Prevalence, risk factors and outcomes of neonatal invasive fungal infection in southern Thailand (1989-2017).
Prevalence, risk factors and outcomes of invasive fungal infection (IFI) in neonates were examined in a retrospective matched case-control study conducted in a tertiary hospital in southern Thailand from 1989 to 2017. Among inborn, incidence of IFI among total, very low birthweight (VLBW) and extremely low birthweight (ELBW) neonates was 0.4, 17.3 and 30.2 per 1,000 live births, respectively, while among neonatal intensive care unit admissions, incidence of IFI was 0.8, 2.0 and 3.4%, respectively. Applying a multivariate analysis, outborn neonates (adjusted odds ratio: adjusted OR) = 7.17, 95% confidence interval (CI): 2.56-20.05, (p-value <0.001), history of cefoperazone plus sulbactam treatment (adjusted OR = 3.94, 95% CI: 1.22-12.72, p-value = 0.021), use of invasive mechanical ventilation (adjusted OR = 2.79, 95% CI: 1.36-5.73, p-value = 0.005), and total parenteral nutrition (adjusted OR = 6.58, 95% CI: 2.28-19.01, p-value < 0.001) are significant risk factors of IFI. Fungemia and Candida albicans was the most common source and species of IFI respectively, and mortality rate and daily cost are significantly higher in neonates with IFI (p-value <0.050). These findings will be useful to attending physicians in preventing neonates from contracting invasive fungal infection.