Journal of the Korean Pediatric Society 2002;45(7):847-854.
Published online July 15, 2002.
A Clinical Characteristics of Systemic Candidiasis in Neonatal Intensive Care Unit : Comparison with Systemic Bacterial Infection
Jung Hwa Lim1, Kyung Pil Park1, Jin Kyung Kim2, Heng Mi Kim1
1Department of Pediatrics, College of Medicine, Kyungpook University, Taegu, Korea
2Department of Pediatrics, College of Medicine, The Catholic University of Korea, Taegu, Korea
신생아 집중치료실 입원아에 있어서 전신성 칸디다증의임상적 특징 : 전신성 세균 감염증과 비교
임정화1, 박경필1, 김진경2, 김행미1
1경북대학교 의과대학 소아과학교실
2대구가톨릭대학교 의과대학 소아과학교실
Correspondence: 
Heng Mi Kim, Email: hmkim@knu.ac.kr
Abstract
Purpose
: Long term hospitalized infants in neonatal intensive care units(NICUs) are prone to systemic infection. It is important to differentiate systemic candidiasis from systemic bacterial infection early in the course. Thus, in this study, we have compared clinical characteristics of systemic candidiasis and systemic bacterial infection, in premature low birth weight infants.
Methods
: Retrospective chart review of the medical records of 20 patients with systemic candidiasis and 23 patients with systemic bacterial infection was performed.
Results
: Among the risk factors of systemic candidiasis, total parenteral nutrition(TPN), the use of broad spectrum antibiotics, central catheter insertion, endotracheal intubation and the use of H2 blockers were more frequent in neonates with systemic candidiasis than neonates with systemic bacterial infection. Apnea with bradycardia developed more frequently in neonates with systemic candidiasis compared with systemic bacterial infection(75% vs 39%). In laboratory findings at symptom onset, seven cases(35%) of systemic candidal infections and two cases(9%) of systemic bacterial infections showed leukopenia and thrombocytopenia(P=0.03). Blood was the most frequent isolation site of candida and bacteria.
Conclusion
: In neonates with systemic candidiasis, apnea with bradycardia, pneumonia and thrombocytopenia were prone to develop more frequently. The use of TPN, antibiotics and central catheters was strongly associated with systemic candidiasis. Empirical treatment with antifungal agent should be considered in critically ill neonates with above findings.
Key Words: Systemic candidiasis, Systemic bacterial infection, Prematurity, Low birth weight infants


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