Korean J Pediatr Infect Dis.  2011 Jun;18(1):15-22.

Prevention of Invasive Candida Infections in the Neonatal Intensive Care Unit

• Kim CS

Abstract

Invasive Candida infections (ICI) have become the third most common cause of late-onset infection among premature infants in the neonatal intensive care unit (NICU). Risk factors include birth weight less than 1,000 g, exposure to more than two antimicrobials, third generation cephalosporin exposure, parenteral nutrition including lipid emulsion, central venous catheter, and abdominal surgery. Candida colonization of the skin and gastrointestinal tract is an important first step in the pathogenesis of invasive disease. Strict infection control measures against the infection should be done in the NICU. The following practices are likely to contribute to reducing the rate of ICI: (1) restriction of broad-spectrum antibiotics, antacids and steroid; (2) introduction of early feeding and promoting breast milk. Fluconazole prophylaxis may be an effective control measure to prevent Candida colonization and infections in individual units with high incidence of fungal infection. In addition, there is a need of further data including the development of resistant strains and the effect on long-term neurodevelopmental outcomes of infants exposed to drugs before the initiation of routine application of antifungal prophylaxis in the NICU.

Keyword

Candida; Neonatal intensive care unit; Infection control; Fluconazole prophylaxis

MeSH Terms

Antacids
Anti-Bacterial Agents
Birth Weight
Candida
Central Venous Catheters
Colon
Fluconazole
Gastrointestinal Tract
Humans
Incidence
Infant
Infant, Newborn
Infant, Premature
Infection Control
Intensive Care, Neonatal
Milk, Human
Parenteral Nutrition
Resin Cements
Risk Factors
Skin
Antacids
Anti-Bacterial Agents
Fluconazole
Resin Cements

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