Neonatal Med.  2013 Aug;20(3):369-377.

Invasive Candida Infections in Extremely Preterm Infants

• Kim CS
• Lee SL

Abstract

Invasive Candida infections (ICI) have become the third most common cause of late-onset infection among extremely preterm infants in the neonatal intensive care unit. Candida colonization of the skin and gastrointestinal tract is an important first step in the pathogenesis of invasive disease. Factors such as exposure to broad spectrum antimicrobials, especially third generation cephalosporin, parenteral nutrition including lipid emulsion, central venous catheter, and abdominal surgery increase the risk of invasive infection. A definite diagnosis of ICI requires isolation the organism from blood or other sterile body fluid. Thrombocytopenia is very common in neonatal candidiasis, but it is also often seen in babies with bacteremia. Candida is capable of invading all vital organs and following candidemia, therefore a thorough evaluation to rule out end organ dissemination is important. Amphotericin-B is the drug of choice for treating ICI. Antifungal susceptibility test is increasingly used to manage ICI, especially in situations refractory to initial antifugal therapy. Invasive candidiasis among extremely preterm infants is associated with chronic lung disease, severe retinopathy of prematurity, and neurodevelopmental impairment at infancy.

Keyword

Candida; Infection; Infants; Extremely premature

MeSH Terms

Bacteremia
Body Fluids
Candida
Candidemia
Candidiasis
Candidiasis, Invasive
Central Venous Catheters
Colon
Gastrointestinal Tract
Humans
Infant
Infant, Extremely Premature
Infant, Newborn
Intensive Care, Neonatal
Lung Diseases
Parenteral Nutrition
Resin Cements
Retinopathy of Prematurity
Skin
Thrombocytopenia
Resin Cements