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ORIGINAL ARTICLE
Korean J Pediatr 2013 February;56(2) :68-74.
Published online 2012 October 24.        doi:https://doi.org/10.3345/kjp.2013.56.2.68
The control of invasive Candida infection in very low birth weight infants by reduction in the use of 3rd generation cephalosporin
Yu Jin Chang (Chang YJ)1, Il Rak Choi (Choi IR)1, Won Sub Shin (Shin WS)1, Jang Hoon Lee (Lee JH)1, Yun Kyung Kim (Kim YK)2, Moon Sung Park (Park MS)1
1Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea
2Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
Corresponding Author: Jang Hoon Lee ,Tel: +82-31-219-4487, Fax: +82-31-219-5169, Email: neopedlee@gmail.com
Copyright © 2013 by The Korean Pediatric Society
ABSTRACT
Purpose: To evaluate the effectiveness of new management policies on the incidence of invasive Candida infections
Methods: This observational study involved a retrospective analysis of the patients medical records. In total, 99 very low birth weight infants, who were admitted to the neonatal intensive care unit at Ajou University Hospital from January 2010 to December 2011, were enrolled for the study. Period I, defined as the period before the revision of management policies, comprised 57 infants; whereas, period II, defined as the period after the implementation of new management policies, comprised 42 infants. The new management policies entailed a reduction in antibiotic and histamine type 2 receptor blocker (H2 blocker) use, duration of central venous catheterization, and duration of endotracheal intubation.
Results: There was a significant overall decrease in the use of antibiotics including 3rd generation cephalosporin and H2 blockers (P<0.05), and a significantly lower incidence of invasive Candida infections in period II as compared to period I (0/42 vs. 6/57, respectively; P =0.037). Comparison between infants with invasive Candida infections (n=6) and those without (n=93) showed that gestational age (odds ratio [OR], 0.909; 95% confidence interval [CI], 0.829 to 0.996; P =0.042) and the duration of 3rd generation cephalosporin use (OR, 1.093; 95% CI, 1.009 to 1.183; P =0.029) were statistically significant risk factors.
Conclusion: The new management policies effectively decreased overall use of antibiotics, especially 3rd generation cephalosporin, and H2 blockers, which led to a significantly lower incidence of invasive Candida infections.
Keywords: Invasive candidiasis | Very low birth weight infant | Nosocomial infection | Sepsis
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