{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T08:22:34Z","timestamp":1778314954258,"version":"3.51.4"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background.<\/jats:title>\n                  <jats:p>Neonatal invasive candidiasis (IC) presenting in the first week of life is less common and less well described than later-onset IC. Risk factors, clinical features, and disease outcomes have not been studied in early-onset disease (EOD, \u22647 days) or compared to late-onset disease (LOD, &amp;gt;7 days).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods.<\/jats:title>\n                  <jats:p>All extremely low birth weight (ELBW, &amp;lt;1000 g) cases with IC and controls from a multicenter study of neonatal candidiasis enrolled from 2001 to 2003 were included in this study. Factors associated with occurrence and outcome of EOD in ELBW infants were determined.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results.<\/jats:title>\n                  <jats:p>Forty-five ELBW infants and their 84 matched controls were included. Fourteen (31%) ELBW infants had EOD. Birth weight &amp;lt;750 g, gestation &amp;lt;25 weeks, chorioamnionitis, and vaginal delivery were all strongly associated with EOD. Infection with Candida albicans, disseminated disease, pneumonia, and cardiovascular disease were significantly more common in EOD than in LOD. The EOD case fatality rate (71%) was higher than in LOD (32%) or controls (15%) (P = .0001). The rate of neurodevelopmental impairment and mortality combined was similar in EOD (86%) and LOD (72%), but higher than in controls (32%; P = .007).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions.<\/jats:title>\n                  <jats:p>ELBW infants with EOD have a very poor prognosis compared to those with LOD. The role of perinatal transmission in EOD is supported by its association with chorioamnionitis, vaginal delivery, and pneumonia. Dissemination and cardiovascular involvement are common, and affected infants often die. Empiric treatment should be considered for ELBW infants delivered vaginally who have pneumonia and whose mothers have chorioamnionitis or an intrauterine foreign body.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/cix001","type":"journal-article","created":{"date-parts":[[2017,1,4]],"date-time":"2017-01-04T04:06:57Z","timestamp":1483502817000},"page":"921-927","source":"Crossref","is-referenced-by-count":30,"title":["Early-Onset Invasive Candidiasis in Extremely Low Birth Weight Infants: Perinatal Acquisition Predicts Poor Outcome"],"prefix":"10.1093","volume":"64","author":[{"given":"Michelle","family":"Barton","sequence":"first","affiliation":[{"name":"Hospital for Sick Children, University of Toronto 1 , Ontario ,"},{"name":"Department of Paediatrics, London Health Sciences Centre, University of Western Ontario 2 ;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex","family":"Shen","sequence":"additional","affiliation":[{"name":"Hospital for Sick Children, University of Toronto 1 , Ontario ,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karel","family":"O\u2019Brien","sequence":"additional","affiliation":[{"name":"Mount Sinai Hospital, University of Toronto 3 , Ontario ,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joan L.","family":"Robinson","sequence":"additional","affiliation":[{"name":"Stollery Children\u2019s Hospital, University of Alberta 4 , Edmonton ,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H. Dele","family":"Davies","sequence":"additional","affiliation":[{"name":"Foothills Hospital, University of Calgary 5 , Alberta ,"},{"name":"University of Nebraska Medical Center 6 , Omaha ;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kim","family":"Simpson","sequence":"additional","affiliation":[{"name":"Hospital for Sick Children, University of Toronto 1 , Ontario ,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Asztalos","sequence":"additional","affiliation":[{"name":"Sunnybrook Health Sciences Centre, University of Toronto 7 , Ontario,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanne","family":"Langley","sequence":"additional","affiliation":[{"name":"IWK Health Centre, Departments of Pediatrics and Community Health and Epidemiology, Dalhousie University, Halifax 8 , Nova Scotia ,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Le Saux","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Eastern Ontario, University of Ottawa 9 ,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reginald","family":"Sauve","sequence":"additional","affiliation":[{"name":"Stollery Children\u2019s Hospital, University of Alberta 4 , Edmonton ,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Synnes","sequence":"additional","affiliation":[{"name":"British Columbia Women\u2019s Hospital, University of British Columbia 10 , Vancouver ,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ben","family":"Tan","sequence":"additional","affiliation":[{"name":"Royal University Hospital, University of Saskatchewan 11 , Saskatoon ,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louis","family":"de Repentigny","sequence":"additional","affiliation":[{"name":"CHU Sainte-Justine, Universit\u00e9 de Montr\u00e9al 12 , Quebec;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Earl","family":"Rubin","sequence":"additional","affiliation":[{"name":"Montreal Children\u2019s Hospital, McGill University 13 , Montreal, Quebec ;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chuck","family":"Hui","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Eastern Ontario, University of Ottawa 9 ,"},{"name":"Hamilton Health Sciences McMaster University 14 , Hamilton, Ontario , and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lajos","family":"Kovacs","sequence":"additional","affiliation":[{"name":"Jewish General Hospital, McGill University 15 , Montreal, Quebec ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yvonne C. 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