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[Disseminated fungal infections in neonates--risk factors, treatment and course]

T G Abrahamsen1, P Gaustad, S Sund

  • 1Barneklinikken, Rikshospitalet, Oslo.

Tidsskrift for Den Norske Laegeforening : Tidsskrift for Praktisk Medicin, Ny Raekke
|November 20, 1992
PubMed

Insights

Disseminated Candida albicans infections occurred in 9% of premature infants with abdominal disease. Amphotericin B showed promise, while fluconazole had poor outcomes in this small study.

Area of Science:

  • Neonatal Medicine
  • Mycology
  • Infectious Diseases

Context:

  • Candida albicans infections pose a significant threat to vulnerable newborns.
  • Intra-abdominal diseases increase the risk of systemic fungal infections in neonates.
  • This study examines a cohort of infants with disseminated candidiasis during 1990/91.

Purpose:

  • To report the incidence and outcomes of disseminated Candida albicans infections in neonates with intra-abdominal disease.
  • To identify risk factors associated with these infections in premature infants.
  • To evaluate the efficacy of antifungal treatments, specifically amphotericin B and fluconazole.

Summary:

  • Eight premature and one mature infant with intra-abdominal disease developed disseminated Candida albicans infections (9% incidence in premature neonates).
  • Commonly observed risk factors included respirator therapy, broad-spectrum antibiotics, parenteral nutrition, and central intravascular catheters.
  • Four patients survived; three of five treated with amphotericin B survived, whereas two treated with fluconazole died. One patient survived without therapy, and another was diagnosed post-mortem.

Impact:

  • Highlights the high-risk nature of disseminated candidiasis in neonates with abdominal conditions.
  • Suggests amphotericin B may be a more effective treatment option than fluconazole in this population.
  • Emphasizes the critical need for accurate fungal diagnostics and interdisciplinary collaboration for optimal patient management.

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