Factors associated with oral Candida colonization in neonates at intensive care unit
Keywords:
neonatal, preterm, oral Candida colonization, KOH examination
Abstract
Background Oral candidiasis still has high prevalence andfrequently causes problems in the neonatal period.
Objective To evaluate some factors associated with the occurrence
of oral Candida colonization in neonates.
Methods A cross sectional study was performed at the Intensive
Care Unit, Neonatology Division, Department of Child Health,
Medical School, Udayana University/Sanglah Hospital Denpasar,
from November 2002 to April 2003. Eighty neonates were enrolled.
Oral mucous swabs were obtained and examined for Candida
colonization using potassium hydroxide (KOH). Data were analyzed
by prevalence ratio and logistic regression; a p value of <0.05 was
considered significant.
Results The prevalence of oral Candida colonization was 55%
(44/80). The colonization was significantly associated with age of
>1 week, male sex, gestational age of <37 weeks, Apgar score of
<7, birth weight of <1500 grams, oral mucous pH of <7, systemic
antibiotic use, and steroid use by mother. Breastfeeding was a
protective factor. Correlation between variables using Spearman
test revealed correlation coefficient of <0.5. By logistic regres-
sion, birth weight of <1500 grams (p=0.04) and systemic antibi-
otic use (p=0.01) were significant associated factors of oral
Candida colonization, while breastfeeding was a significant pro-
tective factor (p=0.03).
Conclusion Birth weight of <1500 grams and systemic antibiotic
use were significant associated factors of oral Candida colonization
and breastfeeding was a significant protective factor of oral Candida
colonization in neonates
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3. Lay KM, Russel C. Candida species and yeasts in mouths
of infants from a special care unit of a maternity hospital.
Arch Dis Child 1987;52:794-6.
4. Melnick JL. Medical mycology. In: Jawetz E, editor.
Review of medical microbiology. 15 th ed. California:
Lange Medical Publication; 1982. p. 297-9.
5. Hughes PA, Martha L, Harry H. Neonatal candidiasis. In:
Bodey GP, editor. Pathogenesis, diagnosis, and treatment.
2 nd ed. New York: Raven Press; 1993. p. 261-77.
6. Shahe V, Smith CB. Pathogenesis, host resistance, and predis-
posing factors. In: Bodey GP, editor. Pathogenesis, diagnosis,
and treatment. 2 nd ed. New York: Raven Press; 1993. p. 59-75.
7. Wade JC. Epidemiology of Candida infection. In: Bodey
GP, editor. Pathogenesis, diagnosis, and treatment. 2 nd
ed. New York: Raven Press; 1993. p. 85-107.
8. Suharno S, Tantien, Evita, Kusmarinah. Mekanisme
pertahanan pejamu pada infeksi Kandida. MDVI
2000;27:187-93.
9. Kirkpatrick CH. Immune responses to fungi. In: Rich
R, Thomas AF, editors. Clinical immunology principle
and practice. Philadelphia: Mosby; 1999. p. 571-7.
10. Roitt I, Brostoff J, Male D. Immunology. 5 th ed.
Philadelphia: Mosby; 1998. p. 43-54.
11. Thrush or Candidiasis. Available from: URL: http://
www.child.org/dental/thrush.asp.html
12. Neonatal candidiasis. Availabe from: URL: http://
www.doctorfungus.org/fungi_action/ human/candida/
neonatal. htm.
13. Koch H, Graber MA. Pediatrics: neonatal infections. Avail-
able from: URL: http://www.vh.org/pediatric/provider/pe-
diatrics/familypracticehanbook/neonatalinfections.html.
14. Mudra K. Oral thrush. Available from: URL: http://
www.emedicine.com/ped/topic25.html.
15. Akpan A, Morgan R. Oral candidiasis. Postgrad Med J
2002;78:455-9.
16. Aisah SB. Lestari TS. Pengobatan kombinasi mikonazol
nitrat 0,25% dan seng oksida 15% pada penderita
dermatitis popok. Presented at PIT IDAI; 2001 June
25; Palembang, Indonesia.
17. Ghazali MV, Sastromiharjo, Soejarwo R. Studi cross sec-
tional. In: Sastroasmoro S, Ismael S, editors. Dasar-dasar
metodologi penelitian klinis. 1 st ed. Jakarta: Binarupa
Aksara; 1995. p. 66-77.
18. Madiyono B, Moeslichan MZ, Perkiraan besar sampel. In:
Sastroasmoro S, Ismael S, editors. Dasar-dasar metodologi penelitian
klinis. 1 st ed. Jakarta: Binarupa Aksara; 1995. p. 187-212
19. Sastroasmoro S. Memahami nilai p dan interval kepercayaan
dalam studi analitik. Sari Pediatri 1994;1:169-78.
20. Gupta P. Clinical profile and risk factors for oral candidi-
asis in sick newborns. Indian Pediatr 1996;33:299-303.
21. Baley JE, Kliegman RM, Fanaroff AA. Disseminated fun-
gal infections in very low-birth-weight infant: therapeu-
tic toxicity. Pediatrics 1984;73:153-7.
22. Baley J, Kliegman RM, Boxerbauem, Fanaroff. Fungal coloniza-
tion in the very low birth weight infant. Pediatrics 1986;78:225-32.
23. Kaufman D, Boyle R, Hazen K, Robinson M. Fluconazole
prophylaxis against fungal colonization and infection in
preterm infants. N Engl J Med 2001;345:1660-6.
24. Botas CM, Kurlat L, Young S. Disseminated Candida in-
fection and intravenous hydrocortisone in preterm in-
fants. Pediatrics 1995;95:883-7.
25. Hoppe JE. Treatment of oropharyngeal candidiasis in
immunocompetent infants: a randomized multicenter
study of miconazole gel vs nystatin suspension. The
anti fungals study group. Pediatr Infect Dis J
1997;16:288-93.
26. Suradi R. Spesifisitas air susu ibu. Presented at The
National Scientific Meeting of The Indonesian Soci-
ety of Pediatricians; 2001 June 25; Palembang, Indo-
nesia.
Published
2016-10-10
How to Cite
1.
Wijana I, Santoso H, Swastika I. Factors associated with oral Candida colonization in neonates at intensive care unit. PI [Internet]. 10Oct.2016 [cited 19Apr.2024];44(5):188-2. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/761
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Received 2016-10-02
Accepted 2016-10-02
Published 2016-10-10
Accepted 2016-10-02
Published 2016-10-10
