Risk Factors for Candidemia in Newborns in the University Reference Hospital

Background and objectives : Newborn admitted to neonatal unit are at high risk of acquiring hospital infections and Candida infections are associated with several preventable risk factors.  Methods : Paired case-control study was carried out in a neonatal referral unit of a university hospital. Data were collected by trained professionals from the Hospital Infection Control Service. The analysis of risk factors was performed using the Statistical Package for the Social Sciences software. The study was approved by the Ethics Committee.  Results : 3,087 admissions and 108 patients were selected (36 cases with Invasive Candidemia and 72 controls). The prevalence of Candidemia was 1.2% and the incidence density was 0.48 per 1000 patients per day. Parenteral nutrition, mechanical ventilation, central venous catheter and use of aminoglycosides showed statistical significance associated with Invasive Candidemia in the univariate analysis. The multivariate analysis showed that newborns who received parenteral nutrition, Odds ratio 3.52 Confidence interval (95%) 1.11-11.16 and urinary catheters Odds ratio 3.91 Confidence interval (95%) 1. 66-9.23 had a higher risk of developing Candidemia.  Discussion :   Good practices are necessary for the administration of parenteral nutrition and insertion and maintenance of urinary catheters to avoid fungal infections since the risk was greater in neonates who used these devices.