Maria Gibelli and Vera Krebs
Fungemia is a severe complication on neonatal period among very low birth weight infants (VLBW). The aim of the study was to describe the incidence of fungal sepsis and to analyze the risk factors among this population. Data were collected prospectively over a 25 months period among VLBW infants admitted at the Neonatal Intensive Care Unit (NICU), with more then 72 hours of life. Patients were divided in five groups, based on the first positive blood culture: without sepsis; sepsis with negative blood culture; Gram-positive bacterial sepsis; Gram-negative bacterial sepsis and fungal sepsis. For statistical analyses the Pearson test, the Kruskal-Wallis test and a logistic regression model were used. 187 newborns were included in the study: 110 (58,8%) had late-onset sepsis; 13 (7%) had fungal sepsis. Rate of mortality was 69,2%. The risk factors identified at the comparison between the fungemia group and no-fungemia (all the remaining sample) were: birth weight (BW), gestational age (GA), central venous catheter (CVC), parenteral nutrition (PN), fasting, mechanical ventilation (MV), exposure to vancomycine, cefepime, meropenem, and amikacine. Further statistical analyses have shown: for each increasing of 10 g in BW, the risk of fungemia diminished 3%; each day of CVC, increased this risk in 8,1%; each day of MV increased this risk in 11,1%. The analyses of the categorized variables have shown: BW 1000 g increased the risk of fungemia 23 times; MV 14 days increased the risk 36 times; each day of CVC increased the risk of fungemia in 9,3%.