amphotericin-b and Birth-Weight

Compare the oral colonization profile of premature infants admitted at NICU before and after doing oral care routine with sterile water versus no intervention.. It was a randomized clinical trial composed of 37 premature infants admitted at the Neonatal Intensive Care Unit (NICU) with a birth weight (BW) <1500 g. They were distributed in two groups: the study group (SG) with 15 patients who received an oral hygiene with sterile water; and a control group (CG) (no intervention) formed by 22 patients. Primary outcome was oral colonization profile before and after doing oral care.. In the study group, the number of patients colonized by the Gram-positive bacteria at the beginning of the study was 53% versus 40% at the end (p=0.10). For Gram negative, 40% at the study's beginning versus 60% at the end (p=0.18). In the control group, the number of colonized patients for the Gram-positive bacteria at the onset of the study was 54.5% versus 32% patients at the end (p=0.24). For Gram negative, 32% patients at the start of the study versus 77% at the end (p = 0.003).. There is a significant increase of the Gram-negative flora in those patients without oral care.

Topics: Amphotericin B; Anti-Bacterial Agents; Birth Weight; Chemoprevention; Cross Infection; Female; Fluconazole; Gram-Negative Bacteria; Gram-Positive Bacteria; Humans; Infant, Newborn; Infant, Premature; Intensive Care Units, Neonatal; Male; Mouth; Neonatal Sepsis; Oral Hygiene

Four cases of intracardiac fungal masses occurred over 2 y amongst 7 cases of systemic candidiasis in a neonatal referral unit. The gestations and birthweights were 25, 23, 24 and 30 wk and 805, 605, 640 and 1395 g, respectively. The pedunculated, solitary right atrial masses were detected 2-17 d after diagnosing candidemia in 3 cases, whereas it was the presenting feature in the 4th. All had indwelling right atrial catheters and received multiple courses of broad-spectrum antibiotics. The masses were removed successfully in two cases fit for surgery. None survived despite antifungal therapy, including liposomal amphotericin B at 6 mg/kg/d. Early introduction of enteral feeds, minimization of prolonged exposure to broad-spectrum antibiotics and judicious use of central catheters may reduce the incidence of systemic candidiasis in high-risk neonates. Surveillance echocardiography and timely surgical intervention may reduce the mortality and/or morbidity related to intracardiac fungal masses.

Topics: Amphotericin B; Anti-Bacterial Agents; Antifungal Agents; Birth Weight; Candidiasis; Echocardiography; Fatal Outcome; Female; Gestational Age; Heart; Humans; Infant, Newborn; Infant, Very Low Birth Weight; Intensive Care, Neonatal; Male; Medical Futility; Parenteral Nutrition, Total

Because invasive candidiasis in newborn infants admitted to a neonatal intensive care unit (NICU) occurs most frequently in very low birth weight infants, the incidence of invasive candidiasis and its clinical features in infants > 2500 g birth weight have not been well-described.. We retrospectively reviewed the medical records of all infants with birth weight > 2500 g admitted to our NICU from 1986 through 1993 who developed invasive candidiasis during their hospitalization.. Seventeen of 3033 (0.6%) infants with birth weights > 2500 g admitted to the NICU developed invasive candidiasis. All 17 infants had a condition that required prolonged NICU hospitalization; 13 of 17 (76%) had a major congenital malformation.. The incidence of invasive candidiasis in infants with birth weights > 2500 g requiring admission to a NICU was much less than has been reported for very low birth weight infants. This review points out that in infants with birth weights > 2500 g who develop invasive candidiasis, major congenital malformations are the most frequent underlying conditions responsible for prolonged NICU hospitalization.

Topics: Amphotericin B; Antifungal Agents; Birth Weight; Candidiasis; Congenital Abnormalities; Female; Fluconazole; Flucytosine; Humans; Infant; Infant, Newborn; Intensive Care Units, Neonatal; Male; Retrospective Studies

Forty-five cases of systemic neonatal candidiasis were diagnosed over a 9-year period in a neonatal intensive care unit; 42 infants weighted less than 1.5 kg. All had been very ill with preceding bacterial sepsis and other complications of low birthweight. Where treatment was instituted the mortality was low (4 out of 39 dying) and complications of treatment were transitory. We therefore recommend diligent examination for the presence of this infection, and treatment with a combination of amphotericin B and 5-flucytosine.

Topics: Amphotericin B; Bacterial Infections; Birth Weight; Candidiasis; Cross Infection; Drug Therapy, Combination; Flucytosine; Humans; Infant, Newborn; Intensive Care Units, Neonatal; Retrospective Studies

Topics: Amphotericin B; Birth Weight; Candidiasis; Catheterization, Central Venous; Catheters, Indwelling; Gestational Age; Humans; Infant, Low Birth Weight; Infant, Newborn; Retrospective Studies

Topics: Amphotericin B; Birth Weight; Blood Glucose; Blood Urea Nitrogen; Calcium, Dietary; Candidiasis; Dietary Carbohydrates; Dietary Proteins; Humans; Hydrogen-Ion Concentration; Infant Nutritional Physiological Phenomena; Infant, Newborn; Infant, Newborn, Diseases; Monosaccharides; Parenteral Nutrition; Potassium; Protein Hydrolysates; Respiratory Insufficiency; Sodium