NYMC Faculty Publications

Fluconazole Prophylaxis is Associated With a Decreased Rate of Coagulase-Negative Staphylococcal Infections in a Subset of Extremely Low Birth Weight Neonates

Author Type(s)

Faculty

DOI

10.1007/s00430-014-0337-2

Journal Title

Medical Microbiology and Immunology

First Page

251

Last Page

256

Document Type

Article

Publication Date

8-1-2014

Department

Pathology, Microbiology and Immunology

Keywords

Antifungal Agents, Chemoprevention, Coagulase, Female, Fluconazole, Humans, Incidence, Infant, Infant, Newborn, Infant, Very Low Birth Weight, Male, Mycoses, New Jersey, Retrospective Studies, Staphylococcal Infections, Staphylococcus

Disciplines

Medicine and Health Sciences

Abstract

Fluconazole prophylaxis is being used efficaciously in the neonatal intensive care unit (NICU) for fungal prophylaxis in very low birth weight and extremely low birth weight (ELBW) neonates. Little is known about the effect of fluconazole prophylaxis on bacterial infections. The purpose of this study was to examine that issue in a subset of ELBW, those weighing ≤900 g at birth. This is a retrospective study conducted in a level III NICU at state-designated children hospital in New Jersey (USA). We examined the data from our records of neonates ≤ 900 g birth weight during the period March 1, 2007-February 28, 2011. Inclusion in the study was all infants ≤ 900 g before (n = 67) and after (n = 81) the institution of fluconazole prophylaxis. Fluconazole prophylaxis was accompanied by a significant decrease in both the rate and number of days of bacterial infections as well as co-infections. We found that the incidence of coagulase-negative Staphylococcus (CONS) decreased from 46.2 to 24.7 % (OR 2.63; 95 % CI 1.31-5.27). Similarly, days of infection also decreased significantly (p < 0.0001). These data suggest that fluconazole prophylaxis may be associated with a reduction in CONS infections in that subset of ELBW neonates.

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