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D. Lepore, F. Molle, M.M. Pagliara, R. DeSantis, P.G. Matassa, G. Vento, F. Gallini, C. Romagnoli; Candida Infection as Factor Risk for Threshold ROP . Invest. Ophthalmol. Vis. Sci. 2003;44(13):592.
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Purpose: To determine the association between Candida Infection and threshold and Retinopathy of Prematurity (ROP). Methods: from Oct ‘94 to Jun '02 210 inborn preterm neonates, with gestational age (GA) ≤30 weeks and/or a birth weight (BW) ≤1250gr, were screened for ROP in our neonatal intensive care unit. The mean BW was 818.0± 212 grams (range 390-1120) and the mean GA was 27.7± 1.5 weeks (range 23-30w). Candida infection was defined as positive blood, urine or CSL culture or pneumonia (Bronchoalveolar fluid lavage positive for candida) or a combination of previous and clinical evidence for sepsis. Results: ROP was diagnosed in 150 preterms (71.43%). Stage 1 or 2 ROP were detected in 85 (55,36% of all ROP), stage 3 was found in 38 babies (25.3%), while 27 infants (12.86%) reached threshold and underwent surgical procedure. Among all screened babies 21 underwent candida infection. Their mean GA was 27.0± 1.5 weeks (range 24-30) and mean BW was 818± 212 grams (range 390-1120). Despite similar mean BW and GA the severity of ROP was greater in the candida-infected infants than in the whole population. In fact, 19 of 21 babies with candida infection (90.48%) showed any stage of ROP, and 10 of them (52.63%) progressed toward a threshold ROP and required treatment. ROP as well as threshold ROP have significantly higher prevalence on preterm infants with candida infection as compared with non-infected infants (p<0.0001). The authors discuss about the possible mechanisms of such association on the basis of neonatal and ophthalmologic parameters. Conclusions: In preterm infants with candida infection the prevalence of threshold ROP was more than 4-fold higher than that of non-infected infants. Candida infection could not be a causal factor, but could be a marker for infants with a complicated neonatal course who are at risk of developing threshold ROP. View OriginalDownload SlideView OriginalDownload Slide
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