CANDIDAINFEKTIONEN BEI FRUHGEBORENEN < 1500 G. MUKOKUTANE KOLONISATION UND INZIDENZ SYSTEMISCHER INFEKTIONEN

Background: An increasing incidence of systemic candidiasis has been reported in low birth weight infants requiring intensive care. We have retrospectively analyzed mucocutaneous Candida-colonization and infection rate in 422 preterm infants with a birthweight < 1500 g. Methods: All infants were treated at the NICU, University of Gottingen, from 1/1985-5/1991. 359 neonates (85%) were on mechanical ventilation, no prophylactic antimycotic regimen was applied. Mucocutaneous swabs and cultures from various anatomic sites were regularly obtained from all infants. Results: 37/422 preterm infants (8.8%) had mucocutaneous colonization with candida, none of our patients developped systemic candidiasis. In 7 mechanically ventilated patients (1.9%) Candida albicans or Candida tropicalis was repeatedly detected in the bronchial secretions; 1 patient who had invasive Candida-pneumonie was effectively treated with 5-Fluocytosin and Fluconazol. 4/352 (1.1%) central silastic catheters were colonized with Candida albicans; none of these patients required specific treatment. Conclusion: The low rate of mucocutaneous Candida-colonization and invasive infection found in our patients may be explained - at least in part - by epidemiological and obstetrical factor as well as by the procedures of the neonatal management.