Fungal colonization in newborn babies of very low birth weight: A cohort study

Objectives: to learn about the profile of fungal colonization and related risk factors in premature newborns. methods: prospective cohort,from april 04,2010 to april 31,2011,with 44 patients admitted to the neonatal intensive care unit,born at the hospital maternity,weighing less than 1,500 g. on admission,data were collected on pre-natal care and childbirth. clinical and laboratory information,nasal and rectal swabs,and peripheral blood cultures were collected on days 1,7,10 and 14 of stay in neonatal intensive care unit and then,every 7 days until discharge or death. for statistical analysis,we used chi-square test,fisher exact test,kaplan-meier and logistic regression model. results: the incidence of colonization was 13.5/1,000 patients/day. the incidence of candidemia was 0.9/1,000 patients/day. the average hospitalization time was 30.5 days (±20.27),and the onset of colonization occurred,in average,at 11.13 days (±8.82). vaginal delivery was found to be an independent risk factor for the development of fungal colonization during hospitalization (p = 0.042,odds ratio = 4.38,95% confidence interval [95%ci] = 1,13-16,99). likewise,leukocytosis (> 30,000/mm3) on admission was an indicator for the simultaneous presence of fungal colonization (p = 0.048). the presence of bronchopulmonary dysplasia tends to be a factor of higher probability for the development of colonization (p = 0.067). the most affected colonization site was the rectal mucosa: 89.09 versus 10.9% of the nasal mucosa. conclusion: vaginal delivery and leukocytosis over 30,000/mm3 on admission were found to be risk factors for fungal colonization during hospitalization. copyright © by sociedade brasileira de pediatria.