Rector, Sally Whitley, Neil N Finer, Maynard R Rasmussen, David Kaegi, Kathy Arnell, Renee Bridge, Clarence Demetrio, Martha G Fuller, Chris Henderson, Wade Rich, Edward F Bell, John A Widness, Karen J Johnson, Diane L Eastman, Ruth Everett-Thomas, Amy Mur Worth, Maria Calejo, Alexis N Diaz, Silvia M Frade Eguaras, Yamiley C Gideon, Sylvia Hiriart- Fajardo, Ann Londono, Elaine O Mathews, Alexandra Stroerger, Robin K Ohls, Conra Backstrom Lacy, Dale L Phelps, Linda J Reubens, Erica Burnell, Diane Hust, Rosemary L Jensen, Julie Babish Johnson, Emily Kushner, Kelley Yost, Lauren Zwetsch, Joan Merzbach, Charles R Rosenfeld, Walid A Salhab, Alicia Guzman, Gaynelle Hensley, Melissa H Leps, Janet S Morgan, Lizette E Torres, Catherine Twell Boatman, Sally S Adams, Elizabeth Heyne, Linda A Madden, Kathleen A Kennedy, Jon E Tyson, Margarita Jiminez, Brenda H Morris, Saba Siddiki, Esther G Akpa, Nora I Alaniz, Susan Dieterich, Beverly Foley Harris, Charles Green, Anna E Lis, Sarah Martin, Georgia E McDavid, Patti L Pierce Tate, Margaret L Poundstone, Stacey Reddoch, Maegan C Simmons, Sharon L Wright, T Michael O'Shea, Nancy J Peters, Korinne Chiu, Deborah Evans Allred, Donald J Goldstein, Carroll Peterson, Ellen L Waldrep, Lisa K Washburn, Barbara G Jackson, Rebecca Bara, Laura Goldston, Patricia Gettner, Monica Konstantino, JoAnn Poulsen, Elaine Romano, Janet Taft, 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 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, Alan H Jobe, Michael S Caplan, William Oh, Abbot R Laptook, Angelita M Hensman, Theresa M Leach, Lucy Noel, Bonnie E Stephens, Dawn Andrews, Kristen Angela, Avroy A Fanaroff, Nancy S Newman, Harriet G Friedman, Bonnie S Siner, Kurt Schibler, Edward F Donovan, Kimberly Yolton, Barbara Alexander, Kate Bridges, Teresa L Gratton, Cathy Grisby, Jody Hessling, Holly L Mincey, C Michael Cotten, Kathy J Auten, Kimberley A Fisher, Katherine A Foy, Sandra Grimes, Kathryn E Gustafson, Melody B Lohmeyer, Yun F Wang, Ellen C Hale, Ann Blackwelder, David P Carlton, Maureen Mulligan LaRossa, Sheena Carter, Gloria Smikle, Stephanie Wilson Archer, Ivan D Frantz 3rd, Brenda L MacKinnon, Ellen Nylen, Anne Furey, Cecelia Sibley, Ana Brussa, Brenda B Poindexter, James A Lemons, Ann B Cook, Faithe Hamer, Dianne E Herron, Carolyn Lytle, Lucy C Miller, Heike M Minnich, Cassandra L Stahlke, Leslie Dawn Wilson, W Kenneth Poole, Dennis Wallace, Jeanette O'Donnell Auman, Margaret Cunningham, Marie Gantz, Amanda R Irene, Betty K Hastings, Elizabeth M McClure, Jamie E Newman, Carolyn M Petrie Huitema, James W Pickett 2nd, Scott E Schaefer, Kristin M Zaterka-Baxter, Krisa P Van Meurs, David K Stevenson, M Bethany Ball, Anne M DeBattista, Alexis S Davis, Jean G Kohn, Barbara Bentley, Ginger K Brudos, Renee P Pyle, Waldemar A Carlo, Namasivayam Ambalavanan, Monica V Collins, Shirley S Cosby, Fred J Biasini, Kristen C Johnston, Kathleen G Nelson, Cryshelle S Patterson, Vivien A Phillips, Richard V Rector, Sally Whitley, Neil N Finer, Maynard R Rasmussen, David Kaegi, Kathy Arnell, Renee Bridge, Clarence Demetrio, Martha G Fuller, Chris Henderson, Wade Rich, Edward F Bell, John A Widness, Karen J Johnson, Diane L Eastman, Ruth Everett-Thomas, Amy Mur Worth, Maria Calejo, Alexis N Diaz, Silvia M Frade Eguaras, Yamiley C Gideon, Sylvia Hiriart- Fajardo, Ann Londono, Elaine O Mathews, Alexandra Stroerger, Robin K Ohls, Conra Backstrom Lacy, Dale L Phelps, Linda J Reubens, Erica Burnell, Diane Hust, Rosemary L Jensen, Julie Babish Johnson, Emily Kushner, Kelley Yost, Lauren Zwetsch, Joan Merzbach, Charles R Rosenfeld, Walid A Salhab, Alicia Guzman, Gaynelle Hensley, Melissa H Leps, Janet S Morgan, Lizette E Torres, Catherine Twell Boatman, Sally S Adams, Elizabeth Heyne, Linda A Madden, Kathleen A Kennedy, Jon E Tyson, Margarita Jiminez, Brenda H Morris, Saba Siddiki, Esther G Akpa, Nora I Alaniz, Susan Dieterich, Beverly Foley Harris, Charles Green, Anna E Lis, Sarah Martin, Georgia E McDavid, Patti L Pierce Tate, Margaret L Poundstone, Stacey Reddoch, Maegan C Simmons, Sharon L Wright, T Michael O'Shea, Nancy J Peters, Korinne Chiu, Deborah Evans Allred, Donald J Goldstein, Carroll Peterson, Ellen L Waldrep, Lisa K Washburn, Barbara G Jackson, Rebecca Bara, Laura Goldston, Patricia Gettner, Monica Konstantino, JoAnn Poulsen, Elaine Romano, Janet Taft
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.
Conflict of interest statement
The authors declare no conflicts of interest.
Copyright © 2013 Mosby, Inc. All rights reserved.
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Source: PubMed