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Objetive: To evaluate the association of candidal colonization and systemic candidiasis in extremely preterm infant (EPTI). Analyse if fluconazole can prevent systemic candidiasis in previously colonized EPTI. Methods: Prospective cohort study of EPTI (birth weight less than 1000 grams), in a Brazilian neonatal intensive care unit (NIUC), at University Hospital, between April, 2012 to April, 2014. Oropharyngeal and rectal swab, and tracheal secretions (in intubed) were collecte for fungal culture on 3rd, 10th, 17th, 24th and 30th days of life. EPTI with positive culture for Candida spp. received fluconazole. Was considered systemic candidiasis those who presented: sepsis with positive blood culture, pneumonia with positive tracheal secretion and changed chest X-ray, and urinary tract infection with positive urine culture. Results: Fity-six infants were evaluated, median weight of 826 grams (435-980), median gestacional age of 27 weeks (23.1-34.1), 23 (43,1%) infants were colonized with Candida ssp. Among 10 infants with candidiasis, 7 (70%) were colonized with Candida. Five (21,7%) infants received fluconazole an from these, one (20%) developed systemic candidiasis (p = 0,6411). The lethality rate was 33,9% and there was one death between EPTI with systemic candidiasis (p = 0,0761). Conclusion: Most infants with systemic candidiasis were previously colonized with Candida. Fluconazole have prevented systemic candidiasis in colonized EPTI.

Fluconazole for prevention of systemic infection in extremely low birth weight infants with Candidal colonization