Trends in Candida central line-associated bloodstream infections among NICUs, 1999-2009.

Abstract:

OBJECTIVES:To assess trends in incidence of Candida spp. central line-associated bloodstream infections (CLABSIs) in US NICUs, 1999-2009. METHODS:Data from NICUs participating in the National Nosocomial Infections Surveillance (1999-2004) and National Healthcare Safety Network (2006-2009) were analyzed. Overall and birth weight-specific incidence rates of Candida spp. CLABSIs per 1000 central line-days were calculated. Trends in incidence were assessed by using Poisson regression, and trends in proportion of CLABSIs identified as Candida albicans were assessed by using weighted-linear regression. RESULTS:Overall, 398 NICUs reported 1407 Candida spp. CLABSIs (706 due to C albicans) among 1400 neonates. Of the 1400 neonates, 963 (69%) were ≤ 1000 g at the time of birth, and 182 (13%) died. From 1999 to 2009, the overall incidence decreased significantly for CLABSIs due to Candida spp. (0.92 vs 0.2), C albicans (0.53 vs 0.09), and non-albicans Candida spp. (0.39 vs 0.1). Birth weight-specific incidence significantly decreased across all birth weight categories for C albicans. For CLABSIs due to non-albicans Candida spp., significant decreases were detected among all birth weight categories, except among neonates 1501 to 2500 g. The proportion of Candida spp. CLABSIs due to C albicans did not significantly change over time, remaining at ~50%. CONCLUSIONS:Incidence of Candida spp. CLABSIs decreased substantially among NICU patients, regardless of birth weight. Decreases in incidence across all birth weight categories, and not only among neonates ≤ 1000 g in whom antifungal prophylaxis may be more common, suggest that multiple factors contributed to the declining incidence.

journal_name

Pediatrics

journal_title

Pediatrics

authors

Chitnis AS,Magill SS,Edwards JR,Chiller TM,Fridkin SK,Lessa FC

doi

10.1542/peds.2011-3620

subject

Has Abstract

pub_date

2012-07-01 00:00:00

pages

e46-52

issue

1

eissn

0031-4005

issn

1098-4275

pii

peds.2011-3620

journal_volume

130

pub_type

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