Trends in Candida central line-associated bloodstream infections among NICUs, 1999-2009
To assess trends in incidence of Candida spp. central line-associated bloodstream infections (CLABSIs) in US NICUs, 1999-2009. Data from NICUs participating in the National Nosocomial Infections Surveillance (1999-2004) and National Healthcare Safety Network (2006-2009) were analyzed. Overall and bi...
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| creator | Chitnis, Amit S Magill, Shelley S Edwards, Jonathan R Chiller, Tom M Fridkin, Scott K Lessa, Fernanda C |
| description | To assess trends in incidence of Candida spp. central line-associated bloodstream infections (CLABSIs) in US NICUs, 1999-2009.
Data from NICUs participating in the National Nosocomial Infections Surveillance (1999-2004) and National Healthcare Safety Network (2006-2009) were analyzed. Overall and birth weight-specific incidence rates of Candida spp. CLABSIs per 1000 central line-days were calculated. Trends in incidence were assessed by using Poisson regression, and trends in proportion of CLABSIs identified as Candida albicans were assessed by using weighted-linear regression.
Overall, 398 NICUs reported 1407 Candida spp. CLABSIs (706 due to C albicans) among 1400 neonates. Of the 1400 neonates, 963 (69%) were ≤ 1000 g at the time of birth, and 182 (13%) died. From 1999 to 2009, the overall incidence decreased significantly for CLABSIs due to Candida spp. (0.92 vs 0.2), C albicans (0.53 vs 0.09), and non-albicans Candida spp. (0.39 vs 0.1). Birth weight-specific incidence significantly decreased across all birth weight categories for C albicans. For CLABSIs due to non-albicans Candida spp., significant decreases were detected among all birth weight categories, except among neonates 1501 to 2500 g. The proportion of Candida spp. CLABSIs due to C albicans did not significantly change over time, remaining at ~50%.
Incidence of Candida spp. CLABSIs decreased substantially among NICU patients, regardless of birth weight. Decreases in incidence across all birth weight categories, and not only among neonates ≤ 1000 g in whom antifungal prophylaxis may be more common, suggest that multiple factors contributed to the declining incidence. |
| doi_str_mv | 10.1542/peds.2011-3620 |
| format | Article |
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Data from NICUs participating in the National Nosocomial Infections Surveillance (1999-2004) and National Healthcare Safety Network (2006-2009) were analyzed. Overall and birth weight-specific incidence rates of Candida spp. CLABSIs per 1000 central line-days were calculated. Trends in incidence were assessed by using Poisson regression, and trends in proportion of CLABSIs identified as Candida albicans were assessed by using weighted-linear regression.
Overall, 398 NICUs reported 1407 Candida spp. CLABSIs (706 due to C albicans) among 1400 neonates. Of the 1400 neonates, 963 (69%) were ≤ 1000 g at the time of birth, and 182 (13%) died. From 1999 to 2009, the overall incidence decreased significantly for CLABSIs due to Candida spp. (0.92 vs 0.2), C albicans (0.53 vs 0.09), and non-albicans Candida spp. (0.39 vs 0.1). Birth weight-specific incidence significantly decreased across all birth weight categories for C albicans. For CLABSIs due to non-albicans Candida spp., significant decreases were detected among all birth weight categories, except among neonates 1501 to 2500 g. The proportion of Candida spp. CLABSIs due to C albicans did not significantly change over time, remaining at ~50%.
Incidence of Candida spp. CLABSIs decreased substantially among NICU patients, regardless of birth weight. Decreases in incidence across all birth weight categories, and not only among neonates ≤ 1000 g in whom antifungal prophylaxis may be more common, suggest that multiple factors contributed to the declining incidence.</description><identifier>ISSN: 0031-4005</identifier><identifier>EISSN: 1098-4275</identifier><identifier>DOI: 10.1542/peds.2011-3620</identifier><identifier>PMID: 22711720</identifier><identifier>CODEN: PEDIAU</identifier><language>eng</language><publisher>United States: American Academy of Pediatrics</publisher><subject>Babies ; Birth Weight ; Blood diseases ; Candida albicans ; Candidemia - epidemiology ; Candidemia - etiology ; Candidemia - prevention & control ; Catheter-Related Infections - epidemiology ; Catheter-Related Infections - prevention & control ; Catheterization, Central Venous - adverse effects ; Catheterization, Central Venous - trends ; Catheterization, Central Venous - utilization ; Cross Infection - epidemiology ; Cross Infection - etiology ; Cross Infection - prevention & control ; Fungi ; Humans ; Incidence ; Infant, Newborn ; Infection Control ; Intensive Care Units, Neonatal - statistics & numerical data ; Intensive Care Units, Neonatal - trends ; Linear Models ; Nosocomial infections ; Pediatrics ; Poisson Distribution ; Population Surveillance ; Regression Analysis ; United States - epidemiology</subject><ispartof>Pediatrics (Evanston), 2012-07, Vol.130 (1), p.e46-e52</ispartof><rights>Copyright American Academy of Pediatrics Jul 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c323t-b7d29c07dfad7c857efe297f11fcfd19258dcab61f2180189bfa5e63cbde54d43</citedby><cites>FETCH-LOGICAL-c323t-b7d29c07dfad7c857efe297f11fcfd19258dcab61f2180189bfa5e63cbde54d43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22711720$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chitnis, Amit S</creatorcontrib><creatorcontrib>Magill, Shelley S</creatorcontrib><creatorcontrib>Edwards, Jonathan R</creatorcontrib><creatorcontrib>Chiller, Tom M</creatorcontrib><creatorcontrib>Fridkin, Scott K</creatorcontrib><creatorcontrib>Lessa, Fernanda C</creatorcontrib><title>Trends in Candida central line-associated bloodstream infections among NICUs, 1999-2009</title><title>Pediatrics (Evanston)</title><addtitle>Pediatrics</addtitle><description>To assess trends in incidence of Candida spp. central line-associated bloodstream infections (CLABSIs) in US NICUs, 1999-2009.
Data from NICUs participating in the National Nosocomial Infections Surveillance (1999-2004) and National Healthcare Safety Network (2006-2009) were analyzed. Overall and birth weight-specific incidence rates of Candida spp. CLABSIs per 1000 central line-days were calculated. Trends in incidence were assessed by using Poisson regression, and trends in proportion of CLABSIs identified as Candida albicans were assessed by using weighted-linear regression.
Overall, 398 NICUs reported 1407 Candida spp. CLABSIs (706 due to C albicans) among 1400 neonates. Of the 1400 neonates, 963 (69%) were ≤ 1000 g at the time of birth, and 182 (13%) died. From 1999 to 2009, the overall incidence decreased significantly for CLABSIs due to Candida spp. (0.92 vs 0.2), C albicans (0.53 vs 0.09), and non-albicans Candida spp. (0.39 vs 0.1). Birth weight-specific incidence significantly decreased across all birth weight categories for C albicans. For CLABSIs due to non-albicans Candida spp., significant decreases were detected among all birth weight categories, except among neonates 1501 to 2500 g. The proportion of Candida spp. CLABSIs due to C albicans did not significantly change over time, remaining at ~50%.
Incidence of Candida spp. CLABSIs decreased substantially among NICU patients, regardless of birth weight. Decreases in incidence across all birth weight categories, and not only among neonates ≤ 1000 g in whom antifungal prophylaxis may be more common, suggest that multiple factors contributed to the declining incidence.</description><subject>Babies</subject><subject>Birth Weight</subject><subject>Blood diseases</subject><subject>Candida albicans</subject><subject>Candidemia - epidemiology</subject><subject>Candidemia - etiology</subject><subject>Candidemia - prevention & control</subject><subject>Catheter-Related Infections - epidemiology</subject><subject>Catheter-Related Infections - prevention & control</subject><subject>Catheterization, Central Venous - adverse effects</subject><subject>Catheterization, Central Venous - trends</subject><subject>Catheterization, Central Venous - utilization</subject><subject>Cross Infection - epidemiology</subject><subject>Cross Infection - etiology</subject><subject>Cross Infection - prevention & control</subject><subject>Fungi</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infant, Newborn</subject><subject>Infection Control</subject><subject>Intensive Care Units, Neonatal - statistics & numerical data</subject><subject>Intensive Care Units, Neonatal - trends</subject><subject>Linear Models</subject><subject>Nosocomial infections</subject><subject>Pediatrics</subject><subject>Poisson Distribution</subject><subject>Population Surveillance</subject><subject>Regression Analysis</subject><subject>United States - epidemiology</subject><issn>0031-4005</issn><issn>1098-4275</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpd0DFv1TAQwHELgdrX0pURRWLpQB535ziOR_REoVIFSyvGyLHPKFViP-y8gW9PohaGTrf87nT6C_EOYY-qoU9H9mVPgFjLluCV2CGYrm5Iq9diByCxbgDUubgo5REAGqXpTJwTaURNsBM_7zNHX6oxVgcb_eht5Tgu2U7VNEaubSnJjXZhXw1TSr4sme288sBuGVMslZ1T_FV9vz08lI8VGmNqAjBvxZtgp8JXz_NSPNx8uT98q-9-fL09fL6rnSS51IP2ZBxoH6zXrlOaA5PRATG44NGQ6ryzQ4uBsAPszBCs4la6wbNqfCMvxfXT3WNOv09cln4ei-NpspHTqfQIJMmoltqVfnhBH9Mpx_W7TTUNdlLBqvZPyuVUSubQH_M42_xnRf2WvN-S91vyfku-Lrx_PnsaZvb_-b_G8i-qa3sa</recordid><startdate>20120701</startdate><enddate>20120701</enddate><creator>Chitnis, Amit S</creator><creator>Magill, Shelley S</creator><creator>Edwards, Jonathan R</creator><creator>Chiller, Tom M</creator><creator>Fridkin, Scott K</creator><creator>Lessa, Fernanda C</creator><general>American Academy of Pediatrics</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>20120701</creationdate><title>Trends in Candida central line-associated bloodstream infections among NICUs, 1999-2009</title><author>Chitnis, Amit S ; Magill, Shelley S ; Edwards, Jonathan R ; Chiller, Tom M ; Fridkin, Scott K ; Lessa, Fernanda C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c323t-b7d29c07dfad7c857efe297f11fcfd19258dcab61f2180189bfa5e63cbde54d43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Babies</topic><topic>Birth Weight</topic><topic>Blood diseases</topic><topic>Candida albicans</topic><topic>Candidemia - epidemiology</topic><topic>Candidemia - etiology</topic><topic>Candidemia - prevention & control</topic><topic>Catheter-Related Infections - epidemiology</topic><topic>Catheter-Related Infections - prevention & control</topic><topic>Catheterization, Central Venous - adverse effects</topic><topic>Catheterization, Central Venous - trends</topic><topic>Catheterization, Central Venous - utilization</topic><topic>Cross Infection - epidemiology</topic><topic>Cross Infection - etiology</topic><topic>Cross Infection - prevention & control</topic><topic>Fungi</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infant, Newborn</topic><topic>Infection Control</topic><topic>Intensive Care Units, Neonatal - statistics & numerical data</topic><topic>Intensive Care Units, Neonatal - trends</topic><topic>Linear Models</topic><topic>Nosocomial infections</topic><topic>Pediatrics</topic><topic>Poisson Distribution</topic><topic>Population Surveillance</topic><topic>Regression Analysis</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chitnis, Amit S</creatorcontrib><creatorcontrib>Magill, Shelley S</creatorcontrib><creatorcontrib>Edwards, Jonathan R</creatorcontrib><creatorcontrib>Chiller, Tom M</creatorcontrib><creatorcontrib>Fridkin, Scott K</creatorcontrib><creatorcontrib>Lessa, Fernanda C</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatrics (Evanston)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chitnis, Amit S</au><au>Magill, Shelley S</au><au>Edwards, Jonathan R</au><au>Chiller, Tom M</au><au>Fridkin, Scott K</au><au>Lessa, Fernanda C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Trends in Candida central line-associated bloodstream infections among NICUs, 1999-2009</atitle><jtitle>Pediatrics (Evanston)</jtitle><addtitle>Pediatrics</addtitle><date>2012-07-01</date><risdate>2012</risdate><volume>130</volume><issue>1</issue><spage>e46</spage><epage>e52</epage><pages>e46-e52</pages><issn>0031-4005</issn><eissn>1098-4275</eissn><coden>PEDIAU</coden><abstract>To assess trends in incidence of Candida spp. central line-associated bloodstream infections (CLABSIs) in US NICUs, 1999-2009.
Data from NICUs participating in the National Nosocomial Infections Surveillance (1999-2004) and National Healthcare Safety Network (2006-2009) were analyzed. Overall and birth weight-specific incidence rates of Candida spp. CLABSIs per 1000 central line-days were calculated. Trends in incidence were assessed by using Poisson regression, and trends in proportion of CLABSIs identified as Candida albicans were assessed by using weighted-linear regression.
Overall, 398 NICUs reported 1407 Candida spp. CLABSIs (706 due to C albicans) among 1400 neonates. Of the 1400 neonates, 963 (69%) were ≤ 1000 g at the time of birth, and 182 (13%) died. From 1999 to 2009, the overall incidence decreased significantly for CLABSIs due to Candida spp. (0.92 vs 0.2), C albicans (0.53 vs 0.09), and non-albicans Candida spp. (0.39 vs 0.1). Birth weight-specific incidence significantly decreased across all birth weight categories for C albicans. For CLABSIs due to non-albicans Candida spp., significant decreases were detected among all birth weight categories, except among neonates 1501 to 2500 g. The proportion of Candida spp. CLABSIs due to C albicans did not significantly change over time, remaining at ~50%.
Incidence of Candida spp. CLABSIs decreased substantially among NICU patients, regardless of birth weight. Decreases in incidence across all birth weight categories, and not only among neonates ≤ 1000 g in whom antifungal prophylaxis may be more common, suggest that multiple factors contributed to the declining incidence.</abstract><cop>United States</cop><pub>American Academy of Pediatrics</pub><pmid>22711720</pmid><doi>10.1542/peds.2011-3620</doi></addata></record> |
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| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Babies Birth Weight Blood diseases Candida albicans Candidemia - epidemiology Candidemia - etiology Candidemia - prevention & control Catheter-Related Infections - epidemiology Catheter-Related Infections - prevention & control Catheterization, Central Venous - adverse effects Catheterization, Central Venous - trends Catheterization, Central Venous - utilization Cross Infection - epidemiology Cross Infection - etiology Cross Infection - prevention & control Fungi Humans Incidence Infant, Newborn Infection Control Intensive Care Units, Neonatal - statistics & numerical data Intensive Care Units, Neonatal - trends Linear Models Nosocomial infections Pediatrics Poisson Distribution Population Surveillance Regression Analysis United States - epidemiology |
| title | Trends in Candida central line-associated bloodstream infections among NICUs, 1999-2009 |
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