Fungal infection is an increasing cause of infant morbidity and mortality in newborns hospitalized in intensive care units. A relationship between hydrocortisone and candidemia has been found but no data about colonization and hydrocortisone therapy have been documented in preterm newborns.
Objective To determine whether low dose of hydrocortisone can increase fungal colonization in a well defined group of high risk preterm infants.
Methods We performed a prospective, placebo-controlled study to determine the association between exposure to hydrocortisone during the first 12 days of life (DOL) (0.5 mg/kg/12 h for 9 days, then 0.5 mg/kg/day) and fungal colonization during the first 15 DOL in high risk preterm infants weighing less than 1.250 g at birth. We also evaluated fungal infection during the first 30 DOL. 28 infants, 10 receiving hydrocortisone and 18 placebo, were enrolled.
Results 8 (28.6%) infants were colonized during the first 15 DOL: 3 (30.0%) in the hydrocortisone group and 5 (28%) in the placebo group (p = NS). 3 (10.7%) infants had urinary infection, 1 in the hydrocortisone group and 2 in the placebo group (p = NS).
Conclusions We did not find a relationship between the administration of a low dose of hydrocortisone to high risk preterm infants and fungal colonization but the small sample size do not allow to provide conclusive result. Attention should be paid to the role of hydrocortisone in Candida infection in high risk preterm infants and, in further studies, data about fungal colonization or infection should be collected and related to the dose of hydrocortisone used.