Clinical Characteristics Risk Factors Associated With Fungal Infections Among Preterm Infants

Abstract

Objectives To examine clinical characteristics and factors associated with fungal blood infection among preterm neonates in a tertiary hospital in Vietnam. Methods A case-control study of 32 preterm neonates with fungal infection (cases) and 303 preterm infants without fungal infection (controls) were treated at the Neonatal Intensive Care Unit of the Pediatrics Department, Bach Mai Hospital, in 2019. Clinical and laboratory characteristics were collected. Multivariate logistic regression was used to identify factors associated with fungal infection. Results The rate of fungal infection was highest in very preterm infants (62.3%) and those had very low birth weight (60.9%). Among infants with invasive fungal infections, the most common fungus in the study was Candida albicans (56.5%), followed by Candida tropicalis (21.7%) and Candida parrapsilosis (8.7%). In addition, invasive fungal infections in preterm infants were associated with central venous catheterization (odds ratio [OR] = 10.2, 95% confidence interval [CI] = 2.5-41.9), anoxia (OR = 12.2, 95% CI = 2.8-53.1), and thrombocytopenia (OR = 4.4, 95% CI = 1.6-12.4). Conclusion Premature babies with invasive fungal infections are mostly very preterm or extremely preterm and have very low birth weight or extremely low birth weights. In addition, children with specific problems such as having a central venous catheter, hypoxia, and thrombocytopenia have a higher risk of fungal infections. These results suggest that appropriate measures are needed to reduce fungal infections and the dangers of fungal infections in this population.