ST. LOUIS — A medical practice intervention reduced the incidence of Candida species from 36% among 45 control neonates admitted between Jan. 1, 1995, and June 30, 1996, to 6% among 69 neonates admitted between July 1, 1996, and December 31, 1998, said Dr. Maliha J. Shareef in a poster presented at the annual meeting of the Midwest Society for Pediatric Research.
The intervention included administration of oral nystatin every 6 hours for the first week of life, and as an accompaniment to each antibiotic course during the first 4 weeks, wrote Dr. Shareef of St. Francis Medical Center, Peoria, Ill. Modification of parameters for early extubation, early discontinuation of central lines, and use of parenteral nutrition and antibiotics also were part of the intervention.
The study included neonates weighing 750 g or less at birth, who were admitted to a neonatal ICU within the first week of life.
A retrospective analysis revealed that the intervention group experienced significantly fewer episodes of Candida after controlling for gestational age, model of delivery, and number of days of central vascular access. However, exposure to a high humidity environment was significantly associated with an increased risk of Candida sepsis within the intervention group (odds ratio 10.5).
Overall infection rates remained in the 0%–3% range during 1999–2004.