Risk factors for invasive candidiasis in the neonatal intensive and intermediate care unit: a case-control study at a referral center in Mexico City.

BACKGROUND

Invasive candidiasis is a high-impact pathology in the neonatal intensive care unit (NICU).

OBJECTIVE

To evaluate risk factors for invasive candidiasis in a referral center in Mexico City.

MATERIAL AND

METHODS

Observational case control study. Neonates diagnosed with invasive candidiasis were included, matched 1:3 with controls hospitalized in the NICU of the National Institute of Perinatology in Mexico City between 2011 and 2021. Risk factors for invasive candidiasis were explored using logistic regression.

RESULTS

Among 2640 patients hospitalized in the NICU, we identified 51 cases of invasive candidiasis, with a prevalence of 1.95% (95% CI: 1.44-2.53). Invasive candidiasis cases were premature with low birth weight and higher exposure to antimicrobials compared to controls (n = 153). The most frequently isolated pathogens of invasive candidiasis were Candida albicans (62.7%), Candida parapsilosis (25.5%) and Nakaseomyces glabratus (5.9%). In multivariate analysis, gestational age at birth < 28 weeks (OR, 2.79; 95% CI: 1.05-7.43) and use of three or more antimicrobials prior to blood culture positivity (OR, 2.83; 95% CI: 1.22-6.59) were identified as risk factors for the development of invasive candidiasis compared to controls.

CONCLUSIONS

Prematurity and higher exposure to multiple antimicrobial regimens increased the risk of invasive candidiasis in the NICU.